Adverse childhood experiences are associated with intimate partner violence-related head and neck injuries and symptom burden among adult women

Abstract Adverse childhood experiences (ACEs) are a well-established risk factor for adult intimate partner violence (IPV) victimisation and traumatic brain injuries (TBI), but their relationship with IPV-related brain injury remains unclear. This retrospective cross-sectional study examined the associations between ACEs and subtypes (physical/sexual abuse, emotional abuse/neglect, family adversities, and witnessing domestic violence) on IPV-related head and neck injuries (mild TBI, head impacts, and non-fatal strangulation; NFS), as well as brain injury symptom burden among 170 community-dwelling women (aged 18–75 years). Participants completed the ACE questionnaire, Composite Abuse Scale, Brain Injury Screening Questionnaire (IPV module), and the Rivermead Post-concussion Questionnaire. Family adversities (59%) and emotional abuse/ neglect (54%) were the most prevalent ACE subtypes. Over 40% reported an IPV-related head impact, 27% reported IPV-related mild TBI, and 28% reported NFS experiences. Higher ACE scores increased the odds of IPV-related mild TBI, head impacts, NFS, and NFS-related brain injury (ORs 1.22–1.32). Associations between ACEs and symptom severity were no longer significant after controlling for PTSD, depression, and IPV recency, with a substantial amount of the variance accounted for by co-occurring PTSD. These findings highlight ACEs as an important upstream risk factor for IPV injury, which is critical for prevention, early identification, and policy.