Evidence map›Paper›PMID 42628986›Full record

Observational studyFamily medicine and community health2026

Impact of adverse childhood experiences, positive childhood experiences and adult protective and risk factors on health in a statewide representative sample.

Krista Kotz, Rachel Gilgoff, Jeffrey Gassen, Devika Bhushan, Jackson Schuetz, Wendy Barrera, David McClendon, George M Slavich

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Family medicine and community health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Krista KotzUCLA-UCSF ACEs Aware Family Resilience Network (UCAAN), University of California Los Angeles, Los Angeles, California, USA kristakotzphd@gmail.com.ORCID http://orcid.org/0009-0007-5528-3641
Rachel GilgoffUCLA-UCSF ACEs Aware Family Resilience Network (UCAAN), University of California Los Angeles, Los Angeles, California, USA.ORCID http://orcid.org/0000-0002-1265-2925
Jeffrey GassenUCLA-UCSF ACEs Aware Family Resilience Network (UCAAN), University of California Los Angeles, Los Angeles, California, USA.ORCID http://orcid.org/0000-0002-8407-0131
Devika BhushanUCLA-UCSF ACEs Aware Family Resilience Network (UCAAN), University of California Los Angeles, Los Angeles, California, USA.ORCID http://orcid.org/0000-0001-7696-0540
Jackson SchuetzSean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, California, USA.
Wendy BarreraUCLA-UCSF ACEs Aware Family Resilience Network (UCAAN), University of California Los Angeles, Los Angeles, California, USA.
David McClendonUCLA-UCSF ACEs Aware Family Resilience Network (UCAAN), University of California Los Angeles, Los Angeles, California, USA.
George M SlavichDepartment of Psychiatry and Human Behavior, University of California Irvine, Irvine, California, USA.ORCID http://orcid.org/0000-0001-5710-3818

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveAdverse childhood experiences (ACEs), positive childhood experiences (PCEs) and adult protective and risk factors have each been associated with health outcomes but have rarely been examined together. We examined associations among ACEs, PCEs, adult protective and risk factors, and adult mental, behavioural, and physical health outcomes, including whether adult factors were independently associated with health after accounting for childhood experiences.

designCross-sectional observational study.

settingCalifornia, USA.

participantsData were analysed from 24 453 adults categorised into 5 age categories (18-25, 26-39, 40-54, 55-64 and ≥65 years) participating in the 2021 California Health Interview Survey, a statewide representative survey. ANALYSIS: Outcomes included multiple mental, behavioural and physical health indicators, including composite measures of any physical condition and any mental/behavioural health condition. Weighted logistic regression models examined associations and interactions among ACEs, PCEs, adult protective and risk factors, and health outcomes, adjusting for age, gender and race/ethnicity. Additional models examined adult factors independent of ACEs and PCEs.

resultsGreater ACE exposure was associated with higher odds of most poor health outcomes, whereas higher PCE exposure was generally associated with lower odds across mental, behavioural and physical health outcomes. Compared with individuals with high ACE exposure and low PCE exposure, progressively less ACE exposure was associated with progressively lower odds of any mental/behavioural health condition (moderate ACEs OR=0.59, 95% CI 0.50 to 0.70; no ACEs OR=0.30, 95% CI 0.24 to 0.37) and any physical condition (moderate ACEs OR=0.75, 95% CI 0.64 to 0.88; no ACEs OR=0.58, 95% CI 0.45 to 0.75). Adult protective and risk factors remained independently associated with health outcomes after accounting for ACEs and PCEs. Higher cumulative protective factor exposure was associated with lower odds of any mental/behavioural health condition (OR=0.49, 95% CI 0.42 to 0.57) and any physical condition (OR=0.63, 95% CI 0.53 to 0.74).

conclusionsAdult protective and risk factors were associated with health outcomes independent of ACEs and PCEs, extending prior ACE and PCE research beyond childhood experiences. Findings highlight the importance of healthcare and public health approaches that address both childhood and adult adversity and strengthen protective resources and supportive environments.

Indexed as

Adverse Childhood ExperiencesHealth StatusAdolescentAdultAgedCaliforniaCross-Sectional StudiesFemaleHealth SurveysHumansMaleMiddle AgedProtective FactorsRisk FactorsYoung AdultChronic DiseaseDomestic ViolenceMental HealthPrimary Health CarePublic Health

Identifiers

PMID42628986
PMCPMC13504943

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.