The association between adverse childhood experiences and adult traumatic brain injury/concussion: a scoping review

Abstract

Background: Adverse childhood experiences are significant risk factors for physical and mental illnesses in adulthood. Traumatic brain injury/concussion is a challenging condition where pre-injury factors may affect recovery. The association between childhood adversity and traumatic brain injury/concussion has not been previously reviewed. The research question addressed is: What is known from the existing literature about the association between adverse childhood experiences and traumatic brain injury/concussion in adults?

Methods: All original studies of any type published in English since 2007 on adverse childhood experiences and traumatic brain injury/concussion outcomes were included. The literature search was conducted in multiple electronic databases. Arksey and O’Malley and Levac et al.’s scoping review frameworks were used. Two reviewers independently completed screening and data abstraction.

Results: The review yielded six observational studies. Included studies were limited to incarcerated or homeless samples, and individuals at high-risk of or with mental illnesses. Across studies, methods for childhood adversity and traumatic brain injury/concussion assessment were heterogeneous.

Discussion: A positive association between adverse childhood experiences and traumatic brain injury occurrence was identified. The review highlights the importance of screening and treatment of adverse childhood experiences. Future research should extend to the general population and implications on injury recovery.

Implications for rehabilitation

• Exposure to adverse childhood experiences is associated with increased risk of traumatic brain injury.

• Specific types of adverse childhood experiences associated with risk of traumatic brain injury include childhood physical abuse, psychological abuse, household member incarceration, and household member drug abuse.

• Clinicians and researchers should inquire about adverse childhood experiences in all people with traumatic brain injury as pre-injury health conditions can affect recovery.

Keywords:

• Adverse childhood experiences
• abuse
• concussion
• traumatic brain injury
• scoping review

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

S.E.P. Munce has been supported by a Heart and Stroke Foundation of Canada Focus on Stroke Fellowship; Toronto Rehabilitation Institute–University Health Network; Canadian Institutes of Health Research Fellowship; and a European Stroke Research Foundation Investigator Award. Z. Ma has been supported by the Institute of Medical Sciences at the University of Toronto under the Summer Undergraduate Research Program; and by the University Health Network.