Category: Brain Injury; Military and Veterans Affairs
Objective : Examine predictors of arrests (Pre-injury demographics, mental health (MH) utilization, and substance use disorders) in Veterans and Service Members (V/SM) with traumatic brain injury (TBI).
Design : Longitudinal cohort design.
Setting : Five Veteran Affairs Polytrauma Rehabilitation Centers (VA PRC).
Participants (or Animals, Specimens, Cadavers) : V/SM with documented TBIs enrolled in VA PRC TBI Model Systems study who completed at least one follow up assessment 1-10 years post TBI (N=948).
Interventions : Not applicable.
Main Outcome Measure(s) : Reported arrests and incarceration post-TBI.
Results : Participants were mostly male (94%), Caucasian (67%), with a median age of 30 years. Participants sustained mild (20%), moderate (16%), and severe (64%) TBI categorization across TBI indices available. Seven percent of participants were arrested post-TBI. Logistic regression models were used to examine predictors of arrests with unadjusted odds ratios (uOR). Moderate (comparison=abstaining; uOR=2.89, p<.01) and heavy alcohol use (comparison=abstaining; uOR=3.31, p<.01), problematic drug use (comparison=no problematic use; uOR=2.26, p<.01), moderate TBI (comparison=mild TBI; uOR=2.62, p=.03), being arrested pre-TBI (uOR=2.06, p<.01), and participating in MH treatment in the year prior to the TBI (uOR=1.88, p<.01) or ever (uOR=2.27, p=.02), were associated with post-TBI arrests. No demographic variables were associated with arrests.
Conclusions : Baseline demographics related to arrests in civilian samples were unrelated to arrests in V/SM with TBI, likely due to the limited variance in this sample. As expected, reported history of MH treatment and problematic alcohol and drug use were associated with arrests/incarceration. Findings support the added significance of addressing behavioral health factors in V/SM with TBI who are at risk for ongoing legal issues. Rehabilitation programs may assess for MH symptoms and make appropriate referrals to increase chances of successful community reintegration.
Shannon Miles– Clinical Research Psychologist, James A. Haley Veterans Hospital, Tampa, Florida
Marc Silva– Neuropsychologist, James A Haley VA Hospital, Tampa, Florida
Christina Dillahunt-Aspillaga– Associate Professor; Research Affiliate, USF - RMHC, Veterans Affairs, James A. Haley Hospital Rehabilitation Outcomes Research Center, Tampa, Florida
John Corrigan– Professor, The Ohio State University, Columbus, Ohio
Dawn Neumann– Associate Professor and Research Director, Indiana University and Rehab Hospital of Indiana, Indianapolis, Indiana
Blessen Eapen– Chief, Physical Medicine and Rehabilitation Service, VA Greater Los Angeles Health Care System, Los Angeles, California
Elizabeth Gavin– Clinical Psychology Resident, James A Haley Veterans' Hospital, Tampa, Florida
Risa Nakase-Richardson– Neuropsychologist, Professor, James A. Haley Veterans Hospital / University of South Florida, Tampa, Florida