Positive childhood experiences (PCEs) are associated with better mental and physical health outcomes and moderate the negative effects of adverse childhood experiences (ACEs). However, knowledge of the associations between PCEs and childhood chronic pain is limited. We conducted cross-sectional analysis of the 2019-2020 National Survey of Children’s Health (NSCH) to evaluate associations between PCEs and childhood chronic pain. Parents of 47,514 children ages 6-17 years old reported on their child’s exposure to seven PCEs and nine ACEs. Associations between PCEs and chronic pain were evaluated using weighted, multivariate logistic regression analyses adjusted for sociodemographic factors. We found that PCEs had dose-dependent associations with pediatric chronic pain; children exposed to higher numbers of PCEs (5-7 PCEs) had the lowest reported rate of chronic pain (7.1%), while children exposed to 2 or fewer PCEs had the highest rate of chronic pain (14.7%). Adjusted analysis confirmed that children experiencing 5-7 PCEs had significant lower odds of chronic pain relative to children experiencing 0-2 PCEs (adjusted odds ratio (aOR): 0.47, 95% confidence interval (CI): 0.39-0.61, p<0.0001). PCEs moderated associations between ACEs and chronic pain: among children reporting 2 or more ACEs, those reporting 5-7 PCEs were significantly less likely to report chronic pain as compared to children only reporting 0-2 PCEs (aOR: 0.64, 95%CI: 0.45-0.89, p=0.009). In conclusion, children with greater PCEs exposure had lower prevalence rates of chronic pain. Furthermore, PCEs was associated with reduced prevalence of chronic pain among children exposed to ACEs. PERSPECTIVE: This article estimates associations between survey-measured positive childhood experiences and pediatric chronic pain among children in the United States. Promoting positive childhood experiences could improve pediatric pain outcomes.
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