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.jpg "Marc Silva photo")
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, IndianaBlessen 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, Associate Professor, James A. Haley Veterans' Hospital / University of South Florida, Tampa, Florida