Considering the associations of adverse and positive childhood experiences with health behaviors and outcomes among emerging adults

•This study focuses on a sample of college students who engage in hazardous substance use to understand how ACEs and PCEs impact health during the critical developmental stage of emerging adulthood.•ACEs are associated with increased cannabis use.•PCEs were associated with reduced pain intensity and interference.•moderated the effects of ACEs on alcohol use and sleep-related impairment.•The results suggest that PCEs may be unlikely to serve as a strong enough protective factor in early life to decrease risk for suboptimal health and health behaviors, particularly in the transition to young adulthood, among individuals who report a greater accumulation of ACEs. Childhood is a sensitive period of development during which early life experiences can facilitate either positive or negative health trajectories across subsequent developmental periods. Previous research has established strong links between adverse childhood experiences (ACEs) and adverse health outcomes (e.g., sleep-related problems, pain, substance use). Despite this, less is known about positive childhood experiences (PCEs) and how they may buffer the effects of ACEs on health outcomes. The current study investigated whether PCEs moderate the associations between ACEs and health behavior and health-related outcomes (i.e., cannabis use, alcohol use, sleep disturbance, sleep-related impairment, pain intensity, and pain interference) in a sample of at-risk emerging adults. Participants (N = 165) were undergraduate college students (18–25 years of age) who reported frequent alcohol and/or cannabis use (≥3 times in the past week). A significant positive association was found between ACEs and cannabis use. There were also significant negative associations found between PCEs and pain interference and intensity. PCEs did not moderate any of the associations between ACEs and health behavior and health-related outcomes (i.e., cannabis use, alcohol use, sleep disturbance, sleep-related impairment, pain intensity, and pain interference). Findings suggest that PCEs may be unlikely to serve as a strong enough protective factor during early life to decrease risk for suboptimal health and health behaviors during emerging adulthood among individuals who report a greater accumulation of ACEs. Longitudinal research is needed to identify additional related risk and protective factors during early life to further support health and health behavior during this transitional period of development and beyond.