Data from: A study of impulsivity and adverse childhood experiences in a population health setting

Importance: Complex mental health traits and life histories are not well
ascertained in a hospital system. Screening unselected populations using
the Barratt Impulsivity Scale and Adverse Childhood Experiences may be
useful predictive tools for assessing adult disease risks. 
Objective: Determine whether two standard self-assessments are predictive
of incidence and onset of disease. Design: Retrospective cohort study. All
participants answered the Healthy Nevada Project Behavioral and Mental
Health Questionnaire between September 2018 and March 2024. 
Setting: Large healthcare system in Northern Nevada. Participants:
All-comer adults in Healthy Nevada Project who answered Behavioral and
Mental Health Questionnaire. Exposure: Impulsivity levels computed via
Barratt’s Impulsivity Scale and retrospective self-reporting of Adverse
Childhood Experiences. Main Outcomes and Measures: Disease associations
with impulsivity and Adverse Childhood Experiences were evaluated using a
phenome-wide association study. Kaplan-Meier disease-free survival
estimates for major depressive disorder and essential hypertension
characterized differences in age of diagnosis between high and low
impulsivity.  Results: 17,482 Healthy Nevada Project participants
(51.54 [16.19] age at consent; 12,458 female [71.26%]) completed the
Behavioral and Mental Health Questionnaire. Adverse Childhood Experiences
were significantly associated with impulsivity. Phenome-wide analyses
revealed 230 significant associations (44 mental health diagnoses) with
impulsivity scores. Median disease-free survival was higher in
participants with Barratt Impulsivity Scales less than 33: 54.8
[53.5-56.0] years vs. 47.0 years [45.5- 48.8] for Major Depressive
Disorder; 60.9 [60.4-61.4] years vs. 53.7 years [52.8-54.6] for
hypertension. Participants with more than 3 Adverse Childhood Experiences
and greater impulsivity scores show a 13-year difference in median
disease-free survival compared to participants with low impulsivity and no
Adverse Childhood Experiences for essential hypertension and Major
Depressive Disorder. Conclusions and Relevance: High impulsivity scores
and Adverse Childhood Experiences are associated with many negative health
outcomes and together are predictive of age at diagnosis for disorders,
such as Major Depressive Disorder and essential hypertension. Simple
self-assessment of complex traits and life history can be used to impact
clinical risk assessments.