Individual- and Population-Level Impacts of Traumatic Brain Injury and Maternal Characteristics on Subsequent Offending Behavior

Handan Wand, Melanie Simpson, Eva Malacova, Peter W. Schofield, David B. Preen, Robyn Tate, Tony Butler

Research output: Contribution to journalArticle


OBJECTIVE:: 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. DESIGN AND PARTICIPANTS:: 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. METHODS AND PROCEDURES:: 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. MAIN OUTCOMES AND RESULTS:: 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. CONCLUSION:: 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.

Original languageEnglish
Pages (from-to)167-176
JournalJournal of Head Trauma Rehabilitation
Issue number3
Publication statusPublished - May 2018

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