Adverse childhood experiences (ACEs) are associated with increased long-term mental and physical health risk, yet inter-individual variation indicates that resilience is possible. Distinct trajectories of sustained mental well-being have been observed among individuals exposed to ACEs, predicting favorable long-term outcomes. However, the biopsychosocial markers underpinning sustained trajectories of resilience remain poorly understood. This study aimed to identify factors that predict higher well-being (‘resilient’) trajectories over time in individuals with and without ACE exposure.

Previously identified 12-year well-being trajectory classes (higher vs. lower well-being) were examined in participants with no ACE history (n = 779) and those exposed to ACEs (n = 889). Logistic regression models were used to identify factors differentiating higher versus lower well-being trajectories in the non-ACE sample, and resilience versus risk trajectories in the ACE sample. Predictors included childhood adversity characteristics, genetic predisposition, demographic and environmental factors, social and occupational factors, health and lifestyle factors, and psychological functioning.

Across both samples, higher well-being was predicted by higher education, better subjective physical health, greater social engagement, stronger work performance, and adaptive personality traits (lower neuroticism and higher extraversion). In the non-ACE sample, polygenic well-being scores and family history of mental illness further differentiated trajectories. In contrast, resilience following ACEs was additionally characterized by modifiable factors, including parenting style, relationship status, BMI, and conscientiousness.

Resilience in the context of childhood adversity is defined by identifiable, largely modifiable social, health, and personality factors, highlighting potential targets for interventions to enhance long-term well-being.