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Objectives To examine if, and to what extent, a history of adverse childhood experiences (ACEs) combines with adult alcohol consumption to predict recent violence perpetration and victimisation.Design Representative face-to-face survey (n=12 669) delivered using computer-assisted personal interviewing and self-interviewing.Setting Domiciles of individuals living in England and Wales.Participants Individuals aged 18textendash69 years resident within randomly selected locations. 12 669 surveys were completed with participants within our defined age range.Main outcome measures Alcohol consumption was measured using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and childhood adversity using the short ACEs tool. Violence was measured using questions on perpetration and victimisation in the last 12 months.Results Compliance was 55.7 There were strong positive relationships between numbers of ACEs and recent violence perpetration and victimisation in both sexes. Recent violence was also strongly related to positive AUDIT-C (>=5) scores. In males, heavier drinking and >=4ACEs had a strong multiplicative relationship with adjusted prevalence of recent violent perpetration rising from 1.3% (95% CIs 0.9% to 1.9 0 ACEs, negative AUDIT-C) to 3.6% (95% CIs 2.7% to 4.9 0 ACEs, positive AUDIT-C) and 8.5% (95% CI 5.6% to 12.7 >=4ACEs, negative AUDIT-C) to 28.3% (95% CI 22.5% to 34.8 >=4ACEs, positive AUDIT-C). In both sexes, violence perpetration and victimisation reduced with age independently of ACE count and AUDIT-C status. The combination of young age (18textendash29 years), >=4ACEs and positive AUDIT-C resulted in the highest adjusted prevalence for both perpetration and victimisation in males (61.9 64.9 and females (24.1 27.2.Conclusions Those suffering multiple adverse experiences in childhood are also more likely to be heavier alcohol users. Especially for males, this combination results in substantially increased risks of violence. Addressing ACEs and heavy drinking together is rarely a feature of public health policy, but a combined approach may help reduce the vast costs associated with both.
Original languageEnglish
Article numbere020591
Number of pages10
JournalBMJ Open
Issue number12
Publication statusPublished - 6 Dec 2018

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