Challakere Ramaswamy Vasudeva Murthy, Butler Tony, Ton Bianca, Wilhelm Kay, Mitchell Philip B, Knight Lee, Greenberg David, Ellis Andrew, Allnutt Stephen, Jones Jocelyn, Gebski Val, Carr Vaughan, Scott Rodney J, Schofield Peter William
School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
University of New South Wales, Sydney, NSW, Australia.
Front Psychol. 2023 Sep 12;14:1243655. doi: 10.3389/fpsyg.2023.1243655. eCollection 2023.
Traumatic brain injury (TBI) is a major public health problem that may be associated with numerous behavioral problems, including impulsivity, aggression and violence. Rates of self-reported TBI are high within offender populations, but the extent to which TBI is causally implicated in causing illegal behavior is unclear. This study examined the psychological and functional correlates of histories of traumatic brain injury in a sample of impulsive violent offenders.
Study participants, all men, had been recruited to participate in a randomized controlled trial of sertraline to reduce recidivism. Study entry criteria were an age of at least 18 years, a documented history of two or more violent offenses and a score of 70 or above on the Barratt Impulsiveness Scale. An extensive list of standardized questionnaires was administered to obtain information on previous TBI and other neuropsychiatric conditions or symptoms.
In the sample of 693 men, 66% were aged between 18 and 35 years old, and 55% gave a history of TBI ("TBI+"). Overall, 55% of study participants reported at least one TBI. High levels of neuropsychiatric symptomatology were reported. In 75% of TBI+ individuals, their most severe TBI (by self-report) was associated with loss of consciousness (LOC) < 30 min. Compared to TBI- (those without history of TBI) participants, TBI+ individuals were more impulsive (Eysenck Impulsivity), irritable, angry, and reported higher levels of assaultive behavior, depressive symptomology, alcohol use disorder, suicidal ideation, suicide attempts, and lower quality of life. Potential "dose effects" of TBI severity and frequency in terms of neuropsychiatric symptomatology were identified.
Like other studies of offender populations, single and multiple TBIs were very common. The associations of TBI, TBI severity, and TBI frequency (i.e., TBI "burden") with adverse neuropsychiatric phenomena suggest TBI contributes importantly to offender morbidity but the select nature of the sample and cross-sectional study design constrain the interpretation of these findings.
创伤性脑损伤（TBI）是一个重大的公共卫生问题，可能与众多行为问题相关，包括冲动、攻击和暴力行为。在罪犯群体中，自我报告的TBI发生率很高，但TBI在导致违法行为中所起的因果作用程度尚不清楚。本研究在一组冲动暴力罪犯样本中，考察了创伤性脑损伤病史的心理和功能相关因素。
研究参与者均为男性，他们被招募来参与一项舍曲林减少累犯的随机对照试验。研究入选标准为年龄至少18岁、有记录的两次或更多暴力犯罪史，以及在巴拉特冲动量表上得分70分或以上。使用了一份详尽的标准化问卷清单来获取关于既往TBI及其他神经精神疾病或症状的信息。
在693名男性样本中，66%年龄在18至35岁之间，55%有TBI病史（“TBI+”）。总体而言，55%的研究参与者报告至少有一次TBI。报告了高水平的神经精神症状。在75%的TBI+个体中，他们最严重的TBI（根据自我报告）与意识丧失（LOC）<30分钟相关。与TBI-（无TBI病史者）参与者相比，TBI+个体更冲动（艾森克冲动性）、易怒、愤怒，且报告有更高水平的攻击行为、抑郁症状、酒精使用障碍、自杀观念、自杀未遂，以及更低的生活质量。确定了TBI严重程度和频率在神经精神症状方面的潜在“剂量效应”。
与其他关于罪犯群体的研究一样，单次和多次TBI非常常见。TBI、TBI严重程度和TBI频率（即TBI“负担”）与不良神经精神现象之间的关联表明，TBI对罪犯的发病率有重要影响，但样本的选择性性质和横断面研究设计限制了对这些发现的解释。
