The Underlying Mechanisms in the Association Between Traumatic Brain Injury in Childhood and Conduct Disorder Symptoms in Late Adolescence.

Hanan K S Khalaf, Alex F Martin, Stephane A De Brito, Edward D Barker
Author Information
  1. Hanan K S Khalaf: Department of Psychology, Department of Psychology, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK. hanan.khalaf@kcl.ac.uk.
  2. Alex F Martin: Department of Psychology, Department of Psychology, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
  3. Stephane A De Brito: Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.
  4. Edward D Barker: Department of Psychology, Department of Psychology, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK. ted.barker@kcl.ac.uk. ORCID

Abstract

The present study examined i) the direct association between traumatic brain injury (TBI) in childhood and conduct disorder symptoms in adolescence, ii) whether this effect is mediated by impulsivity and/or callous unemotional traits (CU traits), and iii) whether these indirect effects are moderated by childhood family adversity and adolescent substance use. Utilising data from the Avon Longitudinal Study of Parents and Children (ALSPAC), participants with head injury information up to 12 years (4.5 years, 5.4 years, 6.5 years, 8.6 years, 11.7 years) were identified and categorised into a TBI (n = 409), orthopaedic injury (n = 1469) or non-injury group (n = 5685). Psychosocial factors such as impulsivity at 13 years, CU traits at 13 years, childhood family adversity (between birth to 4 years) and substance use at 14 years were collated for moderated mediation analyses. Conduct disorder symptoms were assessed at 16 years of age. TBI and conduct disorder symptoms were positively associated, and this association was mediated by impulsivity but not CU traits. The indirect effects were higher in magnitude for individuals with higher levels of childhood family adversity. Adolescent substance use was not found to moderate the indirect effects between TBI and conduct disorder symptoms. These results were specific to TBI individuals, and not in participants with orthopaedic injury and no reported injuries. Targeting impulsivity and early family adversity may alleviate the risk of conduct disorder symptoms following TBI in childhood. These findings have important implications for informing neuro-rehabilitative and preventative measures in clinical and community settings.

Keywords

References

  1. Alcohol Alcohol. 2013 Nov-Dec;48(6):633-40 [PMID: 23926213]
  2. Alcohol Clin Exp Res. 2014 Oct;38(10):2615-21 [PMID: 25257574]
  3. Disabil Rehabil. 2020 Aug;42(17):2437-2443 [PMID: 31006276]
  4. Nat Rev Dis Primers. 2021 Jul 8;7(1):49 [PMID: 34238935]
  5. Psychol Bull. 2002 Jan;128(1):118-50 [PMID: 11843545]
  6. JAMA Psychiatry. 2016 Jan;73(1):64-72 [PMID: 26650724]
  7. F1000Res. 2019 Jul 9;8:1027 [PMID: 32185018]
  8. Brain Inj. 2006 Jan;20(1):41-9 [PMID: 16403699]
  9. Appl Neuropsychol Child. 2014;3(2):83-93 [PMID: 24716867]
  10. Am J Psychiatry. 2001 Nov;158(11):1783-93 [PMID: 11691682]
  11. J Am Acad Child Adolesc Psychiatry. 2010 Nov;49(11):1134-44 [PMID: 20970701]
  12. Am J Drug Alcohol Abuse. 2019;45(2):151-160 [PMID: 29870277]
  13. Curr Opin Neurol. 2005 Dec;18(6):734-9 [PMID: 16280687]
  14. Ital J Pediatr. 2017 Sep 20;43(1):84 [PMID: 28931400]
  15. J Abnorm Psychol. 2017 Feb;126(2):225-236 [PMID: 27977232]
  16. Am J Psychiatry. 2015 Jan;172(1):59-70 [PMID: 25219348]
  17. Brain Inj. 2009 Nov;23(12):944-55 [PMID: 19831491]
  18. Br J Psychiatry. 2012 Mar;200(3):177-8 [PMID: 22383762]
  19. Psychol Rev. 1993 Oct;100(4):674-701 [PMID: 8255953]
  20. Arch Gen Psychiatry. 2010 Feb;67(2):113-23 [PMID: 20124111]
  21. J Correct Health Care. 2010 Apr;16(2):147-59 [PMID: 20339132]
  22. J Neurol Neurosurg Psychiatry. 2001 Dec;71(6):727-31 [PMID: 11723191]
  23. Lancet Psychiatry. 2016 Mar;3(3):251-64 [PMID: 26905480]
  24. Nat Rev Neurosci. 2013 Nov;14(11):786-99 [PMID: 24105343]
  25. J Crim Psychol. 2015;5(2):99-123 [PMID: 26500722]
  26. Arch Phys Med Rehabil. 2010 Nov;91(11):1637-40 [PMID: 21044706]
  27. Int J Epidemiol. 2013 Feb;42(1):111-27 [PMID: 22507743]
  28. Evolution. 2002 Mar;56(3):433-40 [PMID: 11989675]
  29. Psychiatry Res. 2012 Dec 30;200(2-3):767-72 [PMID: 22560660]
  30. Addict Behav. 2004 Sep;29(7):1389-405 [PMID: 15345272]
  31. Multivariate Behav Res. 2010 Aug 6;45(4):661-701 [PMID: 26735714]
  32. Brain. 2014 Apr;137(Pt 4):1254-61 [PMID: 24519974]
  33. Child Dev. 2002 Jul-Aug;73(4):1220-37 [PMID: 12146744]
  34. Br J Psychiatry. 1975 Jun;126:493-509 [PMID: 1174767]
  35. Rehabil Psychol. 2008 Aug;53(3):370-386 [PMID: 19649151]
  36. Nat Rev Dis Primers. 2019 Jun 27;5(1):43 [PMID: 31249310]
  37. Eur J Neurol. 2016 Jan;23(1):21-9 [PMID: 25919757]
  38. Int J Epidemiol. 2013 Feb;42(1):97-110 [PMID: 22507742]
  39. J Neuropsychiatry Clin Neurosci. 2009 Fall;21(4):420-9 [PMID: 19996251]
  40. BMC Neurol. 2011 Dec 02;11:151 [PMID: 22136635]
  41. Arch Dis Child. 2020 Mar;105(3):282-287 [PMID: 31666244]
  42. Expert Rev Neurother. 2012 Apr;12(4):475-83 [PMID: 22449218]
  43. Inj Prev. 2019 Dec;25(6):514-520 [PMID: 30317219]
  44. J Neurotrauma. 2017 Oct 1;34(19):2790-2800 [PMID: 28376700]
  45. Eur Child Adolesc Psychiatry. 2022 Feb;31(2):289-297 [PMID: 33386525]
  46. J Head Trauma Rehabil. 2015 Mar-Apr;30(2):94-105 [PMID: 25734840]
  47. Eur Child Adolesc Psychiatry. 2017 Oct;26(10):1197-1206 [PMID: 28314984]
  48. J Am Acad Child Adolesc Psychiatry. 2005 May;44(5):434-42 [PMID: 15843765]
  49. Lancet Neurol. 2017 Dec;16(12):987-1048 [PMID: 29122524]
  50. Eur Child Adolesc Psychiatry. 2014 Apr;23(4):197-205 [PMID: 23824470]
  51. J Child Psychol Psychiatry. 2011 Aug;52(8):878-88 [PMID: 21410472]
  52. Neurosci Biobehav Rev. 2008;32(4):777-810 [PMID: 18295884]
  53. Soc Psychiatry Psychiatr Epidemiol. 2011 Jun;46(6):521-32 [PMID: 20376427]
  54. Int J High Risk Behav Addict. 2014 Jun 01;3(2):e20428 [PMID: 25032165]
  55. Br J Psychiatry. 2009 Sep;195(3):249-56 [PMID: 19721116]
  56. J Int Neuropsychol Soc. 2001 Sep;7(6):755-67 [PMID: 11575597]
  57. J Child Psychol Psychiatry. 2004 Feb;45(2):260-73 [PMID: 14982240]
  58. J Stud Alcohol. 1994 Mar;55(2):149-58 [PMID: 8189735]

Grants

  1. MC_PC_19009/Medical Research Council
  2. MC_PC_15018/Medical Research Council
  3. G9815508/Medical Research Council
  4. 217065/Z/19/Z/Wellcome Trust

MeSH Term

Child
Humans
Adolescent
Conduct Disorder
Antisocial Personality Disorder
Longitudinal Studies
Behavioral Symptoms
Brain Injuries, Traumatic
Substance-Related Disorders

Word Cloud

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