Associations between adverse childhood experiences and acquired brain injury, including traumatic brain injuries, among adults: 2014 BRFSS North Carolina.

Adverse childhood experiences (ACEs) can negatively affect lifelong health and opportunity. Acquired brain injury (ABI), which includes traumatic brain injury (TBI) as well as other causes of brain injury, is a health condition that affects millions annually. The present study uses data from the 2014 North Carolina Behavioral Risk Factor Surveillance System to examine the relationship between ACEs and ABI. The study sample included 3454 participants who completed questions on both ABI and ACEs. Multivariable logistic regression models were used to determine the relationship between ACEs and ABI as well as ACEs and TBI. Sexual abuse, emotional abuse, physical abuse, household mental illness and household substance abuse were significantly associated with ABI after adjusting for age, race/ethnicity, gender and employment. Compared with those reporting no ACEs, individuals reporting three ACEs had 2.55 times the odds of having experienced an ABI; individuals reporting four or more ACEs had 3.51 times the odds of having experienced an ABI. Examining TBI separately, those who experienced sexual abuse, physical abuse, household mental illness and had incarcerated household members in childhood had greater odds of reported TBI, after adjusting for age, race/ethnicity, gender and income. Respondents reporting three ACEs (AOR=4.16, 95% CI (1.47 to 11.76)) and four or more ACEs (AOR=3.39, 95% CI (1.45 to 7.90)) had significantly greater odds of reporting TBI than respondents with zero ACEs. Prevention of early adversity may reduce the incidence of ABI; however, additional research is required to elucidate the potential pathways from ACEs to ABI, and vice versa. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.