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ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Mental Health
Volume 12 - 2024 |
doi: 10.3389/fpubh.2024.1447008
This article is part of the Research Topic Mental Health of Vulnerable Groups: Predictors, Mechanisms, and Interventions View all 9 articles
A Study of Impulsivity and Adverse Childhood Experiences in a Population Health Setting
Provisionally accepted- 1 School of Medicine, University of Nevada, Reno, Nevada, United States
- 2 University of Nevada, Reno, Reno, Nevada, United States
- 3 Renown Health, Reno, Nevada, United States
As complex mental health traits and life histories are often poorly captured in hospital systems, the utility of using the Barratt Impulsivity Scale (BIS) and Adverse Childhood Experiences (ACEs) for assessing adult disease risks is unknown. Here, we use participants from the Healthy Nevada Project (HNP) to determine if two standard selfassessments could predict the incidence and onset of disease. We conducted a retrospective cohort study involving adult participants who completed the Behavioral and Mental Health Self-Assessment (HDSA) between September 2018 and March 2024. Impulsivity levels were measured using the BIS-15, and retrospective self-reports of ACEs were collected through a standardized questionnaire. In total, 17,482 HNP participants completed the HDSA. Our findings indicate that ACEs were significantly associated with impulsivity. Disease associations with impulsivity and ACEs were evaluated using a phenome-wide association study, identifying 230 significant associations with impulsivity. Among these, 44 were related to mental health diagnoses, including major depressive disorder (MDD).Kaplan-Meier survival estimates characterized the differences in the lifetime predicted probability between high and low impulsivity for major depressive disorder and essential hypertension. This analysis showed that having both high ACEs and high impulsivity confer substantial risk of MDD diagnosis (hazard ratios 2.81, 2.17, respectively).Additionally, lifetime predicted probability of MDD was approximately 40% higher for high ACEs and high impulsivity compared to no ACEs and low impulsivity. Essential hypertension demonstrated similar trends, with an approximate 20% increase in predicted lifetime probability of diagnosis. These results demonstrate that high ACES and elevated impulsivity scores are associated with a range of negative health outcomes and a simple selfassessment of complex traits and life history may significantly impact clinical risk assessments.
Keywords: public mental health, impulsivity, Adverse childhood experiences, social determinants of health, PheWAS, Kaplan-Meier Analyses
Received: 10 Jun 2024; Accepted: 15 Nov 2024.
Copyright: © 2024 Read, Schlauch, Elhanan, Neveux, Koning and Grzymski. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Gai Elhanan, School of Medicine, University of Nevada, Reno, 89557, Nevada, United States
Iva Neveux, School of Medicine, University of Nevada, Reno, 89557, Nevada, United States
Joseph J Grzymski, School of Medicine, University of Nevada, Reno, 89557, Nevada, United States
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