Research Reports - Substance abuse and criminal activities following traumatic brain injury in childhood

J Head Trauma Rehabil. 2013 Nov 20

McKinlay A, Corrigan J, Horwood LJ, Fergusson DM

OBJECTIVE:: Use a longitudinal birth cohort to evaluate the association of
traumatic brain injury at ages 0 to 5, 6 to 15, and 16 to 21 years with drug and
alcohol abuse and engagement in criminal activities.
MAIN MEASURES:: Follow-up over 21 to 25 years using self-report of drug and
alcohol use, arrests, and violent and property offenses. Outcomes were assessed
for 2 levels of severity (inpatient, hospitalized; outpatient, seen by general
practitioner or at emergency department).
PARTICIPANTS:: Members of the Christchurch Health and Development Study, a
longitudinal birth cohort.
SETTING:: Christchurch, New Zealand.
RESULTS:: Adjusted for child and family factors, compared with noninjured
individuals, inpatients injured at 0 to 5 years or 16 to 21 years were more
likely to have symptoms consistent with drug dependence. All inpatient groups had
increased risk of arrest, with the age groups of 0 to 5 and 6 to 15 years more
likely to be involved in violent offenses and the age group of 0 to 5 years more
likely to engage in property offenses. Outpatient group had an increased risk of
violent offenses for first injury 0 to 5 years, arrests and property offenses for
injury 6 to 15 years, and increased risk of arrests and violent offenses for
injury 16 to 21 years of age. However, when alcohol dependence and drug
dependence were added as an additional covariate, traumatic brain injury was no
longer associated with criminal behavior for the age group of 0 to 5 years.
CONCLUSIONS:: Traumatic brain injury is associated with increased criminal
behavior and may represent a risk factor for offending. However, early substance
use is a mediating factor for those injured early in life.

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