Instruments
Dr. Angela Narayan and the PROTECT Lab have developed several clinical research instruments designed to fill gaps in the literature on brief, effective and culturally-sensitive assessment of adults’ retrospectively-reported positive childhood experiences (PCEs).
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- The Centeredness Scale is intended to help researchers and providers assess the emotional atmosphere of the most formative childhood family environment, including the relationships that the target individual had with his/her/their primary caregivers and among the members of that household.
These instruments are described more below and are publicly available. Please see links to the relevant publications for scale items and contact Dr. Narayan (Angela.Narayan@du.edu) with requests for PDFs of the ready-to-use instruments.
The Benevolent Childhood Experiences (BCEs) Scale
The Benevolent Childhood Experiences (BCEs) scale is a brief, well-validated, published instrument that assesses adults’ retrospective reports of positive childhood experiences. The BCEs scale was originally developed to be a counterpart to the 10-item adverse childhood experiences (ACEs scale) disseminated by the Centers for Disease Control and Prevention (CDC; Felitti et al., 1998).
The first BCEs scale (BCEs-Original) included 10 items on relational resources (with safe caregivers, close friends, teachers, neighbors, and non-parental caregivers) and experiences reflecting a positive and predictable quality of life (e.g., strong core beliefs, positive self-esteem, regular home routines). All 10 items were intended to be culturally sensitive and reflect positive experiences, relationships, and resources that could apply to individuals who grew up in developing as well as developed regions of the world and were not heavily contingent on socioeconomic status.
Positively-reported items are summed for a total BCE score. Indeed, the psychometric pilot study of the BCEs scale found that mean levels of total BCEs did not significantly differ between individuals who a) identified as White versus Black versus Latinx; b) were English speaking versus monolingual Spanish speaking; or c) were born in the U.S. or were foreign born (Narayan et al., 2018; Child Abuse & Neglect).
Research in the past five years since the original BCEs study has shown that the BCEs-Original scale is widely used around the world. A recent systematic review of the effects of PCEs and childhood adversity on adult outcomes found that two-thirds of all studies on PCEs conducted in the United States and two-thirds of all studies on PCEs conducted outside the U.S. have used the BCEs scale (Han et al., 2023; Child Abuse & Neglect). The BCEs scale is currently translated into more than 10 languages: Chinese, Finnish, French Canadian, Hebrew, Italian, Japanese, Lithuanian, Norwegian, Portuguese, Spanish, and Turkish).
The PROTECT Lab recently developed and published an expanded 20-item BCEs scale, which includes the 10 original items plus 10 additional items (Narayan et al., 2023; Development and Psychopathology). These additional items include physical and health resources of childhood (e.g., adequate medical care, nutritious food, and sleep quality), public safety factors (e.g., adequate law enforcement), and environmental resources (e.g., time outdoors), in addition to other positive childhood experiences not captured on the BCEs-Original scale.
The purpose of expanding the original BCEs scale was twofold: to develop more comprehensive BCE items and to identify specific items that may increase scale variability. Indeed, across six samples that varied in racial/ethnic composition, socioeconomic strain, and history of childhood adversity, 10 items from the 20-item scale were found to be “less commonly reported” across all samples.
When we created a composite of these 10 “less-commonly-reported items,” this total BCEs score (termed “BCEs Revised”) was significantly more strongly associated with young adults’ current depression, anxiety and PTSD symptoms compared to associations between BCEs-Original total scores and these three mental health problems. Therefore, composite scores from the total BCEs-Revised scale may capture slightly but significantly more variability in adulthood mental health than composite scores from the total BCEs-Original scale.
Similar to total scores on the BCEs-Original scale, total scores on the BCEs-Revised scale did not show significant mean differences between individuals who identified as White versus Black versus Latinx versus Asian.
There are now three versions of the BCEs scale (the BCEs-Original scale, the BCEs-20 scale, and the BCEs-Revised scale), all of which have several unique advantages.
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BCEs-Original Scale
The BCEs-Original scale currently has the strongest research support because it has been included in research studies around the world for the past five years and is translated into many languages. Although the BCEs-Revised scale may be associated with significantly more variance in some adult outcomes, the BCEs-Original scale still significantly predicted the same adult outcomes after accounting for individuals’ childhood adversity. The BCEs-Original scale also has several items that most individuals are highly likely to report as being present in their childhoods (items #1, 2, 5, and 8). For use in clinical work and community mental health, providers can be confident that most individuals will positively report these items. The BCEs-Original scale is extremely brief to administer and can be completed in less than five minutes. Check out the 10 BCEs-Original items in the paper "Positive childhood experiences predict less psychopathology and stress in pregnant women with childhood adversity: A pilot study of the benevolent childhood experiences (BCEs) scale".
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BCEs-20 Scale
The BCEs-20 scale is the most comprehensive version. It contains a mix of items that most individuals are highly likely to report as being present in their childhoods (items #1, 2, 5, 8, 12, 14, 15, 17, 18, and 20) and items that are less commonly present (#3, 4, 6, 7, 9, 10, 11, 13, 16, and 19). The BCEs-20 scale is brief to administer and can be completed in approximately five minutes. If research or clinical and community work allow for this time, it is recommended that investigators and providers use the BCEs-20 scale because it will generate the most comprehensive understanding of individuals’ BCEs. You can find all 20 BCE items in the paper "A multisystem, dimensional interplay of assets versus adversities: Revised benevolent childhood experiences (BCEs) in the context of childhood maltreatment, threat, and deprivation."
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BCEs-Revised Scale
The BCEs-Revised Scale includes only the 10 least commonly reported items (#3, 4, 6, 7, 9, 10, 11, 13, 16, and 19). The advantages of only using the BCEs-Revised subset are that it takes slightly less time to administer than the full BCEs-20 scale. Also, for research purposes, item frequencies and total scores on the BCEs-Revised scale will likely show greater variability than item frequencies and total scores on the BCEs-Original scale because all of the BCEs-Revised items have been found to be less commonly reported (at rates between 50%-80% but not usually higher) across several samples. The 10 items on the BCEs-Revised scale are part of the BCEs-20 scale published in the paper "A multisystem, dimensional interplay of assets versus adversities: Revised benevolent childhood experiences (BCEs) in the context of childhood maltreatment, threat, and deprivation."
If you have questions about the BCEs scales, or you would like to request a specific translation, or perform a new translation on the BCEs scales, please email the developer, Dr. Angela Narayan, at Angela.Narayan@du.edu.
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All BCEs publications (most recent first) from the PROTECT Lab and our collaborators
- Han, D., Dieujuste, N., Doom, J. R., & Narayan, A. J. (in press). A systematic review of positive childhood experiences and adult outcomes: Promotive and protective processes for resilience in the context of childhood adversity. Child Abuse & Neglect. doi: https://doi.org/10.1016/j.chiabu.2023.106346
- Narayan, A. J., Merrick, J. S., Lane, A. S., & Larson, M. D. (2023). Dimensional interplay of assets versus adversities: Revised benevolent childhood experiences (BCEs) in the context of childhood maltreatment, threat, and deprivation. Development and Psychopathology. https://doi.org/10.1017/S0954579423000536
- Clark, H. M., Hankin, B. L., Narayan, A. J., & Davis, E. P. (2023 online). Risk and resilience factors for psychopathology during pregnancy: An application of the Hierarchical Taxonomy of Psychopathology (HiTOP). Development and Psychopathology. https://doi/org/10.1017/S0954579422001390
- Nevarez-Brewster, M., Aran, O., Narayan, A. J., Harrall, K. K., Brown, S. M., Hankin, B. L., & Davis, E. P. (2022). Adverse and benevolent childhood experiences predict prenatal sleep quality. Adversity and Resilience Science, 3, 391-402. https://doi.org/10.1007/s42844-022-00070-0
- Doom, J. R., Seok, D., Narayan, A. J., & Fox, K. R. (2021). Adverse and benevolent childhood experiences predict mental health during the COVID-19 pandemic. Adversity and Resilience Science, 2, 193-204. https://doi.org/10.1007/s42844-021-00038-6
- Merrick, J. S., & Narayan, A. J. (2020). Assessment and screening of positive childhood experiences along with childhood adversity in research, practice, and policy. Journal of Children and Poverty, 26, 269-281. https://doi.org/10.1080/10796126.2020.1799338
- Narayan, A. J., Atzl, V. M., Merrick, J. M., Harris, W. W., & Lieberman, A. F. (2020). Developmental origins of ghosts and angels in the nursery: Adverse and benevolent childhood experiences. Adversity and Resilience Science, 1, 121-134. https://doi.org/10.1007/s42844-020-00008-4
- Merrick, J. S., Narayan, A. J., Atzl, V. M., Harris, W. W., & Lieberman, A. F. (2020). Type versus timing of adverse and benevolent childhood experiences for pregnant women’s psychological and reproductive health. Children and Youth Services Review, 114, 1-11. https://doi.org/10.1016/j.childyouth.2020.105056
- Narayan, A. J., Atzl, V. M., Merrick, J. S., River, L. M., & Peña, R. (2019). Therapeutic perinatal research with low-income families: Leveraging Benevolent Childhood Experiences (BCEs) and fathers’ perspectives to promote resilience. ZERO TO THREE Journal, 39, 43-53.
- Merrick, J. S., Narayan, A. J., DePasquale, C. E., & Masten, A. S. (2019). Benevolent childhood experiences (BCEs) in homeless parents: A validation and replication study. Journal of Family Psychology, 33, 493-498. https://doi.org/10.1037/fam0000521
- Narayan, A. J., Rivera, L. M., Bernstein, R. E., Harris, W. W., & Lieberman, A. F. (2018). Positive childhood experiences predict less psychopathology and stress in pregnant women with childhood adversity: A pilot study of the benevolent childhood experiences (BCEs) scale. Child Abuse and Neglect, 78, 19-30. https://doi.org/10.1016/j.chiabu.2017.09.022
- Narayan, A. J., Rivera, L. M., Bernstein, R. E., Castro, G., Gantt, T., Thomas, M., Nau, M., Harris, W. W., & Lieberman, A. F. (2017). Between pregnancy and motherhood: Identifying unmet mental health needs in pregnant women with lifetime adversity. ZERO TO THREE Journal, 37, 4-13.
The Centeredness Scale
The Centeredness scale is a brief published instrument that assesses adults’ retrospective reports of the emotional atmosphere of their predominant home environment from birth to age 18 years.
The Centeredness Scale contains 20 items on five-point Likert scales. The first nine questions assesses whether the target individual perceived qualities of supportiveness, acceptance, and belongingness among all members that made up the predominant childhood household. The latter 11 questions then assess whether the individual perceived these qualities specifically from their primary caregiver(s).
Advantages of the Centeredness scale over other existing instruments are that the Centeredness scale flexibly accommodates diverse childhood family structures and compositions [e.g., caregiving systems in which the primary caregiver(s) might not have been the biological parent(s) and households with any number of family members. All 20 items use five-point Likert scales, and overall Centeredness scores, ranging from 20-100, are generated by summing responses (with some items first reverse-scored).
The initial psychometric study on the Centeredness scale was conducted in two samples (a test sample and a replication sample). The first sample of 548 U.S. young adults participated before the COVID-19 pandemic, and the second sample of 1,198 U.S. young adults participated during the COVID-19 pandemic.
- In both samples, mean levels of overall Centeredness did not differ between young adults who identified as White versus Black versus Latinx versus Asian.
- In both samples, Centeredness significantly predicted the broadest range of outcomes (depression symptoms, suicidal thoughts and behaviors, anxiety symptoms, aggressive behavior, life satisfaction, and a dimensional composite of each individual outcome).
The BCEs-Original scale predicted five of six outcomes in the test sample, and all six outcomes in the replication sample. Neither childhood adversity nor attachment-related anxiety or avoidance predicted as many outcomes.
Findings indicated that the Centeredness scale and the BCEs-Original scale may be broader predictors of young adulthood wellbeing then childhood adversity or attachment-related problems. These findings and all Centeredness items are available in the paper "Childhood Centeredness is a Broader Predictor of Young Adulthood Mental Health than Childhood Adversity, Attachment, and Other Positive Childhood Experiences."