Network analysis of adverse and positive childhood experiences in a national sample of university students

Background: Adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) often co-occur and interact to exert long lasting impacts on health and other outcomes. However, current analytical approaches fall short in exploring the complex interplay between ACEs and PCEs, particularly within non-Western contexts. Objective: This study used network analysis to examine the complexity and interplay of ACEs and PCEs in a large sample of Chinese young adults. Methods: Leveraging data collected from 9468 Chinese university students through online surveys between August and November 2020, we examined ACE items (n = 6458), PCE items (n = 9249), and ACE x PCE items combined (n = 6365) for this study. ACEs were assessed using the Chinese version of the WHO ACE-International Questionnaire, while PCEs were measured using the Chinese Positive Childhood Experiences Scale. We first conducted zero-order tetrachoric correlation analysis, followed by network estimation using the Ising model with the eLasso method. We visualized the networks using the plot function from the IsingFit R package. Network communities were detected using the Walktrap algorithm, and network sensitivity and stability were assessed. Results: Network analysis revealed a high degree of connectivity within both ACEs and PCEs networks. Emotional abuse and household violence emerged as central nodes in the ACEs network, while family support and having a harmonious family environment were central in the PCEs network. The combined ACEs x PCEs network highlighted significant inverse associations between specific adverse and positive experiences, with emotional neglect closely linked with an inability to talk about feelings with family. The Walktrap algorithm identified distinct clusters within the networks, such as abuse and household dysfunction in the ACEs network, and family support and positive school experiences in the PCEs network. Conclusions: Our findings confirm that ACEs and PCEs tend to co-occur and demonstrate that network analysis can elucidate their complex and intertwined nature. The findings suggest the need for culturally sensitive interventions that address both ACEs and PCEs to promote resilience and well-being in Chinese young adults.