Does Traumatic Brain Injury Increase Risk for Substance Abuse?

Bjork, James M.; Grant, Steven

doi:10.1089/neu.2008.0849

Cited by 146 publications

(24 citation statements)

References 51 publications

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“…The need to do so is supported by the finding of a relationship between right MOFC thickness and SES. However, in regards to both socioeconomic status and substance abuse, the directionality of causation when interacting with TBI is unclear (Bjork & Grant, ; Felde, Westermeyer, & Thuras, ; Hoofien, Vakil, Gilboa, Donovick, & Barak, ; Nordstrom, Edin, Lindstrom, & Nordstrom, ; Rassovsky et al., ). Further, the groups were not matched for aggressive behavior; a future study comparing aggression‐matched controls would be valuable to more completely evaluate the relationship between OFC morphometry and aggressive behavior in subjects with and without mTBI.…”

Section: Discussionmentioning

confidence: 99%

Orbitofrontal cortical thinning and aggression in mild traumatic brain injury patients

Epstein

Legarreta²,

Bueler³

et al. 2016

Brain and Behavior

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IntroductionAlthough mild traumatic brain injury (mTBI) comprises 80% of all TBI, the morphological examination of the orbitofrontal cortex (OFC) in relation to clinical symptoms such as aggression, anxiety and depression in a strictly mTBI sample has never before been performed.ObjectivesThe primary objective of the study was to determine if mTBI patients would show morphological differences in the OFC and if the morphology of this region would relate to clinical symptoms.MethodsUsing structural images acquired in a 3T MRI machine, the cortical thickness and cortical volume (corrected for total brain volume) of the OFC was collected for healthy control (N = 27) subjects and chronic mTBI (N = 55) patients at least one year post injury. Also, during clinical interviews, measures quantifying the severity of clinical symptoms, including aggression, anxiety, and depression, were collected.Results MTBI subjects displayed increased aggression, anxiety, and depression, and anxiety and depression measures showed a relationship with the number of mTBI in which the subject lost consciousness. The cortical thickness of the right lateral OFC displayed evidence of thinning in the mTBI group; however, after correction for multiple comparisons, this difference was no longer significant. Clinical measures were not significantly related with OFC morphometry.ConclusionThis study found increased aggression, anxiety, and depression, in the mTBI group as well as evidence of cortical thinning in the right lateral OFC. The association between clinical symptoms and the number of mTBI with loss of consciousness suggests the number and severity of mTBI may influence clinical symptoms long after injury. Future studies examining other brain regions involved in the production and regulation of affective processes and inclusion of subjects with well‐characterized mood disorders could further elucidate the relationship between mTBI, brain morphology, and clinical symptoms.

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Section: Discussionmentioning

confidence: 99%

Orbitofrontal cortical thinning and aggression in mild traumatic brain injury patients

Epstein

Legarreta²,

Bueler³

et al. 2016

Brain and Behavior

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“…Traumatic brain injury (TBI) is currently underdiagnosed . Mild TBI may predispose patients to increased substance abuse . Those with head trauma tend to have higher premorbid rates of abuse and addiction which may be the mechanism of the trauma in many cases .…”

Section: Factors Affecting Chronic Painmentioning

confidence: 99%

The Complexity Model: A Novel Approach to Improve Chronic Pain Care

Peppin¹,

Cheatle²,

Kirsh³

et al. 2015

Pain Med

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“…When studying TBI in offender populations, possible confounders of an association between TBI and offending need to be considered. Previous studies have demonstrated an association between TBI and varying symptoms and diagnoses of mental disorders including substance use disorders (SUD), both of which are common in offender populations (2,(21)(22)(23)(24). A systematic review of TBI in prison populations demonstrated that comorbid mental disorders and neurocognitive deficits were more common among offenders with TBI compared to those without TBI (18).…”

Section: Introductionmentioning

confidence: 99%

“…A systematic review of TBI in prison populations demonstrated that comorbid mental disorders and neurocognitive deficits were more common among offenders with TBI compared to those without TBI (18). In particular, SUD needs to be considered in this respect, as an increasing number of studies show that early life TBIs increase the risk of subsequent substance use and other risky behaviors in offender populations, with younger age at TBI being associated with early substance (including alcohol) use (21,22,24). This seems especially important to consider in studies of the association between TBI and aggressive antisocial behaviors, since younger age at onset of substance use increases the total aggression, and there is a well-established association between SUD and violent criminality (22,25,26).…”

Section: Introductionmentioning

confidence: 99%

Exploring Traumatic Brain Injuries and Aggressive Antisocial Behaviors in Young Male Violent Offenders

et al. 2020

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Background: Traumatic brain injury (TBI) is a major cause of disabilities and mortality worldwide, with higher prevalence in offender populations than in the general population. Previous research has strongly advocated increased awareness of TBI in offender populations. The aim of this study was to explore the prevalence and characteristics of TBI, and to investigate associations and interactions between TBI, aggressive antisocial behaviors, general intellectual functioning, and substance use disorders (SUD) in a well-characterized group of young violent offenders. Methods: The study investigated a cohort (n = 269) of 18 to 25-year-old male violent offenders in Sweden. Data on TBI (files + self-report), aggressive antisocial behaviors (Life History of Aggression), SUD (clinical interviews), and general intellectual functioning (General Ability Index, Wechsler Adult Intelligence Scales Third Edition) were collected between 2010 and 2012. Parametric (Student's t-test) and non-parametric (Mann-Whitney U-test, Spearman's rho, χ 2 , Kruskal Wallis test) inferential statistics were applied and effect sizes reported. Results: TBI, both with and without loss of consciousness, was common, with 77.5% of the offenders reporting having suffered at least one TBI during their lifetime. TBI was associated with an increased occurrence of aggressive antisocial behaviors and SUD, and offenders with both TBI and SUD evidenced the largest amount of aggressive antisocial behaviors. No clinically meaningful associations were found between TBI and general intelligence. Effect sizes were in the small to medium range. Conclusions: Our study confirms an increased prevalence of TBI among young violent offenders compared to the general population, as well as associations between TBI, aggressive antisocial behaviors, and SUD. However, it provides no information on the severity of the TBI, nor on the causality of the demonstrated associations. Nevertheless, TBI, and possible related deficits, need to be considered in the assessment and treatment of young violent offenders.

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Does Traumatic Brain Injury Increase Risk for Substance Abuse?

Cited by 146 publications

References 51 publications

Orbitofrontal cortical thinning and aggression in mild traumatic brain injury patients

Orbitofrontal cortical thinning and aggression in mild traumatic brain injury patients

The Complexity Model: A Novel Approach to Improve Chronic Pain Care

Exploring Traumatic Brain Injuries and Aggressive Antisocial Behaviors in Young Male Violent Offenders

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