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Family and community positive childhood experiences and mental health from childhood to adolescence: Independent and cumulative associations

European Child & Adolescent Psychiatry

Published online on

Abstract

{"p"=>"Childhood mental and behavioral health problems have increased in recent years in the United States, yet limited research has examined how positive childhood experiences (PCEs) across family and community contexts are associated with mental health across development. Using data from 68,000 children aged 6—17 years in the 2022–2023 National Survey of Children’s Health, this study assessed whether Family- and community-level PCEs were independently and cumulatively associated with depression, anxiety, and behavioral problems. Family and community PCEs were categorized as low, moderate, or high. Weighted logistic regression models estimated associations with mental and behavioral health outcomes, with and without adjustment for adverse childhood experiences (ACEs) and sociodemographic characteristics. Predicted probabilities were calculated to evaluate cumulative patterns across contexts. Low family PCEs were associated with higher odds of depression (AOR = 1.53; 95% CI, 1.25–1.89), anxiety (AOR = 1.25; 95% CI, 1.05–1.48), and behavioral problems (AOR = 1.65; 95% CI, 1.36–2.09), and low community PCEs showed similar associations across outcomes. These associations remained robust after adjustment for ACEs and sociodemographic factors. Although interaction effects were small, predicted probabilities revealed a clear cumulative pattern, with the lowest risk observed when both family and community PCEs were high. Findings suggest that family and community PCEs were each independently associated with mental and behavioral health outcomes, and predicted probabilities revealed a cumulative pattern across PCE domains. These findings underscore the importance of supporting both family and community environments, as each context showed independent associations with depression, anxiety, and behavioral problems across developmental stages, highlighting the value of multilevel approaches to support child and adolescent mental and behavioral health."}