Adverse childhood experiences in adults with chronic traumatic brain injury: Support for a life course approach to brain injury rehabilitation

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal Pub Date : 2025-01-01 DOI:10.1016/j.dhjo.2024.101714

Umesh M. Venkatesan PhD , Shannon B. Juengst PhD

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引用次数: 0

Abstract

Background

Adverse childhood experiences (ACEs) confer greater risk for adult traumatic brain injury (TBI), but little is known about their effects on post-injury outcomes.

Objective

To determine the prevalence and correlates of conventionally defined ACEs (occurring within household/in private; e.g., physical abuse) and community-level ACEs (e.g., bullying) after TBI.

Methods

Participants were 85 Philadelphia-area TBI Model System participants with chronic (>1 year post-injury) TBI. We examined cross-sectional associations between total conventional and community ACEs reported (out of 21) before age 18, mental health symptoms, and health-related quality of life (HRQoL), as well as relationships between ACEs and neighborhood deprivation (census-derived neighborhood socioeconomic status).

Results

The median number of total ACEs was 3 (range: 0–17). Emotional abuse, physical abuse, and alcohol abuse in the household were the most common conventional ACEs (each at 36.5 %). Witnessing violence (45 %) was the most common community ACE. Black individuals (n = 32) reported more community ACEs (p < .001) than White individuals (n = 45). Community ACEs were significantly associated with greater neighborhood deprivation, though this relationship was confounded by race. Total ACEs was significantly related to more severe mental health symptoms (p < .001) and poorer HRQoL (p = .005), even after covariate adjustment. A fully-adjusted path model supported mental health as a mediator between total ACEs and HRQoL.

Conclusions

Results of this preliminary study reveal an appreciable prevalence and potential far-reaching consequences of conventional and community ACEs among those with chronic TBI. The results underscore the value of trauma-informed and life course approaches to research and clinical care in TBI.

查看原文本刊更多论文

慢性脑外伤成人的不良童年经历：支持脑损伤康复的生命过程方法。

背景：童年不良经历（ACEs）会增加成人创伤性脑损伤（TBI）的风险，但人们对其对伤后结果的影响知之甚少：目标：确定创伤性脑损伤后传统定义的 ACE（发生在家庭/私人内部；如身体虐待）和社区层面的 ACE（如欺凌）的发生率和相关性：参与者为费城地区 TBI 模型系统的 85 名慢性（受伤后 1 年以上）TBI 患者。我们研究了 18 岁前报告的常规和社区 ACE（共 21 项）总数、心理健康症状和健康相关生活质量（HRQoL）之间的横截面关联，以及 ACE 与邻里贫困（人口普查得出的邻里社会经济状况）之间的关系：ACE总数的中位数为3（范围：0-17）。家庭中最常见的传统 ACE 是情感虐待、身体虐待和酗酒（各占 36.5%）。目睹暴力（45%）是最常见的社区 ACE。黑人（n = 32）报告了更多的社区 ACE（p 结论：黑人报告的社区 ACE 更多：这项初步研究的结果显示，在慢性创伤性脑损伤患者中，传统和社区 ACE 的发生率相当高，并可能产生深远的影响。这些结果凸显了创伤知情和生命历程方法在创伤性脑损伤研究和临床治疗中的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Disability and Health Journal HEALTH CARE SCIENCES & SERVICES-PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

CiteScore

7.50

自引率

6.70%

发文量

134

审稿时长

34 days

期刊介绍： Disability and Health Journal is a scientific, scholarly, and multidisciplinary journal for reporting original contributions that advance knowledge in disability and health. Topics may be related to global health, quality of life, and specific health conditions as they relate to disability. Such contributions include: • Reports of empirical research on the characteristics of persons with disabilities, environment, health outcomes, and determinants of health • Reports of empirical research on the Systematic or other evidence-based reviews and tightly conceived theoretical interpretations of research literature • Reports of empirical research on the Evaluative research on new interventions, technologies, and programs • Reports of empirical research on the Reports on issues or policies affecting the health and/or quality of life for persons with disabilities, using a scientific base.