Childhood Traumatic Brain Injury and the Associations With Risk Behavior in Adolescence and Young Adulthood: A Systematic Review.
Eleanor Kennedy, Miriam Cohen, Marcus Munafò
PMID 28092286WHAT IT FOUND
Childhood TBI was linked to later substance use in all 3 reviewed articles, but behavior findings were inconsistent.
The studies were observational, so this does not prove injury causes risk behavior.
Key findings
01Inpatient TBI increased the odds of alcohol or illicit substance use/dependence at ages 14 to 16.
02Participants with TBI were more likely to report drinking to intoxication at age 14 years.
03Behavior findings were inconsistent: higher parent and teacher ratings of conduct disorders and peer problems were found in one study, while no differences in externalizing behavior, aggression, or rule-breaking behavior were found in another study.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
All included studies were observational, so they cannot show that childhood TBI caused later risk behavior. The review included only 6 articles based on 4 separate studies, and some control groups were small. The Australian studies had very low quality because they did not adequately control for confounding and reported no effect sizes or confidence intervals. The UK cross-sectional study was downgraded to very low because it did not consider confounding and reported no effect sizes. Mild TBI was defined differently across studies, and medical records alone may miss injuries. No meta-analysis was possible because outcomes and TBI groupings varied.
Declared interests
The supplied article text does not report funding or conflict of interest declarations.
The easy way to misread this
Do not conclude that childhood TBI causes adolescent or young adult risk behavior. The included studies were observational, the evidence was low to very low, and behavioral findings were inconsistent.