A systematic review of positive childhood experiences and adult outcomes: Promotive and protective processes for resilience in the context of childhood adversity

Background: Research on positive childhood experiences (PCEs) as counterparts to childhood adversity has surged in the last five years. A systematic review of the additive and interactive effects of childhood adversity and PCEs across adult outcomes is needed that contextualizes the long-term correlates of childhood experiences within a developmental perspective. Objective: The current review synthesizes the empirical evidence for PCEs as resilience factors for a range of adult outcomes. Methods: Articles published until May 2023 were systematically identified according to PRISMA Guidelines through PubMed and PsycINFO databases and references of included articles. Then, 131 records were screened, and 58 studies were included. Results: Higher levels of PCEs were significantly but modestly associated with lower levels of childhood adversity. Higher levels of PCEs were associated with outcomes reflecting mental health, psychosocial functioning, physical health and health behaviors, and psychosocial stress. Most studies found direct, promotive effects of PCEs for more favorable outcomes. Few studies found significant interaction effects between childhood adversity and PCEs on outcomes, suggesting that PCEs may more frequently directly promote positive outcomes rather than moderate the effects of adversity on outcomes. Conclusions: Individuals' childhood adversity and PCEs are somewhat independent sets of experiences; many individuals experience both, and the presence of one does not preclude the other. PCEs predict more favorable outcomes independent of childhood adversity more often than they interact with and moderate the effects of adversity on outcomes. Although the literature base is steadily growing, more research on PCEs in diverse and international samples is needed.