Physical, mental, and behavioral health after adverse and benevolent childhood experiences: a comparison of two adversity conceptualizations

Ho, Grace W.K.; Ling Chan, Ko; Ho Wong, Kwan; Fong Leung, Sau; Karatzias, Thanos

Abstract

Objective: Adverse and benevolent childhood experiences (ACEs, BCEs) impact health across the lifespan. No known study has investigated these associations across different health domains using a representative adult sample. This study examined the associations between adult physical, mental, and behavioral health with ACEs and BCEs based on two ACEs conceptualizations. Methods: A cross-sectional population-based survey was conducted in Hong Kong. Thirteen ACEs were measured and conceptualized as cumulative ACE scores and ACE patterns. Selfreports of BCEs; ten physical health problems; current mental health; posttraumatic stress; history of diagnosed mental illness; suicidal thought and suicide attempt; and engagement in three health-risk behaviors (smoking, illicit substance misuse, binge drinking) were also included. A series of regression analyses were conducted to examine the association between childhood experiences and health. Results: In a random sample of 1,070 Hong Kong adults (mean age, 41.78 years; 53.93% female; mean ACEs=1.64), 649 (60.65%) reported at least one ACE. Four ACE patterns were identified (Low ACEs, Household Instability, Household Violence, and High ACEs). Higher ACE scores associated with poorer health in a dose-response fashion. Two ACE patterns shared similar average ACE scores but differentially linked with outcomes across health domains. High BCEs negatively associated with mental and behavioral health problems.

Citation

Ho, G. W., Ling Chan, K., Ho Wong, K., Fong Leung, S., & Karatzias, T. (online). Physical, mental, and behavioral health after adverse and benevolent childhood experiences: a comparison of two adversity conceptualizations. Psychological Trauma: Theory, Research, Practice, and Policy, https://doi.org/10.1037/tra0001732

• Journal Article Type: Article
• Acceptance Date: Apr 4, 2024
• Deposit Date: Apr 9, 2024
• Publicly Available Date: Aug 1, 2025
• Print ISSN: 1942-9681
• Electronic ISSN: 1942-969X
• Publisher: American Psychological Association
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1037/tra0001732