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Child Abuse Negl. 2017 Aug;70:240-246. doi: 10.1016/j.chiabu.2017.06.016. Epub 2017 Jun 21.

Adverse family experiences and flourishing amongst children ages 6-17 years: 2011/12 National Survey of Children's Health.

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Yale School of Public Health, Department of Chronic Disease Epidemiology, New Haven, CT, USA; Laboratory of Epidemiology and Public Health, 60 College St., New Haven, CT, 06510, USA. Electronic address:
Division of Reproductive Health, Centers for Disease Control and Prevention, Family Health Services Division, Hawaii Department of Health, Honolulu, HI, USA; Hawaii Department of Health, Family Health Services Division, 714-A Sunset Ave, Room 109, Honolulu, HI 96816, USA. Electronic address:


Adverse Childhood Experiences (ACEs) are prevalent in the population and linked to various negative long-term health and social consequences. However, due to the retrospective nature of most studies on the topic, little is currently known regarding ACEs' immediate health impact. This study aims to provide insight into this area by examining the association between a new measurement, Adverse Family Experiences (AFEs), and flourishing amongst children ages 6-17 years in the United States. Data from the 2011/12 National Survey of Children's Health were analyzed. Adjusted prevalence ratios assessed flourishing by the number of AFEs (0 events versus 1, 2, 3/3+) controlling for individual/household characteristics. A sub-analysis examined characteristics of flourishing children ages 12-17 years with 3/3+ AFEs. The results showed children with 1 AFE (APR=0.87; 95% CI=0.83-0.91), 2 AFEs (0.74; 0.69-0.79), and 3/3+ AFEs (0.68; 0.62-0.72) were less likely to flourish compared to those without any AFEs. Sub-analysis of children ages 12-17 years with 3/3+ AFEs revealed a higher proportion of flourishing children volunteering, participating in extracurricular activities, and working for pay compared to those who did not flourish. Findings show significant differences in flourishing by number of AFEs and suggest that social connectedness may play a role in determining flourishing amongst children with 3/3+ AFEs. Furthermore, the results highlight the potential importance of identifying children with high AFE counts and helping them build resilience outside of the home.


2011/12 National Survey of Children's Health; Adverse childhood experiences (ACEs); Adverse family experiences (AFEs); Flourishing

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