Adverse Childhood Experiences, Traumatic Brain Injuries, and Modifying Effects of Parental Aggravation and Bullying-Victimization Among Children and Adolescents.

Previous research has shown an association between Adverse Childhood Experiences (ACEs) and traumatic brain injuries (TBIs). Our study seeks to assess the effect of parental aggravation and bullying-victimization on the association between ACEs and TBIs. The sample was 6-17-year-old participants in the 2019 National Survey of Children's Health (NSCH). Descriptive and multivariate analysis was conducted in SAS 9.4, to examine the association between ACEs and TBIs, and to test for effect modification by parental aggravation and bullying-victimization. Of 19,883 children, 1,188 had a TBI. About 23.0% of children had reported one ACE, followed by 10.3% with two ACEs, 6.1% with three ACEs, and 7.0% with four or more ACEs. Those with four or more ACEs were 1.79 times more likely to have experienced a TBI compared to those with zero ACEs (95% confidence interval () = 1.03-3.13,  = 0.04) in adjusted analysis. Those who experienced four or more ACEs and whose parents expressed more frequent aggravation had 2.73 times the odds of having had a TBI, compared to those with zero ACEs and rare parental aggravation. Additionally, those who had four or more ACEs and were victims of bullying were 2.68 times more likely to have experienced a TBI compared to those with zero ACEs. Intervention efforts to reduce parental aggravation and bullying-victimization among children and adolescents may mitigate the association between ACEs and TBIs. Further research is needed to understand the relationship between ACEs and TBIs, emphasizing the role of bullying involvement.