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Does binge drinking mediate the relationship between four adverse childhood experiences and adult traumatic brain injury? Results from the National Longitudinal Survey of Youth 1979 Cohort
  1. Jill Daugherty1,
  2. Sarah Treves-Kagan2,
  3. Nisha C Gottfredson3,
  4. Stephanie Miedema2,
  5. Juliet Haarbauer-Krupa1
  1. 1Division of Injury Prevention, National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  2. 2Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  3. 3Department of Health Behavior, University of North Carolina, Chapel Hill, North Carolina, USA
  1. Correspondence to Dr Jill Daugherty, Division of Injury Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; xdu1{at}cdc.gov

Abstract

Objective Adverse childhood experiences (ACEs) are associated with increased risk of sustaining a traumatic brain injury (TBI). Alcohol use may play an important role in this relationship. This study examines whether binge drinking mediates the relationship between four ACEs and TBIs sustained in adulthood.

Methods Using the National Longitudinal Survey of Youth, 1979 cohort, we conducted longitudinal mediation analyses (n=6317). Interviews occurred annually from 1979 to 1994 and biennially until 2016. We evaluated the direct and indirect effects of individual ACEs (ie, experiencing physical violence, low parental warmth, familial alcoholism and familial mental illness; reported retrospectively) and a cumulative ACEs score on mean level of binge drinking (calculated across waves) and having a TBI in adulthood. To establish temporality, we included binge drinking that was measured at age 18 or older and before any reported TBI.

Results Cumulative ACEs, familial alcoholism and physical abuse exposure were significantly associated with having a TBI through binge drinking, although this only explained a small part of the association between ACEs and TBI. Other ACEs were not significantly associated with binge drinking or TBI.

Conclusion The results indicate that while ACEs and adult TBI risk were significantly associated, lifetime binge drinking explains only a small part of the association. Future research could examine alternative social, biological and behavioural mechanisms along the pathway between ACEs and TBI. Determining this mechanism will allow public health practitioners to design and implement effective TBI prevention programmes for those at higher risk of injury due to ACE exposure.

  • Traumatic Brain Injury
  • Public Health
  • Longitudinal
  • Child
  • Alcohol

Data availability statement

Data are available in a public, open access repository. Data are publicly available.

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Data availability statement

Data are available in a public, open access repository. Data are publicly available.

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Footnotes

  • Contributors JD, ST-K and NCG designed the project; JD, SM and NCG developed the theoretical framework; ST-K and NCG performed the statistical analysis; JH-K supervised the project; all authors discussed the results and contributed to the final manuscript. JD is the guarantor of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.