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Boys with inattention, hyperactivity have higher risk for TBIs

Guido I. Guberman

Boys who exhibit inattention, hyperactivity and externalizing problems are at an increased risk for traumatic brain injury, or TBI, and evidence-based treatments to reduce these behaviors may decrease the risk for TBIs to age 34, according to a prospective cohort study published in The Canadian Journal of Psychiatry. Further, researchers reported that childhood TBIs were associated with an increased risk for adolescent TBIs.

“In our study, we showed that childhood behaviors rated by teachers at age 10 predicted subsequent TBIs,” Guido I. Guberman, BA&Sc, of the department of neurology and neurosurgery at McGill University in Montreal, told Healio Psychiatry. “Boys rated by their teachers at age 10 as showing inattention-hyperactivity were at increased risk, compared with their peers without these problems, to sustain a TBI from ages 11 to 17 and from ages 18 to 34.”

Although TBIs occur in approximately 17% of males in the general population, there is little research about TBI predictors and prevention, according to the researchers. Guberman and colleagues analyzed data from 727 Canadian males prospectively from ages 6 to 34 to determine whether inattention, hyperactivity and/or all externalizing problems among boys aged 10 years are associated with subsequent TBIs to age 34 after accounting for family social status and previous TBIs.

The researchers extracted TBI diagnoses from health files and collected parents-reported sociodemographic and family characteristics when participants were aged 6. They administered the Social Behavior Questionnaire to the participants’ teachers, who completed them regarding classroom behaviors when the participants were aged 10 years. They then used separate logistic regression models to predict TBIs sustained from ages 11 to 17 years and from ages 18 to 34 years.

Guberman and colleagues found that for models including inattention and hyperactivity, TBIs sustained from ages 11 to 17 years were predicted by age 10 inattention and hyperactivity (OR = 1.46; 95% CI, 1.05-2.05) and by TBIs before age 11 (OR = 3.5; 95% CI, 1.49-8.24). TBIs from ages 18 to 34 years were predicted by age 10 inattention and hyperactivity (OR = 1.31; 95% CI, 1.01-1.7). In models with all externalizing problems, prior TBIs predicted TBIs from ages 11 to 17 years (OR = 3.66; 95% CI, 1.51-8.39) and externalizing problems by age 10 predicted TBIs sustained from ages 18 to 34 years (OR = 1.45; 95% CI, 1.12-1.86). Family social status and interaction terms did not predict TBIs in any of the models.

“To prevent suffering and disability, prevention strategies are needed, yet little is known about factors that promote traumatic brain injuries," Guberman said. "Our results also suggest that trials are needed to determine whether treatments that reduce inattention-hyperactivity and conduct problems could also reduce the risk for subsequent traumatic brain injuries." – by Joe Gramigna

Disclosures: The authors report no relevant financial disclosures.