Childhood Maltreatment and Patterns of Lifetime Traumatic Brain Injury: A Latent Profile Analysis

Traumatic brain injury (TBI) is a major public health concern associated with long-term cognitive, behavioral, and emotional consequences. Although prior research has examined links between childhood maltreatment and TBI, findings have been inconsistent, and binary indicators may not capture heterogeneity in injury severity and frequency. The current study has three research questions: (1) Does childhood maltreatment increase risk for TBI? (2) Are there distinct profiles of lifetime TBI exposure among individuals with TBI? and (3) Do childhood maltreatment and other risk factors predict membership in specific TBI profiles compared to individuals without TBI? In a prospective cohort design study, individuals with documented childhood maltreatment (ages 0–11 years) and a matched control group were interviewed during 1989–1995 ( N = 1196, M _age = 29), 2000–2002 ( N = 896, M _age = 40), and 2022–2023 ( N = 447, M _age = 59). Participants completed the Ohio State University TBI Identification Method at the last interview. Latent profile analysis revealed four distinct profiles among individuals with TBI ( N = 220): Mild TBI without Loss of Consciousness (LOC) ( n = 114, 51.8%), High-Frequency Mild TBI ( n = 19, 8.6%), Mild-to-Moderate TBI with LOC ( n = 71, 32.3%), and Severe TBI with LOC ( n = 16, 7.3%). Multinomial logistic regressions compared each TBI profile to the no-TBI group and examined predictors of profile membership. Childhood maltreatment was associated with increased likelihood of membership in the High-Frequency Mild TBI profile. Alcohol and drug use symptoms, antisocial personality, psychopathy, and lifetime traumas and victimizations experiences predicted profile membership relative to the no-TBI group. Findings revealed subgroups often obscured by single event classifications and suggest that childhood maltreatment may be associated with repeated mild injuries rather than isolated or severe injuries alone.