Research Reports - Does traumatic brain injury lead to criminality?

PLoS One. 2015 Jul 14;10(7)

Schofield PW(1), Malacova E(2), Preen DB(2), D'Este C(3), Tate R(4), Reekie J(5),
Wand H(5), Butler T(5)

BACKGROUND: Traumatic brain injury (TBI) may be a risk factor for criminal
behaviour however multiple factors potentially confound the association.
METHODS: Record linkage and Cox proportional hazards regression analyses were
used to examine the association between hospital-recorded TBI (n = 7,694) and
subsequent first criminal conviction in a retrospective cohort matched 1:3 with
22,905 unaffected community controls and full-sibling controls (n = 2,397).
Aboriginality, substance abuse, social disadvantage, and mental illness were
included in analyses as potential confounders.
RESULTS: In multivariable models, relative to general population controls, TBI
was associated with any conviction (males: Hazard Ratio (HR) = 1·58 (95% CI 1·46
to 1·72); females: HR = 1·52 (95% CI 1·28 to 1·81)); and similar Hazard Ratios
were obtained for the sibling analyses in males (HR = 1.68 (95% CI 1.31-2.18))
and females (HR 1.27 (95% CI 0.71-2.29)). TBI was also associated with violent
convictions relative to the general population, (males: HR = 1.65 (95% CI 1.42 to
1.92); females HR = 1.73 (95% CI 1.21 to 2.47)), and in analyses with sibling
controls in men (HR = 1.89 (95% CI 1.20-3.00)), but not in women (HR 0.73, 95% CI
CONCLUSION: The results support a modest causal link between TBI and criminality
after comprehensive adjustment for confounding. Reducing the rate of TBI, a major
public health imperative, might have benefits in terms of crime reduction.

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