Research Reports - Substance use, criminal behaviour and psychiatric symptoms following childhood traumatic brain injury

Eur Child Adolesc Psychiatry. 2017 Mar 17. doi: 10.1007/s00787-017-0975-1. [Epub
ahead of print]

Kennedy E(1,)(2), Heron J(3), Munafò M(4,)(5).

Recent research suggests a link between traumatic brain injury (TBI) in youth and
later risk behaviour. We explored the association between mild TBI and
psychiatric symptoms, substance use and criminal behaviour using data from a
longitudinal birth cohort. Participants with mild TBI (n = 800), orthopaedic
injuries (n = 2305) and no injuries (n = 8307) were identified from self and
parent reports up to age 16 years. Self-report measures of substance use
(alcohol, tobacco and cannabis) and criminal behaviours, and parent-reported
psychiatric symptoms were collected at age 17 years. Analyses were adjusted for
pre-birth and early childhood confounders. Participants with a TBI showed
increased odds of hazardous alcohol use compared to those with no injury and
those with an orthopaedic injury. Relative to those with no injury, participants
with a TBI showed increased odds of problematic use of tobacco and cannabis,
being in trouble with the police and having more parent-reported conduct
problems. Sustaining either a TBI or an orthopaedic injury increased the odds of
offending behaviour compared to having no injuries. There was no clear evidence
of association between orthopaedic injury and the other risk outcomes. The
increased odds of risk behaviour associated with TBI relative to no injury
replicated previous research. However, the inclusion of a non-brain-related
injury group adds evidence for a possible causal pathway between mild TBI in
youth and later hazardous alcohol use only. This highlights the importance of
including an additional negative control injury group in mild TBI research. 

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