Research Reports - Suicidality, bullying and other conduct and mental health correlates of traumatic brain injury in adolescents

PLoS One. 2014 Apr 15;9(4)

Ilie G(1), Mann RE(2), Boak A(3), Adlaf EM(4), Hamilton H(4), Asbridge M(5), Rehm J(4), Cusimano MD(6)

OBJECTIVE: Our knowledge on the adverse correlates of traumatic brain injuries
(TBI), including non-hospitalized cases, among adolescents is limited to case
studies. We report lifetime TBI and adverse mental health and conduct behaviours
associated with TBI among adolescents from a population-based sample in Ontario.
METHOD AND FINDINGS: Data were derived from 4,685 surveys administered to
adolescents in grades 7 through 12 as part of the 2011 population-based
cross-sectional Ontario Student Drug Use and Health Survey (OSDUHS). Lifetime TBI
was defined as head injury that resulted in being unconscious for at least 5
minutes or being retained in the hospital for at least one night, and was
reported by 19.5% (95%CI:17.3,21.9) of students. When holding constant sex,
grade, and complex sample design, students with TBI had significantly greater
odds of reporting elevated psychological distress (AOR = 1.52), attempting
suicide (AOR = 3.39), seeking counselling through a crisis help-line
(AOR = 2.10), and being prescribed medication for anxiety, depression, or both
(AOR = 2.45). Moreover, students with TBI had higher odds of being victimized
through bullying at school (AOR = 1.70), being cyber-bullied (AOR = 2.05), and
being threatened with a weapon at school (AOR = 2.90), compared with students who
did not report TBI. Students with TBI also had higher odds of victimizing others
and engaging in numerous violent as well as nonviolent conduct behaviours.
CONCLUSIONS: Significant associations between TBI and adverse internalizing and
externalizing behaviours were found in this large population-based study of
adolescents. Those who reported lifetime TBI were at a high risk for experiencing
mental and physical health harms in the past year than peers who never had a head
injury. Primary physicians should be vigilant and screen for potential mental
heath and behavioural harms in adolescent patients with TBI. Efforts to prevent
TBI during adolescence and intervene at an early stage may reduce injuries and
comorbid problems in this age group.

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