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创伤性脑损伤后 10 年内逮捕的人口统计学和心理健康预测因素:退伍军人事务 TBI 模型系统研究。

Demographic and Mental Health Predictors of Arrests Up to 10 Years Post-Traumatic Brain Injury: A Veterans Affairs TBI Model Systems Study.

机构信息

Mental Health and Behavioral Sciences, James A. Haley Veterans' Hospital, Tampa, Florida (Drs Miles, Silva, and Nakase-Richardson); Department of Psychiatry & Behavioral Neurosciences, University of South Florida, Tampa, Florida (Drs Miles and Silva); Department of Internal Medicine, Division of Pulmonary and Sleep Medicine, University of South Florida, Tampa, Florida (Drs Silva and Nakase-Richardson); Defense and Veterans Brain Injury Center, James A. Haley Veterans' Hospital, Tampa, Florida (Drs Silva and Nakase-Richardson); Department of Psychology, University of South Florida, Tampa, Florida (Dr Silva); Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana (Dr Neumann); Rehabilitation Hospital of Indiana, Indianapolis, Indiana (Dr Neumann); Rehabilitation & Mental Health Counseling Program, Department of Child & Family Studies, University of South Florida, Tampa, Florida (Dr Dillahunt-Aspillaga); Research Service, James A. Haley Veterans' Hospital, Tampa, Florida (Dr Dillahunt-Aspillaga); Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, Ohio (Dr Corrigan); Tampa VA Research and Education Foundation, Inc, Tampa, Florida (Dr Tang); Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Health Care System, Los Angeles, California (Dr Eapen); and David Geffen School of Medicine at UCLA, Los Angeles, California (Dr Eapen).

出版信息

J Head Trauma Rehabil. 2021;36(4):E240-E248. doi: 10.1097/HTR.0000000000000640.

DOI:10.1097/HTR.0000000000000640
PMID:33528175
Abstract

OBJECTIVE

Examine rates and predictors of arrests in Veterans and Service Members (V/SM) who received inpatient rehabilitation for traumatic brain injury (TBI).

SETTING

Veterans Administration (VA) Polytrauma Rehabilitation Centers.

PARTICIPANTS

A total of 948 V/SM drawn from the VA TBI Model Systems cohort with arrest data up to 10 years post-TBI.

DESIGN

Longitudinal cohort study; secondary analysis of pre-TBI characteristics predicting post-TBI arrests.

MAIN MEASURES

Disclosure of arrests pre-TBI and up to10 years post-TBI.

RESULTS

Thirty-six percent of the sample had been arrested prior to their TBI; 7% were arrested post-TBI. When considering all variables simultaneously in a multivariate model, pre-TBI mental health treatment (adjusted odds ratio [aOR] = 4.30; 95% confidence interval [CI]: 2.03-9.14), pre-TBI heavy alcohol use (aOR = 3.04; CI: 1.08-8.55), and number of follow-up interviews (aOR = 2.05; CI: 1.39-4.50) were significant predictors of post-TBI arrest.

CONCLUSION

Arrest rates of V/SM prior to TBI were consistent with rates of arrest for people of similar ages in the United States. Post-TBI rates were lower for V/SM than published rates of post-TBI arrests in civilians with TBI. As part of rehabilitation planning for V/SM with TBI, providers should assess for preinjury mental health services and alcohol misuse to (1) identify those who may be at risk for postinjury arrests and (2) provide relevant resources and/or supports.

摘要

目的

调查接受创伤性脑损伤(TBI)住院康复治疗的退伍军人和军人(V/SM)中的逮捕率和预测因素。

地点

退伍军人事务部(VA)多发创伤康复中心。

参与者

从 VA TBI 模型系统队列中抽取了总共 948 名 V/SM,这些队列的数据在 TBI 后长达 10 年。

设计

纵向队列研究;对 TBI 前特征预测 TBI 后逮捕的二次分析。

主要措施

TBI 前和 TBI 后长达 10 年的逮捕记录披露。

结果

该样本中有 36%的人在 TBI 前曾被捕;7%的人在 TBI 后被捕。在多变量模型中同时考虑所有变量时,TBI 前的心理健康治疗(调整后的优势比[aOR]=4.30;95%置信区间[CI]:2.03-9.14)、TBI 前的大量饮酒(aOR=3.04;CI:1.08-8.55)和随访访谈次数(aOR=2.05;CI:1.39-4.50)是 TBI 后逮捕的显著预测因素。

结论

V/SM 在 TBI 前的逮捕率与美国同龄人群的逮捕率一致。TBI 后 V/SM 的逮捕率低于平民 TBI 后公布的逮捕率。作为 TBI 退伍军人和军人康复计划的一部分,提供者应评估 TBI 前的心理健康服务和酒精滥用情况,以(1)确定那些可能有 TBI 后被捕风险的人,(2)提供相关资源和/或支持。

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