# Tipping the scales: the predictive utility of the PCE-ACE ratio for criminogenic and wellbeing outcomes in a general adult population

## TL;DR

This study shows that a balance between positive and adverse childhood experiences predicts better adult outcomes like reduced crime and mental health issues.

## Contribution

Introduces a novel PCE:ACE ratio to assess the balance of childhood experiences and its impact on adult outcomes.

## Key findings

- Higher PCE:ACE ratios were linked to lower odds of arrest, incarceration, and mental health issues.
- Low-ratio groups had the highest rates of adverse outcomes, even after adjusting for demographics and deprivation.
- The ratio offers a standardized way to assess developmental balance and public health outcomes.

## Abstract

Adverse Childhood Experiences (ACEs) and Positive Childhood Experiences (PCEs) are each independently associated with a range of adult outcomes, including mental health, substance use, and criminal justice involvement. However, few studies have examined how the balance between these experiences influences outcomes. This study explores the predictive utility of a PCE:ACE ratio. Unlike previous measures of resiliency and risk protection scales that treat risk and protective factors as parallel dimensions, the ratio is population-level heuristic intended to capture the relative balance of positive versus adverse experiences using a single relational metric. Using data from a representative sample of 1,203 adults in Northern Ireland, participants completed validated measures of 13 ACEs and 10 positive childhood experiences (PCEs) A weighted PCE:ACE ratio was calculated, and participants were categorised into high, moderate, or low ratio groups.

Findings showed that a higher ratio was significantly associated with reduced odds of arrest, incarceration, school exclusion, substance use, and mental health diagnosis, even after adjusting for age, gender, and deprivation. Those in the low-ratio group had the highest rates of adverse outcomes. While the ratio offers an intuitive and accessible framework for understanding developmental balance, limitations include the potential for oversimplification of distinct ACE-PCE profiles.

These findings support the feasibility of a ratio-based approach that standardises balance rather than the independent accumulation of risks and strengths, and suggests that a stronger balance of protective experiences may buffer the impact of adversity. Further research is needed to explore threshold effects and interaction dynamics. However, the ratio provides a useful metric and sound basis for capturing population health and the extent to which public investment is tipped in favour of positive or less positive outcomes.