Longitudinal Predictors of Criminal Arrest After Traumatic Brain Injury

Abstract

OBJECTIVE: To examine how pre-traumatic brain injury (TBI) variables and TBI-related characteristics predict post-TBI criminal arrest, using longitudinal data from the Traumatic Brain Injury Model System National Database. SETTINGS: Medical hospitals; rehabilitation facilities. PARTICIPANTS: Participants with documented TBI and nonmissing Traumatic Brain Injury Model System data, resulting in N = 6315 at 1 year post-TBI, N = 4982 at 2 years post-TBI, and N = 2690 at 5 years post-TBI. DESIGN: Prospective cohort study with secondary data analysis of the relationship between pre-TBI/TBI factors and post-TBI criminal arrest as measured at 3 time points. MAIN MEASURES: Self-report of post-TBI criminal arrest. RESULTS: Post-TBI criminal arrest was associated with gender, age, marital status, educational attainment, pre-TBI felony, pre-TBI drug abuse, pre-TBI alcohol abuse, and violent cause of TBI. Frontal, temporal, parietal, or occipital lobe lesions from computed tomographic scans did not predict post-TBI criminal arrests. Higher numbers of post-TBI arrests were predicted by loss of consciousness (≥24 hours), combined with retention of motor function. CONCLUSION: Premorbid variables, especially pre-TBI felonies, were strongly linked to post-TBI criminal arrests. The relationship between TBI and arrest was complex, and different brain functions (eg, physical mobility) should be considered when understanding this association. Findings highlight that for post-TBI criminal behavior, many risk factors mirror those of the non-TBI general population.