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66 The contribution of adverse childhood experiences to post-injury psychological outcomes in urban black men in the US
  1. S Richmond Therese1,
  2. Nancy Kassam Adams2,
  3. Douglas Wiebe1,
  4. John Rich3,
  5. Patrick Reilly1,
  6. Justine Shults1
  1. 1University of Pennsylvania, USA
  2. 2Children's Hospital of Philadelphia, USA
  3. 3Drexel University, USA

Abstract

Statement of purpose To examine whether adverse childhood experiences (ACEs) contribute to severity of PTSD and depression symptoms after recent serious injury in Black men.

Methods/approach Injured Black adult men were consecutively enrolled during hospitalisation for an acute, serious injury. Baseline data, including demographics and injury-related characteristics, were collected during interviews conducted in hospital. A questionnaire assessed whether seven Adverse Childhood Experiences had been experienced prior to the age of 18 years. Primary outcomes were collected at 3 months post-discharge during an in-person interview using the PTSD Checklist (PCL-C) for PTSD symptom severity and the Quick Inventory of Depressive Symptoms-Self Report (QID-SR) for depression symptom severity.

Results 231 men (mean age = 37 years, SD = 15.8) were included in this analysis. Injury was classified as unintentional (52%) or intentional (48%, i.e. the result of interpersonal violence). Mean number of ACEs was 2.51; 83% reported at least 1 ACE and 37.7% reported >4. No association was found between number of ACEs and whether the index injury was intentional versus unintentional. Intentional injuries were associated with higher mean PCL-C scores (42.8 vs. 33.6, p < 0.0001) and higher mean QID-SR scores (10.0 vs. 8.0, p < 0.01). In adjusted multiple regression, younger age, intentional injury, and number of ACEs were independently associated with higher PCL-C scores. Intentional injury and number of ACEs were independently associated with higher QID-SR scores.

Conclusions This sample of urban Black men reported substantial histories of childhood trauma and adversity. There is a dose response relationship with higher numbers of ACEs contributing to more severe symptoms of PTSD and depression after serious traumatic injury.

Significance and contributions To improve outcomes after serious injury in urban Black men, previous trauma histories should be obtained and drive care practices that are trauma-informed. Funder: NINR R01NR013503

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