The impact of adolescent traumatic brain injury on health risk behaviors

Traumatic brain injury (TBI) is associated with disinhibition, impulsivity, and other sequelae which may make adolescent TBI survivors more likely to engage in health risk behaviors though this has not yet been comprehensively investigated. Extant literature on TBI-related health risk behaviors is limited by a dearth of studies on adolescents, reliance on self-report of TBI, lack of an orthopedic injury (OI) control group, and the fact that TBI's effects on various health risk behavior domains are generally examined separately. The current study clarifies the impact of TBI on health risk behaviors among adolescents, specifically those related to 1) unintentional injury and violence (including aggression- and suicide-related behaviors); 2) tobacco use; and 3) alcohol and other drug use in an analytic sample of 74 adolescents (<i>n</i> = 43 for youth with a complicated mild to severe TBI, <i>n</i> = 31 for youth with an OI). Results indicate youth with a TBI exhibited more suicide-related health risk behaviors at 12-month follow-up (<i>F</i> = 6.063; <i>p</i> = .016; η_p² = .079), as well as a nonsignificant trend toward greater marijuana use (<i>F</i> = 3.747; <i>p</i> = .057; η_p² = .050), compared to youth with an OI while controlling for age. Youth with an OI exhibited greater increases in violence and victimization over the 12-month post-injury period compared to youth with a TBI (<i>F</i> = 4.243; <i>p</i> = .044; η_p² = .067) while controlling for age. Interventions to reduce psychological distress and improve social connectedness, problem-solving, coping, and emotion regulation skills may be most relevant for youth who receive a TBI. Emotion regulation and anger management skills may be relevant for youth who receive an OI.