Citation

Wand H, Simpson M, Malacova E, Schofield PW, Preen DB, Tate R, Butler T. J. Head Trauma Rehabil. 2018; 33(3): 167-176.

Affiliation

The Kirby Institute, UNSW Sydney, Sydney, Australia (Drs Wand, Simpson, and Butler); Centre for Health Services Research, School of Population and Global Health, University of Western Australia, Perth, Australia (Drs Malacova and Preen); School of Public Health, Curtin University, Perth, Australia (Dr Malacova); Neuropsychiatry Service, Hunter New England Local Health District, Newcastle, Australia (Dr Schofield); School of Medicine and Public Health, University of Newcastle, Newcastle, Australia (Dr Schofield); and John Walsh Centre for Rehabilitation Research, Kolling Institute for Medical Research, Sydney Medical School - Northern, The University of Sydney, St Leonards, Australia (Dr Tate).

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000326

PMID

28731869

Abstract

OBJECTIVE: To evaluate the individual- and population-level impact of a combination of factors, including traumatic brain injury (TBI) and certain maternal characteristics, on subsequent criminal conviction. DESIGN AND PARTICIPANTS: A retrospective record linkage study involving a cohort of 30 599 individuals born between 1980 and 1985, with ratio of 1 (with TBI): 3 (no TBI), matched by sex and the year of birth.

METHODS AND PROCEDURES: Cox proportional hazard regression models and population attributable risk percentages (PAR%) were used to assess the contribution of TBI and other risk factors on subsequent criminal convictions. MAIN OUTCOMES AND RESULTS: Overall, individuals born to the teenaged mothers (<20 years) have significantly higher proportion of TBI than those born to older mothers (35% vs 22%; P <.001). In the gender-specific analyses, a history of TBI was associated with increased risk for criminal convictions (adjusted hazard ratio [aHR]: 1.48, 95% confidence interval [CI]: 1.36-1.60, and aHR: 1.45, 95% CI: 1.22-1.73, for men and women, respectively). Maternal characteristics (maternal age, single parent, multiparity) were identified as the greater contributor to the criminal convictions (PAR%: 57% and 67% for men and women, respectively). The combined impact of mental illness, maternal factors, and TBI was estimated to be 67% and 74% (for men and women, respectively); with nonoverlapping 95% CIs for PAR%, these factors were estimated to have had a higher impact among females than among males.

CONCLUSION: More than half of the criminal convictions were associated with a relatively small number of risk factors, including poor mental health, low socioeconomic status, and TBI as well as certain maternal characteristics.

Language: en