Wand Handan, Simpson Melanie, Malacova Eva, Schofield Peter W, Preen David B, Tate Robyn, Butler Tony
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).
J Head Trauma Rehabil. 2018 May/Jun;33(3):167-176. doi: 10.1097/HTR.0000000000000326.
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.
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.
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.
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.
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.
评估包括创伤性脑损伤（TBI）和某些母亲特征在内的多种因素组合对后续刑事定罪的个体和人群层面的影响。
一项回顾性记录链接研究，涉及1980年至1985年出生的30599名个体队列，比例为1（有TBI）：3（无TBI），按性别和出生年份匹配。
使用Cox比例风险回归模型和人群归因风险百分比（PAR%）来评估TBI和其他风险因素对后续刑事定罪的贡献。
总体而言，青少年母亲（<20岁）所生孩子的TBI比例显著高于年龄较大母亲所生孩子（35%对22%；P<.001）。在按性别分析中，TBI病史与刑事定罪风险增加相关（调整后风险比[aHR]：男性为1.48，95%置信区间[CI]：1.36 - 1.60；女性为1.45，95%CI：1.22 - 1.73）。母亲特征（母亲年龄、单亲、多胎）被确定为刑事定罪的更大贡献因素（男性和女性的PAR%分别为57%和67%）。精神疾病、母亲因素和TBI的综合影响估计分别为67%和74%（男性和女性）；PAR%的95%CI不重叠，估计这些因素对女性的影响高于男性。
超过一半的刑事定罪与相对较少的风险因素相关，包括心理健康不佳、社会经济地位低、TBI以及某些母亲特征。
