Positively Powerful: A Scoping Review Exploring the Connection between Positive Childhood Experiences and Mental Health Outcomes in Children and Adolescents

Background: Positive Childhood Experiences (PCEs) occur when children are provided with safe, stable, and nurturing relationships and environments. Unlike Adverse Childhood Experiences (ACEs), which focus on deficits, PCEs emphasize and build on the strengths of individuals, families, and communities. The Healthy Outcomes from Positive Experiences (HOPE) conceptual model categorizes PCEs into four areas: nurturing and supportive relationships, safe and stable environments, opportunities for constructive social engagement that foster a sense of connectedness, and the development of social and emotional competencies. Whereas PCEs have been linked to better physical, emotional, and relational health in adulthood, fewer studies have investigated shorter-term connections between PCEs and the mental health of children and adolescents. This scoping review aims to address an existing research gap by addressing how PCEs influence the mental health outcomes of children and adolescents. Specifically, the study sought to answer the following research question: Do Positive Childhood Experiences (PCEs) improve mental health outcomes in children and adolescents?

Methods: To answer the research questions and contribute to the growing body of PCE research, an iterative scoping review was conducted. The review followed the methodological framework outlined by Arksey & O’Malley (2007) and refined by Colquhoun et al. (2014). The scoping review also followed the extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) guidelines to increase validity and replicability (Tricco, n.d). Covidence was utilized for screening and examining studies that focused on PCEs and their association with child and adolescent mental health outcomes. The review included peer-reviewed research articles published between 2015-2025 utilizing a variety of study designs. Studies were selected based on specific inclusion criteria. Data from selected studies were extracted and analyzed; findings were summarized to address the research questions.

Results: Through the search of six databases, 111 peer-reviewed articles were identified and screened. 152 duplicates were removed. 28 remained for the full-text review, and 18 met all inclusion criteria. All included articles were quantitative studies. Following data extraction and synthesis of the literature, the majority of the studies reported a positive association between PCEs and better mental health outcomes. Multiple articles found that PCEs mitigated the effects of ACEs in children and adolescents. Reviewed articles recommended a continued focus and promotion of PCEs to improve mental health outcomes among children and adolescents.

Conclusions and Implications These findings speak to the importance of promoting positive experiences during childhood as an important strategy to address the growing mental health challenges among children and youth. When experiencing PCEs, children and adolescents have a greater opportunity to develop strong emotional, social, and relational foundations that promote flourishing and future health. Implications for practice include the integration of PCE knowledge into schools and community-based programs serving children and youth. Results suggest that policymakers should invest in early childhood initiatives that focus on building supportive environments and relationships, preventing ACEs. Further research is needed to explore the long-term effects of PCEs across generations, within various cultural contexts and groups, and to identify the most effective interventions that promote PCEs across systems.