Positive Childhood Experiences (PCE): Cumulative Resiliency in the Face of Adverse Childhood Experiences

Abstract

The maltreatment-offending relationship has been well elucidated. Less examined are protective factors that effectively serve to mitigate offending among ACE-exposed youth. The current study examines whether cumulative positive childhood experiences (PCEs) are themselves associated with a reduction in recidivism among juvenile justice-involved adolescents, and the ability of cumulative PCE to moderate the ACE-recidivism relationship. Results demonstrate, among over 28,000 juvenile offenders, high ACE scores were associated with increased reoffending, and high PCE scores were associated with decreased recidivism, as measured by both rearrest and reconviction. Further, among juveniles with four or more ACEs who have six or more PCEs, reconviction was 23% lower and rearrest 22% lower when compared to those youth with four or more ACEs and less than six PCEs, controlling for a host of demographic and criminal history measures. Findings indicate that among youth with high PCE scores the positive association between ACEs and recidivism is no longer significant. Implications for juvenile justice practice and policy are discussed.

Keywords

positive childhood experiences adverse childhood experiences traumatic exposure juvenile offending

Introduction

The childhood maltreatment-delinquency link has been well established for decades (e.g., Widom, 1989) providing vast evidence of the increased likelihood for “hurt people to hurt people.” Borrowing from public health research, the adverse childhood experiences (ACE) concept of cumulative exposure has more recently been advanced, and well-supported, as a strong risk for internalizing and externalizing behaviors and crime (Baglivio, 2018; Craig, Piquero, et al., 2017). Research is growing regarding the pathways by which the ACE-crime relationship manifests, while exploring protective factors in that relationship has been slower, with strong notable exceptions (Craig, Baglivio et al., 2017). Quite surprisingly, this line of research has not yet examined the relevance of cumulative protective factors in building resilience to keep ACE exposure from leading to delinquency. The current study, again borrowing from medical/public health research, examines whether the effects of increased ACE exposures on juvenile recidivism differ by the extent to which justice-involved adolescents have experienced potentially resiliency-building cumulative positive childhood experiences (PCEs).

Heightened ACE Exposure and Deleterious Outcomes

Felitti and colleagues (1998) first articulated an ACE score based on self-reported exposure to 10 types abuse, neglect, and household dysfunction by age 18 and the dose-response, graded relationship between this cumulative measure to the leading causes of death and disease and health-risk behaviors (see also Anda et al., 2010; Flaherty et al., 2013).¹ Astonishingly, findings included that individuals with six or more ACEs died, on average, nearly 20 years younger than those with no ACE exposure (Brown et al., 2009). Recent research suggests that exposure to four or more ACEs has been linked to a greater than three times increase in the odds of food insecurity in young adulthood (Testa & Jackson, 2020). With respect to antisocial and violent behavior, it has long been demonstrated that childhood maltreatment is related to offending (Maxfield & Widom, 1996; Widom, 1989; Wilson et al., 2009), including among juvenile offenders (Trulson et al., 2016), and that poly-victimization increases the likelihood of both substance abuse and delinquency (Ford et al., 2010). However, as espoused by the developers of the ACE score, and supporting research, an essential concept of the composite ACE score is the interrelatedness and dose-response, cumulative impact of the individual exposures, which has been demonstrated repeatedly (Anda et al., 1999; Baglivio & Epps, 2016; Dietz et al., 1999; Dong et al., 2003, 2004; Dube et al., 2001). As Malvaso and colleagues state in their meta-analysis of prospective maltreatment-offending research “it is common for children to experience multiple forms of maltreatment at the same time and it is therefore difficult to disentangle the unique effects of different types of abuse” (2016, p. 11). It could be argued that such individual exposure examinations are not only difficult, but may be inappropriate, as they miss the broader context in which exposures occur. This necessitates the consideration of the cumulative impact of the exposures; the reason for which the composite ACE score was created. While the terminology “adverse childhood experiences” has exploded in criminological-oriented journals in recent years, many such investigations of ACE exposures do not include a cumulative score.

Perhaps the first use of a cumulative ACE score to examine a violence-related outcome was Duke and colleagues’ (2010) examination of 136,549 Minnesota students, finding each additional ACE exposure increased the odds of both self-directed violence and violence perpetration by 35%–144% (see also Hughes et al., 2017, meta-analysis demonstrating ACE effects on health issues among the strongest for problematic drug use and interpersonal and self-directed violence). The first study comparing adult offenders to a normative male sample found offenders evidence significantly higher prevalence of eight of the 10 ACE exposures, with convicted sexual offenders and (nonsexual) child abusers more likely to experience sexual abuse than the domestic violence and stalker offender groups (Reavis et al., 2013). Heightened ACE exposures among juvenile offenders relative to the general population has been demonstrated, with these youth 13 times less likely to have no ACE exposure, and four times more likely to have ACE scores of four or above (Baglivio et al., 2014). Subgroups of juvenile offenders, such as those with sexual offenses evidence even greater ACE exposure (e.g., Levenson et al., 2017).

Beyond prevalence, a recent prospective analysis of “high-risk” families noted higher ACE scores increased likelihood of alcohol use, marijuana use, violence, and arrest, with noted race differences (Fagan & Novak, 2018), while a separate study of Chicago youth suggests higher ACEs related to delinquency for boys but more so substance use for girls (Leban & Gibson, 2020). Importantly, justice-involved youth with higher ACE exposures have been demonstrated to have be at increased odds of internalizing and externalizing behaviors (Hunt et al., 2017; Muniz et al., 2019), higher recidivism rates and shortened time to reoffense (Wolff et al., 2017), violent felony arrests (Johnson, 2018), being more likely to attempt suicide (Perez et al., 2016), being victims of human trafficking (Reid et al., 2016) and arrested for trading sex (Naramore et al., 2017), being placed in a long-term juvenile justice residential program prior to age 18 (Zettler et al., 2018), being gang-involved (Wolff et al., 2020) and to evidence early-onset, serious, violent, and chronic juvenile offending trajectories (Baglivio, Wolff, Piquero, & Epps, 2015; Fox et al., 2015; Perez et al., 2018). Further, recent work has demonstrated adverse exposures increase offending up to age 56 (Craig, Piquero, et al., 2017), and distinguish life-course persistent offending from adolescent-limited and adult-onset offending types and from non-offenders (Kerridge et al., 2020).

A notable exception has been found, as higher cumulative ACE scores did not increase 3-year general recidivism or felony recidivism among those released from Texas state juvenile correctional facilities (Craig et al., 2020); in contrast to higher ACEs significantly increasing 1-year recidivism of juveniles completing Florida juvenile justice residential placements, until official child welfare placement was included in regression models (Baglivio, Wolff, Piquero, Bilchik, et al., 2015). The Craig and colleagues’ (2020) study was important as the vast majority of work examining a cumulative ACE score and recidivism has been conducted with Florida Department of Juvenile Justice (FDJJ) samples. Additional credence to the possible implications of dataset (e.g., FDJJ data) and sample (e.g., adjudicated youth in residential commitment versus community-based placements) differences was the examination of the commitment offense, race, and ethnicity differences in the ACE-crime relationship among males confined in juvenile justice facilities in an unnamed large southern state (DeLisi et al., 2017). These researchers found large variations across offenses and race/ethnicity in the relationship between cumulative ACE and the offense for which youth were committed, with some offenses less likely with higher ACE scores (homicide and serious property offending), and others more likely (such as sexual offending). Among over 50,000 Washington State juvenile offenders, higher ACEs significantly predicted 1-, 2-, and 3-year general, property, and violent recidivism for males, and general and violent recidivism for females, with notable differences across race for drug and sexual reoffending (Kowalski, 2019). Higher ACE exposure among detained adolescents in South Australia with violent offense convictions has also been found (Malvaso et al., 2019).

As supporting evidence builds among ACE score research, studies began to examine the potential pathways by which the ACE-juvenile offending relationship manifests. For example, Meldrum and colleagues (2020) posit a transactional/reciprocal relationship between ACE exposure and self-control deficits, as they found heightened ACE exposure was negatively associated with self-control among both youth across 13 middle and high schools in Michigan as well as Florida juvenile offenders. Further, Wolff and Baglivio (2017) found that while a significant direct effect remained, nearly half of the total effect that ACEs have on recidivism operates through increasing negative emotionality. Similarly, Perez and colleagues found negative emotionality and effortful control partially mediated the relationship between ACE and suicide attempts among juvenile offenders, though the direct effect of ACEs remained significant (Perez et al., 2016). While not examining recidivism, a recent study found the relationship between ACEs and gang-involvement among juvenile offenders was mediated by the effect of ACEs on substance use and a difficult temperament (low effortful control and high negative emotionality; Wolff et al., 2020). These studies suggest that the negative repercussions ACE exposure has on juvenile antisocial behavior may manifest through temperament constructs of effortful control and negative emotionality, suggestive of DeLisi and Vaughn’s (2014) temperament-based theory of antisocial behavior and justice system involvement, which has garnered growing evidence in support (e.g., Baglivio et al., 2016; DeLisi et al., 2018).

Searching for ACE-Offending Protective Factors

ACE exposure is a critical public health issue, highlighting the importance of prevention, yet understanding of factors that may protect ACE-exposed individuals from deleterious outcomes also becomes paramount. Protective factors that can modify or improve an adolescent’s response to ACE exposure may transcend multiple ecological levels, including individual (e.g., self-regulation, coping skills), family (e.g. supportive, caring/warmth), and community (e.g., connection, engagement, supportive relationships) (Racine et al., 2020; see also Afifi & Macmillian, 2011; Gartland et al., 2019). Several studies have examined moderators of ACE effects on negative mental health (e.g., Logan-Greene et al., 2014; Nurius et al., 2012), such as perceived social support (Cheong et al., 2017; see also Crouch et al., 2019) and psychological resilience (Poole et al., 2017) on later-life depression. Among juvenile offenders, internal resilience and school connectedness reduced the ACE-psychological distress relationship, though the ACE effect remained significant (Clements-Nolle, & Waddington, 2019). Related to substance use and delinquency, Brown and Shillington (2017) found protective and supportive adult relationships moderated the ACE-substance abuse relationship, but not ACE and delinquency among child welfare-involved youth. Gender-specific findings have indicated internal assets (social competencies, commitment to learning, positive identity) moderated ACE-marijuana and alcohol initiation for girls, but not for boys among ninth and 11th grade students (Chatterjee et al., 2018). Importantly, among students, social support, empathy, school belonging, and parental monitoring served as significant in buffering the ACE-dating violence perpetration relationship (Davis et al., 2019).

Unfortunately, far less work has examined factors that may serve to protect adjudicated youth from the effects of cumulative ACE exposure on subsequent offending. Craig and colleagues have demonstrated that ACE exposure increases the likelihood of community-based juvenile justice youth recidivism among those with moderate and high substance use, yet not among those with little or no such use (Craig et al., 2019). Craig, with a similar team of researchers, had previously found that while ACEs increased rearrest likelihood, and social bonds decreased such odds, stronger social bonds did not reduce the cumulative ACE-recidivism relationship (Craig, Baglivio, et al., 2017). A similar result was found as Craig (2019) demonstrated that the extent to which adolescent offenders possessed positive attitudes toward their futures (future orientation) did decrease the likelihood of recidivism, but did not mediate the ACE-reoffending relationship. More recently, ACE exposure was found related to initial levels of empathy at admission to juvenile justice residential facilities, and that large improvements in empathy during placement rendered the cumulative ACE effect on recidivism nonsignificant, while ACE still predicted recidivism after moderate empathy improvements (Narvey et al., 2020). Finally, Craig and colleagues examined the most extensive list of protective factors with respect to the ACE-offending relationship (Craig, Piquero, et al., 2017). Leveraging the Cambridge Study in Delinquent Development data, their findings demonstrated high nonverbal IQ, high verbal IQ, high school attainment, low daring, low hyperactivity, low impulsivity, low neuroticism, low dishonesty, low troublesomeness, small family size, low school delinquency, and high parental interest in education all protected youth with at least one ACE by lowering the odds for ever offending up to age 56. While examining the largest number of protective factors, that study did not assess the main effect of cumulative protective factors nor whether effects held for youth with extensive ACE exposure, as analyses compared those with no ACEs to those with at least one ACE. It is unknown as to whether having an accumulation of protective factors, or positive childhood experiences is beneficial, as, to date, we know of no study that has examined the implications of cumulative protective factor exposures on the ACE-offending relationship.

Cumulative Positive Childhood Experiences (PCE)

Outside of delinquency and juvenile/criminal justice work, researchers have demonstrated resiliency and protective factors across multiple domains help mitigate ACE effects on health-related outcomes. As example, among rural community adults, those with better emotion regulation, meaning making (ways to seek personal/spiritual fulfillment), community support, social support and practicing forgiveness reported better physical health among ACE exposed participants (Banyard et al., 2017). Further Sabina and Banyard (2015) called on research to examine multiple protective factors rather than looking for singular constructs (see also Lenzi et al., 2015). Recently, public health research has advocated the role of cumulative positive childhood experiences (PCE) and their ability to modulate the negative effects of ACEs. Notably, cumulative PCEs represent the sum of a number of binary exposure types, just as ACEs are (exposure to each measured PCE is classified as yes/no, with affirmative responses added to arrive at a cumulative summary score). While not nearly as well defined as ACE exposures at this point, PCE exposures involve concepts such as family-child communication, feeling supported by family, participating in community/family traditions, feeling a sense of belonging/engagement in school, support from friends, participating in organized activities, and having adult mentors. Higher PCE scores have been associated with better health outcomes, such as ideal cardiovascular health in midlife (Slopen et al., 2017).

Bethell and colleagues (2019) found adults reporting 6–7 (of 7) PCEs had 72% lower adjusted odds of depression/poor mental health than those reporting only 0–2 PCEs, and a dose-response relationship with depression/poor mental health after accounting for exposure to ACEs. They concluded “that PCEs may have lifelong consequences for mental and relational health despite co-occurring adversities such as ACEs” (p. 8). Similarly, among low income women receiving prenatal care at Philadelphia health centers, PCEs were associated with lower odds of symptoms of depression (Chung et al., 2008). While PCEs and ACEs both had expected direct effects on adult health behaviors and outcomes in a sample of Amazon Mechanical Turk (mTurk) users, and PCE largely neutralized the effects of ACEs on health, the relationship between ACEs and adult health was stronger among those with the highest PCE scores, going against a protective factors model (Crandall et al., 2019). Alternatively, among 489 adolescents in the northwestern U.S., when examining both cumulative ACEs and PCEs in the same models, ACEs were not predictive of health indicators, while PCEs predicted less risky sex, substance abuse, and depression, and a more positive body image (Crandall et al., 2020). Examining children, Liu and colleagues (2020) found youth similarly situated with respect to ACE exposure but with higher total PCE scores have better health outcomes than their peers with lower total PCEs. Unfortunately, they also found that among youth with similar total PCE scores those with higher ACE scores did not do as well as youth with lower ACE exposures, suggesting exposure to PCEs “generally promotes healthy adaptation in the face of adversity, but whose effects become insignificant in the presence of extreme risk” (p. 181).

With respect to outcomes beyond health, a team of researchers, several of which were involved in the original ACE Study, included family closeness, support, loyalty, protection, love, importance, and responsiveness to health needs in a cumulative PCE score. They found a higher number of PCEs was associated with decreased the odds of teenage pregnancy, with a 46% reduction in adolescent pregnancy rates for those with high PCE scores (6–7 of 7 possible PCE exposures) and at least one ACE exposure, compared with those having low PCE scores (1–2 PCEs) and coexisting ACE exposure (Hillis et al., 2010). Further, while the study involved retrospective recall of PCE and ACE exposure, they found PCEs decreased the odds of psychosocial problems associated with teenage pregnancy including employment issues, financial problems, high stress, and uncontrollable anger. Critically important, both ACE and adolescent pregnancy were included in the models that examined the long-lasting cumulative PCE effects on psychosocial consequences (Hillis et al., 2010). Notably, women without any ACE exposure, regardless of cumulative PCE exposure, were at lower risk than those with ACE exposures. One condition not examined was the effect of PCE exposures on those with a range of ACE exposures, as the only classifications examined were those with no history of ACE and those with at least one ACE.

Importantly, a study of 259 participants in Turkey aged 18–62 demonstrated the presence of a direct relationship between PCE exposures and 11 of 14 personality disorder symptoms (antisocial, avoidant, borderline, dependent, depressive, obsessive-compulsive, paranoid, passive-aggressive, schizoid, schizotypal, and self-defeating, but not histrionic, sadistic, or narcissistic) despite ACE exposure (Gunay-Oge et al., 2020). Notably, the independent effects of ACE exposures remained significant (after the inclusion of PCE in regression models) for the majority of disorders examined. Importantly, this study did not assess moderation, leaving the idea that PCEs may protect individuals from the deleterious effects of ACE exposure relatively untested.

Current Study

Examinations of the effects of childhood maltreatment on juvenile offending have a decades-long history (e.g., Widom, 1989; Widom et al., 2017), while the study of cumulative traumatic exposure, as measured in an ACE score concept borrowed from public health research, is more recent (Baglivio et al., 2014). ACE studies among offender populations have dramatically increased in the six years since their introduction. Interestingly, criminology has not yet advanced a concept of cumulative positive childhood experiences (PCEs) that may potentially buffer the deleterious effects of ACEs of juvenile recidivism. The current study aims to fill that void by examining whether higher ACE exposures are associated with increased recidivism among adjudicated juveniles who have experienced extensive PCEs as well as those with fewer positive exposures. Leveraging a 3-year cohort of 28,048 juvenile offenders completing community-based juvenile justice placements in Florida, the current study examines if 1) cumulative PCE exposure is directly related to reoffending, and 2) whether higher ACE exposure has a similar association with reoffending among those with and without extensive PCE exposure using two measures of official recidivism (rearrest and reconviction). Importantly, the current study’s inclusion of particular measures to be considered as PCE is based on those established in the limited prior PCE work, and an attempt to term any potentially positive available measure as a PCE. Similarly, to Baglivio and colleagues’ (2014) approach to using risk assessment items to closely mimic the original ACE Study measures (Felitti et al., 1998), the current study attempts to mimic PCE already explored in prior work, and apply such measures to juvenile justice outcomes.

Sample

Male and female juvenile offenders who completed a Florida Department of Juvenile Justice (FDJJ) community-based placement between July 1, 2009 and June 30, 2012 were examined. Notably, this is the same base sample used by different researcher teams exploring the ACE-crime relationship (e.g., Craig, 2019; Craig et al., 2017, 2019; Wolff & Baglivio, 2017). Community-based placements included formal diversion, probation supervision, day treatment/day reporting, and intensive family therapy as a probation overlay service (predominately multisystemic therapy and functional family therapy during the study period). Youth formally processed into the juvenile justice system are administered the Positive Achievement Change Tool (PACT) risk/needs assessment, which has two versions: a prescreen and a full assessment. Both versions provide a composite risk to reoffend classification (low, moderate, moderate–high, and high risk), while the full assessment additionally provides criminogenic need domain scores (criminal history, school, free time, employment, relationships, family, substance use, mental health, antisocial attitudes, aggression, and social skills). Youth assessed as moderate–high or high risk receive the full assessment, as does any youth considered for the intensive family therapy overlay, or residential placement. Both the pre-screen and full assessment are conducted through semi-structured interviews by a trained juvenile probation officer, a review of the youth’s case file, and corroboration with available official child abuse and education records from other state agencies. Only youth assessed with the full assessment were included in the current study, as only this version contains the requisite items to create the ACE score. Further, 121 youth classified as “other” race/ethnicity were excluded, resulting in a final analysis sample of 28,048 youth.

Measures

Study measures were derived from data maintained in the FDJJ information system, inclusive of all referral (equivalent to an adult arrest), disposition, justice system placement, and risk assessment (C-PACT) histories for all included youth. The C-PACT risk/need assessment information was used to construct the independent and control measures. The reliability of the C-PACT, as administered by FDJJ, has been assessed with an intraclass correlation coefficient (ICC) of .83 (Baird et al., 2013). Subsequent juvenile arrests and data obtained annually by FDJJ on adult arrests were used to construct the dependent measures of official recidivism. The Full C-PACT administered just prior to the youths’ completion of community-based services was used as it most accurately captures the youth’s risks/needs at the beginning of the 1-year recidivism follow-up period.

Dependent Variables—Recidivism

Two dependent measures of official recidivism were employed to ensure robustness of the findings obtained: rearrest and readjudication. Rearrest was measured as a subsequent referral or adult arrest for a new-law offense committed within 365 days of the date of completion of the juvenile justice community-based placement for a given youth. Readjudication uses the official definition of the FDJJ of a subsequent adjudication, adjudication withheld, or adult conviction for a new-law offense that occurred within 365 days of a given adolescent’s date of community-based placement completion. The offense must have occurred within 365 days, but the tracking period is months longer to allow for court processing time. Both measures of recidivism included juvenile and adult official records as some participants were (or turned) 18 years of age (the age of majority in Florida) during the tracking period. As shown in Table 1, 40.3% of the sample was rearrested within one year of release, and 24.7% was readjudicated (or had adjudication withheld) or reconvicted (in the adult system) for an offense committed within 1 year.

Table 1.

Descriptive Statistics for the Analysis of ACEs and PCEs.

	n (mean)	% (sd)
Rearrested w/in 365 days
No	16,735	59.67%
Yes	11,313	40.33%
Reconvicted w/in 365 days
No	21,112	75.27%
Yes	6,936	24.73%
High ACE Score
<4 ACEs	19,894	70.93%
4+ ACEs	8,154	29.07%
High PCE Score
<6 PCEs	19,081	68.03%
6+ PCEs	8,967	31.97%
Sex
Female	6,424	22.90%
Male	21,624	77.10%
Race
White	10,789	38.47%
Black	12,986	46.30%
Hispanic	4,273	15.23%
Age	17.01	1.67
Age at First Offense
<12	8,594	30.64%
13–14	10,908	38.89%
15	4,503	16.05%
16	2,669	9.52%
>16	1,374	4.90%
Prior Felonies
0–1	7,914	28.22%
2	10,706	38.17%
3–4	5,026	17.92%
5+	4,402	15.69%
Mental Health Problems
No	22,489	80.18%
Yes	5,559	19.82%
Substance Use History
No Past Use	9,530	33.98%
Past Use	12,027	42.88%
Problematic Past Use	6,491	23.14%
Residential Placement History
None	19,368	69.05%
One Prior Placement	7,047	25.12%
Two or More	1,633	5.82%

Key Independent Variables

High Positive Childhood Experience (PCE) Exposures

Cumulative PCE exposure is inclusive of 11 specific protective exposures (described below). Similar to the ACE score, the cumulative PCE score is the sum of these 11 dichotomous exposures, having a potential range of 0 (having experienced none) to 11 (having experienced each of the childhood experiences). As prior research has leveraged items/responses from the PACT assessment to create the ACE score (e.g., Baglivio et al., 2014), the PACT was used to extrapolate dichotomous PCE exposures. Specifically: (1) Belief school provides an encouraging environment; (2) Youth likes or feels comfortable talking with two or more teachers, education staff, or coaches; (3) Youth is involved in one or more school activities; (4) youth is involved in one or more prosocial structured recreational activities (such as community, cultural, or religious groups, clubs, athletics); (5) youth has a history of and/or currently has two or more relationships with positive adults (adults who are not family or teachers but who can provide support and/or model prosocial behavior; (6) youth has only prosocial friends (youth indeed has friends but none are antisocial or gang-associated peers); (7) youth has strong prosocial community ties (youth feels there are people in his/her community who are willing to help and who discourage getting into trouble); (8) youth’s family has a strong support network of extended family or friends who can provide additional support (emotional and/or tangible) for the family; (9) youth’s family is consistently willing to support him/her; (10) youth’s family provides opportunities for his/her involvement or participation in family activities and decisions affecting the youth; and (11) the youth indicates he/she is close to or has a good relationship with both mother/female caretaker and father/male caretaker or with both mother/female caretaker and extended family members. The eleven dichotomous PCE were summed to create a cumulative measure of PCE, or PCE score (mean = 4.4; SD = 2.5). Finally, the PCE summary score was used to split the sample into those that had high PCE (six or greater) versus those with less than six PCE. Of note, 31.97% of the sample had high PCE (see Table 1).

High Adverse Childhood Experience (ACE) Exposures

The ACE score measures the youth’s extent of cumulative exposure to the 10 ACE indicators. In keeping with the prior ACE-specific work discussed above, we include binary (yes/no) indications for the 10 indicators, then summing exposures for 0 (no exposures) to 10 (exposure to each of the 10 indicators) ACE score. A brief description of each ACE and responses indicating affirmative exposure are as follows: (1) Emotional abuse: Parents/caretakers were hostile, berating, and/or belittling to youth; (2) Physical abuse: The youth reported being victimized or physically abused by a family member; (3) Sexual abuse: The youth reported being the victim of sexual abuse/rape; (4) Emotional neglect: Family has little or no willingness to support youth and/or youth does not feel close to any family member; (5) Physical neglect: The youth has a history of being the victim of neglect (includes a negligent or dangerous act or omission that constitutes a clear and present danger to the child’s health, welfare, or safety, such as failure to provide food, shelter, clothing, nurturing, or health care); (6) Family violence: Domestic violence or sexual abuse in the home (not against the youth him/herself), or if the youth has witnessed violence in either their home, or in a foster/group home; (7) Household substance abuse: Problem history of parents and/or siblings in the household includes alcohol or drug problems; (8) Household mental illness: Problem history of parents and/or siblings in the household includes mental health problems; (9) Parental separation/divorce: Youth does not live with both mother and father; and (10) Incarceration of household member: There is a jail/prison history of family members. The 10 exposures were summed, resulting in an average ACE score for the sample of 3.35 (SD = 1.86).² To examine whether higher ACE scores increase the likelihood of reoffending, a cut off of four or more ACEs was used to differentiate those with high ACE Scores (29.07%).

Control Variables

Demographics

Demographic measures included sex (77.1% male), race/ethnicity measured as a series of dichotomous items for Black (46.3%), white (38.5%), and Hispanic (15.2%), and age at completion of the community-based placement, as this is the time at which the recidivism tracking period began (measured continuously, mean = 17.01, SD = 1.67). Of note, according to FDJJ protocol, ethnicity supersedes race such that Black youth were all non-Hispanic and Hispanic youth may be either Black or White.

Criminal History

Measures of the youth’s prior offending included age at first arrest, extent of prior felony arrests, and long-term residential placement history. Importantly, all criminal history indicators are automated from the FDJJ information system and therefore do not depend on recall of the youth or ability of the C-PACT assessor to understand and aggregate prior charges. Age at first arrest was captured according to the C-PACT protocol of under 12, 13–14, 15, 16, or over 16 years old at first arrest (coded 1–5, with higher values indicative of being older when first arrested. Felony offending classified youth as having none or one, two, three or four, or five or more prior felony adjudications (coded 1–4, with higher values indicating a greater number of felony adjudications). Finally, whether the youth had a history of a juvenile justice residential placement history was included, classifying those with no, one, or two or more such placements (coded 1–3; of note, 30.9% of youth had at least one such prior placement).

Mental Health problems

A dichotomous indicator for youth no history of mental health problems (= 0) and those with mental health problems (= 1) was included. Mental health problems included schizophrenia, bipolar, mood, thought, personality, and adjustment disorders. Conduct disorder, oppositional defiant, ADD/ADHD, and substance abuse disorders were excluded. All mental health problems must have been confirmed by a professional qualified to do so (e.g., psychologist, licensed mental health counselor).

Past Drug Use

Whether the youth had a history of drug and/or alcohol use was captured by an R-PACT item distinguishing youth without a history of drug and/or alcohol use from those with prior use and those whose substance use has caused problems across life domains such as school, family, health, peer associations, or criminal behavior (coded 0–2, respectively). Descriptive statistics for all variables included in the current analysis are shown in Table 1.

Analysis

After providing a description of the sample understudy we use a series of logistic regression models in order to assess both the main effect of PCEs on continued delinquent behavior as well as the potential for PCEs to moderate the relationship between ACEs and two measures of juvenile recidivism. The first set of regression models shown represent our baseline models in which the main effects of both ACEs and PCEs are assessed, first independently, then jointly, while accounting for a host of common control variables shown in past research to be related to juvenile recidivism. The second set of logistic regression models estimated rely on the analysis of split samples in order to assess the role of ACEs on reoffending among those with different levels of PCEs. This “pick-a-point” method has been used in past research to probe the interaction between two variables within the context of logistic regression (Hayes & Matthes, 2009) as well research on ACEs and juvenile recidivism (Craig et al., 2019). The process involves selecting designated values on the moderator variable (the PCE score) and then estimating the association between ACEs and recidivism among distinct samples comprised of youth with a PCE score below (or above) that value (see, e.g. Aiken & West, 1991; Cohen et al., 2003). Following Aiken and West’s (1991) advice for choosing the cut points (a value somewhere near the mean plus one standard deviation), the models presented below are based on two groups, 1) youth with less than six PCEs and 2) those with 6+ PCEs.

Results

Table 1 presents the descriptive statistics associated with the sample used in the current study. The majority of analysis sample was male (77.11%), Black (46.3%), and committed their first offense between the age of 13 and 14 years old (38.9%). Over half of the youth had two or more felonies at the time of their focal arrest and assessment and just over 30% had spent time serving a residential placement. Of the youth included in the study, just over 40% were rearrested (24.7% reconvicted) within a year completing their community-based placement. There was also evidence that youth in this sample had experienced a substantial amount of adversity with 29% of youth reporting they had experienced four or more ACEs. On the other hand, nearly 32% of youth reported experiencing six or more PCEs suggesting a mix of both adverse and positive experiences.

Table 2 displays the results a series of models designed to assess the association of our focal variables with each of the outcomes being explored. There are two models for each outcome (rearrest and reconviction). The first assesses the association between having a high ACE score (4+) and being rearrested/reconvicted within 1 year of program completion. Results shown in Model 1 and Model 3 of Table 2 suggest that having four or more ACEs was associated with a significantly higher likelihood of recidivism, net of the other factors considered. More specifically, youth with four or more ACEs were roughly 15% more likely to be rearrested within 1 year, and 20% more likely to be reconvicted for an offense that was committed during that year.

Table 2.

Association Between ACEs–PCEs and Juvenile Recidivism (n = 28,048).

	Rearrest		Reconviction
	Model 1	Model 2	Model 3	Model 4
	OR/CI95	OR/CI95	OR/CI95	OR/CI95
High ACE Score (4+)	1.154***	1.112***	1.206***	1.170***
	[1.090, 1.223]	[1.049, 1.178]	[1.131, 1.285]	[1.097, 1.248]
High PCE Score (6+)	—	.802***	—	.834***
	—	[.759, .847]	—	[.783, .888]
Male	1.871***	1.879***	2.025***	2.031***
	[1.753, 1.997]	[1.761, 2.006]	[1.871, 2.191]	[1.876, 2.198]
Age	.992	.987	.947***	.943***
	[.975, 1.010]	[.970, 1.005]	[.928, .966]	[.924, .962]
Black	1.649***	1.637***	1.408***	1.399***
	[1.558, 1.746]	[1.546, 1.733]	[1.321, 1.500]	[1.312, 1.491]
Hispanic	1.249***	1.242***	1.000	.995
	[1.157, 1.348]	[1.150, 1.340]	[.915, 1.093]	[.910, 1.088]
Age at First Offense	.850***	.854***	.867***	.871***
	[.827, .872]	[.832, .877]	[.841, .894]	[.844, .898]
Prior Felonies	1.138***	1.138***	1.119***	1.119***
	[1.106, 1.171]	[1.106, 1.170]	[1.085, 1.155]	[1.084, 1.155]
Residential Placement History	1.255***	1.261***	1.298***	1.302***
	[1.196, 1.317]	[1.202, 1.323]	[1.232, 1.367]	[1.236, 1.372]
Substance Use History	1.348***	1.331***	1.305***	1.292***
	[1.299, 1.398]	[1.283, 1.380]	[1.253, 1.360]	[1.240, 1.346]
Mental Health History	1.078*	1.075*	1.074	1.071
	[1.011, 1.150]	[1.007, 1.146]	[1.000, 1.154]	[.997, 1.151]
Constant	.201***	.238***	.209***	.240***
	[.154, .263]	[.181, .312]	[.155, .283]	[.177, .325]

Note: * p < .05, ** p < .01, *** p < .001. Odds ratios with 95% confidence intervals shown.

The second set of models include our indicator of positive childhood experiences, which is coded 1 if a youth has six or more PCEs. Results shown in the second and forth model of Table 2 indicate that having a substantial number of PCEs (6+) is associated with a lower likelihood of rearrest (20% reduction) and reconviction (16.6% reduction). In addition to adverse/positive childhood experiences, the results shown suggest that males, as well as Black and Hispanic youth are more likely to be rearrested and reconvicted, as are those youth with greater offending histories or a history of substance use. In general, the results are consistent with expectations presented above as well as past research on the association between ACEs and juvenile justice outcomes. In short, ACEs are anticipated increase the likelihood of continued involvement in delinquent behavior, while PCEs are likely to curtail it, net of other factors considered. After establishing these main effects for the sample under study, we assessed whether the association between ACE exposures and our measures of juvenile recidivism is moderated by the number of positive childhood experiences.

Table 3 includes the results of four logistic regression models designed to assess the association between ACEs and our measures juvenile recidivism among two distinct groups: youth with and without a substantial number of PCEs (six or more). The results in the first model suggest that four or more ACEs is associated with a higher likelihood of rearrest among youth with fewer than 6 PCEs. Among youth with six or more PCEs, however, the association between ACE exposures and rearrest reaches the point of being non-significant (although it is still positive it is much smaller in magnitude). The results in Model 3 and Model 4 tell a similar story. Youth who experienced a high degree of adversity and did not have six or more positive experiences were just over 19% more likely to be reconvicted (OR = 1.19; CI: 1.11, 1.28). Among those with a substantial number of PCEs, however, ACEs were not significantly associated with being reconvicted post completion (although, again, the estimate was in the anticipated positive direction).³ It is important to note that this variation in the association between ACEs and juvenile recidivism is unlikely to be a function of the different sample sizes alone. We note that the relationships between sex, race, and the criminal history variables and our measures of recidivism are much more consistent between the two groups (<6 and 6+ PCEs) than the ACE exposures and recidivism relationship. This suggests there is something about a greater number of PCEs that proves protective for youth involved in the juvenile justice system, and that positive experiences may insulate youth with heightened adverse experience exposures when it comes to further justice system involvement. Figure 1 presents the results displayed in Table 3 in graphical form, illustrating a 20.7% lower rearrest rate among youth with high ACE exposure and less then six PCEs compared to youth with high ACE exposure and six or more PCEs (.21/.27−1 = 20.7%) and a 22.8% lower reconviction rate (.35/.44−1 = 22.8%). The protective effect of PCE among low ACE youth is evident, but not as large, as per the 17% lower rearrest and 16% lower reconviction rates among low ACE youth with high PCE compared to low ACE youth with low PCE. Results are discussed in greater detail below.

Table 3.

Association between ACEs and Juvenile Recidivism Among Youth With and Without PCEs.

	Rearrest		Reconviction
	Model 1	Model 2	Model 3	Model 4
	<6 PCEs	6+ PCEs	<6 PCEs	6+ PCEs
	OR/CI95	OR/CI95	OR/CI95	OR/CI95
High ACE Score (4+)	1.127***	1.048	1.191***	1.087
	[1.055, 1.203]	[.924, 1.189]	[1.107, 1.281]	[.943, 1.254]
Male	1.891***	1.860***	2.084***	1.903***
	[1.752, 2.041]	[1.641, 2.109]	[1.901, 2.286]	[1.631, 2.220]
Age	.973*	1.012	.937***	.952**
	[.952, .994]	[.979, 1.045]	[.915, .960]	[.917, .988]
Black	1.598***	1.726***	1.380***	1.440***
	[1.492, 1.710]	[1.555, 1.917]	[1.279, 1.489]	[1.278, 1.623]
Hispanic	1.252***	1.218**	.998	.990
	[1.142, 1.372]	[1.059, 1.401]	[.898, 1.109]	[.839, 1.169]
Age at First Offense	.849***	.865***	.870***	.871***
	[.822, .876]	[.824, .907]	[.839, .903]	[.822, .921]
Prior Felonies	1.111***	1.210***	1.092***	1.193***
	[1.074, 1.148]	[1.147, 1.277]	[1.053, 1.133]	[1.123, 1.268]
Residential Placement History	1.254***	1.283***	1.305***	1.302***
	[1.185, 1.327]	[1.171, 1.407]	[1.228, 1.387]	[1.177, 1.440]
Substance Use History	1.265***	1.476***	1.226***	1.452***
	[1.211, 1.322]	[1.381, 1.578]	[1.168, 1.287]	[1.346, 1.566]
Mental Health History	1.043	1.155*	1.064	1.081
	[.967, 1.124]	[1.018, 1.311]	[.979, 1.156]	[.937, 1.246]
Constant	.348***	.094***	.293***	.140***
	[.250, .483]	[.059, .151]	[.203, .421]	[.082, .240]
n	19,081	8,967	19,081	8,967

Note: * p < .05, ** p < .01, *** p < .001. Odds ratios with 95% confidence intervals shown.

Figure 1.

Recidivism by ACE and PCE Exposure.

Discussion

The ACE concept is centered on a dose-response, cumulative exposure framework (Felitti et al., 1998), rather than examining each exposure type in isolation. Similarly, criminologists have argued for decades that serious and violent delinquency and gang involvement is based on the extent of risk exposure across multiple domains and not a singular cause (e.g., Howell, 2009; Loeber & Farrington, 2012; Thornberry et al., 1995).⁴ Prior work examining the maltreatment-offending and specifically cumulative ACE-offending relationship have examined singular protective factors, or multiple protective measures in isolation (assessing the independent effects). The current study argues, and assesses, the effects of cumulative exposure to positive experiences during childhood and adolescence on juvenile recidivism. We examined whether those with higher cumulative PCE have similar justice system outcomes as those with lower PCE. Further, we explored whether high PCE moderate the increasingly supported ACE-juvenile recidivism relationship. Our approach is in keeping with definitions investigating risk-based protective factors that are promotive in situations of risk as variables that predict a low probability of offending among an at-risk group (Loeber et al., 2008; see also Farrington et al., 2016). The results of current study support our proposition that exposure to extensive PCEs protect justice-involved youth from further system involvement. Further, we found cumulative PCE exposure moderates the harmful effects of cumulative ACE exposures on two measures of official recidivism.

It is worth reiterating that that the variation in the association between ACEs and juvenile recidivism found for low-PCE youth in comparison to high PCE youth is not likely a function of sample sizes. The results of the relationships between sex, race, and the criminal history variables with both measures of recidivism being much more consistent between the two groups examined (juveniles with < 6 PCE and those with 6+ PCE), while the ACE exposures and recidivism relationship changed substantially across PCE groupings. A 21% rearrest and 23% reconviction difference between highly ACE-exposed youth without extensive PCE compared to similarly situated high ACE-exposed youth with six or more PCE is a substantial, public safety and policy-relevant difference (discussed below).

While the current study contributes significantly to our knowledge of ACEs and juvenile justice involvement, several limitations are worthy of mention. As levied against the ACE score, our measure cumulative PCE suffer from a similar lack of consideration of the frequency, severity, and chronicity/duration of each exposure, as well as indication of the developmental period during which the exposure was experienced (e.g., Jaffee & Maikovich-Fong, 2011; Lemmon, 2006; Nofzinger & Kurtz, 2005; Smith & Thornberry, 1995; Wolff et al., 2020). This limitation is echoed by longitudinal research from age 4–18 showing early ACE exposure does not necessarily result in similar deleterious health implications as chronic exposure (Thompson et al., 2015), and other work demonstrating exposure during perinatal development more significant in effecting current functioning (in childhood) than infancy, early childhood, and childhood. Additionally, the data leveraged in the current study did not allow for examining the timing of PCEs relative to the timing of ACE exposure. Future work is need to ascertain whether PCEs are more/less effective in buffering ACE effects on reoffending when the PCE exposures occur before/after the ACE exposures. Similarly, there is a large void in our understanding of how both PCE and ACE exposures change over the course of childhood and adolescence and how such changes may influence antisocial, delinquent, and violent behavior. Future study is encouraged to examine more sophisticated considerations of both adverse and positive exposures (Hambrick et al., 2019).

Further, critiques of whether enough ACEs are included have called for additional exposures, both within and outside the home, such as witnessing community violence, experiencing racial discrimination, bullying, food insecurity, homelessness, and chaotic homes (Bonor et al., 2019; DeLisi et al., 2019; Finkelhor et al., 2015; Mersky et al., 2017). Similarly, our 11 PCE exposures are unlikely to be the quintessential constellation of positive experiences in protecting justice-involved adolescents from reoffending. To reiterate, the current study attempted to include only items as PCE measures that were examined in the limited, but growing, prior PCE work. PCEs should not simply become a synonym for a protective/promotive factor with every measure suggestive of being a strength included. However, future work would be advised to explore more statistically-based approaches to PCEs, such as factor analysis to examine different groupings/constructs of PCEs. Nonetheless, ours is the first examination of the relationship of cumulative PCE in coordination with ACE exposure on recidivism. Further, related to both ACEs and PCEs, is the argument for the inclusion of considering genetic and shared environmental influences, such as using family-based research designs (Connolly & Kavish, 2019).

An important consideration related to childhood experiences is whether PCEs are simply the “opposite side of the same coin” or simply the absence of an ACE. Similarly, is the notion that perhaps ACEs and PCEs represent the extremes of the same construct, while the majority of youth may fall in some middle group of each characteristic. This would be similar to approaches to risk, promotive, and protective factors examined by others (e.g., Farrington et al., 2016; Loeber et al., 2008). With respect to several ACEs, however, there is no possibility to trichotomize measures. While emotional neglect or emotional abuse can be grouped into those youth with strong emotional support, some modicum of support, and those with either emotionally absent or even hostile/berating parents, there is no middle group, for example, for sexual abuse, incarceration history of household members. As such, not all ACEs and PCEs would be part of the same construct (or risk assessment items(s)). Indeed, however, some of the current study’s PCEs were composed of similar items as the ACE measures (emotional abuse and emotional ACEs have C-PACT items in common with family support network, family willingness to support the youth, and positive relationships with both mother/female caretaker and father/male caretaker or with both mother/female caretaker and extended family members PCEs). Importantly, a sensitivity analysis which removed the three PCEs with overlapping C-PACT items to ACEs (leaving eight of the 11 PCEs) yielded substantively identical results (see Note 3). Nonetheless, future work could examine the effect of protective and adverse childhood experiences in a trichotomized fashion, and thus explore whether each truly has a risk and promotive end and which are protective, where overlapping items make doing so possible.

Additionally, future work is needed to examine the effects of cumulative PCE exposure across socioeconomic conditions. Widom (2014) has well-articulated the confounding nature of the maltreatment-offending relationship with socioeconomic status. Disadvantaged neighborhoods suffer disproportionately in terms of maltreatment exposure (Coulton et al., 2007; Slack et al., 2017), while ACE exposure at the individual level is greater among justice-involved youth residing in neighborhoods distinguished by concentrated disadvantage and higher residential mobility in comparison to more affluent areas and those with higher immigrant concentration (see also Baglivio et al., 2017; Wolff et al., 2018). Further, with respect to juvenile offending, multidisciplinary research shows neural development likely disrupted by poor pre- and postnatal nutrition, maternal substance abuse, pre- and postnatal toxic agent exposure, and even brain injury related to abuse/neglect, increase the likelihood of cognitive and temperamental disadvantages (Cravioto & Arrieta, 1983; Needleman & Beringer, 1981; Rodning et al., 1989; Stewart, 1983; Yeates et al., 2007), which are integral in Moffitt’s developmental taxonomy as adolescents with “compromised neuropsychological function” are more likely reared in contexts of concentrated disadvantage (Moffitt, 1993).

Policy & Practice Implications

Certainly, the call for primary and secondary prevention programs to minimize ACE exposure is warranted. The fact, however, is that adolescents are exposed to ACEs, and that justice-involved youth are disproportionately exposed. The question then becomes what the system can do for ACE-exposed youth to reduce their further involvement in the juvenile or criminal justice system. The search for singular protective factors among ACE-exposed juvenile offenders has not been particularly fruitful, as discussed above. The current findings, in contrast, highlight the importance of cumulative PCE scores as they are associated with a substantially reduced risk recidivism among a sample of adolescents with extensive ACE exposure and who are also already involved in the juvenile justice system. Relevant policy and juvenile justice system practice implications can be gleaned from these initial findings, and would be strengthened pending additional supportive findings from future research. While specific trauma treatments, such as trauma-focused cognitive behavioral therapy (TF-CBT) and Seeking Safety have demonstrated efficacy in reducing trauma-related symptoms (e.g., Cohen et al., 2016; Morina et al., 2016; Najavits et al., 2006), the evidence base for such treatments in reducing subsequent offending, especially among already justice-involved youth is surprisingly sparce, and often even less examined for male trauma-exposed offenders and those serving community-based juvenile placements as opposed to within residential facilities (Zettler, 2020). The current findings, in contrast demonstrate the needs for case workers, probation officers, and service providers to assist youth with access to opportunities to enhance the extent of positive experiences youth may be exposed to.

Fortunately, the positive experiences composing the cumulative PCE score in the current study do not involve expensive commercially marketed treatments, and/or interventions that require a high degree of treatment quality and sufficient dosage to have appreciable recidivism-reduction effects (see also Baglivio, Wolff, Howell, et al., 2018; Baglivio, Wolff, Jackowski, et al., 2018; Lipsey, 2009). Rather, the PCE score is composed of positive school experiences such as encouragement, supportive relationships with school personnel, and involvement in structured activities like sports or club, or hobby groups. The PCEs understudy also involve supportive family environments that consider the youth’s voice, that support his or her prosocial goals. While some families may historically have not been supportive, and maybe never will be (even with family counseling), a prosocial adult mentor and support may prove to be a sufficient substitute. Likely, these positive experiences may not be the norm, especially in disadvantaged contexts where resources are limited and already stretched, and are likely even less the norm for youth exhibiting behavior challenges and aggression. But the extent to which communities can provide these positive experiences to youth with trauma-riddled childhoods, the return on investment with respect to public safety, reducing future victims, and minimizing the intergenerational transmission of ACE exposure may be substantial.

The focus on enhancing PCEs among justice-involved youth is one of a strengths-based approach. While dynamic risk reduction is at the center of the prolific Risk-Need-Responsivity (RNR) paradigm, the need to enhance protective factors and strengths should not be ignored. Justice system workers across disciplines may be well served to promote prosocial relationships and access to structured prosocial opportunities among ACE-exposed youth on their caseloads. Policies that ensure case planning and referral targets intervention to assessed dynamic risk may be buttressed by requiring some focus also devoted to enhancing strengths and building exposure to PCEs more generally.

Conclusion

Adverse childhood exposures carry one of the costliest lifetime public health expenditures (Fang et al., 2012; Putnam, 2006). The negative implications of ACE exposure are so prolific that recently $45 million for ACE screenings was proposed in a state budget (California Pan Ethnic Health Network, 2019). It is clear that at-risk and justice-involved youth are disproportionately exposed (e.g., Baglivio et al., 2014; Grasso et al., 2016), and that ACE exposures contribute to not only self-directed (e.g. Perez et al., 2016) and interpersonal violence and offending (Fox et al., 2015), but that ACE effects on offending continue through young- and middle-adulthood (e.g., Craig, Piquero, et al., 2017). Given this mounting evidence, there is a need to better understand both ACE prevention efforts as well as factors that serve to protect ACE-exposed individuals from system involvement and ACE-exposed justice-involved individuals from deeper system penetration. The current study borrowed from public health research and demonstrated the ability of cumulative positive childhood experiences (PCEs) to mitigate the deleterious effect of ACE exposure on juvenile recidivism. We echo Bethell and colleagues (2019) in concluding “a joint inventory of ACEs and PCEs…may improve efforts to assess needs, target interventions, and engage individuals in addressing the adversities they face by leveraging existing assets and strengths” (p. 8). We encourage consideration of the inclusion of cumulative positive childhood experiences in future studies of the effects of maltreatment on antisocial and violent behavior.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Michael T. Baglivio

Kevin T. Wolff

Notes

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