Symptoms and Engagement in Anti-social Behavior 10 Years After Mild Traumatic Brain Injury Within a Community Civilian Sample: A Prospective Cohort Study With Age-Sex Matched Control Group

Objective: To determine if there are longer -term effects on symptoms, health status, mood, and behavior 10 years after a mild traumatic brain injury (mTBI). Design: Prospective cohort study. Setting: Community -based, civilian sample. Participants: Adults aged >= 16 years at follow-up who experienced an mTBI 10 years ago, and an age and sex -matched non -injured control group. Interventions: Not applicable. Main Outcome Measures: mTBI cases and controls were asked to complete self -report assessments of functioning (WHO Disability Assessment Schedule Version 2), symptoms (Rivermead Post -Concussion Symptom Questionnaire), health status (100 -point scale), alcohol (Alcohol Use Disorders Identification Test) and substance use (Alcohol, Smoking and Substance Involvement Screening Test), and whether they had engaged in any anti -social behaviors over the past 12 months. Results: Data were analyzed for 368 participants (184 mTBI cases and 184 age -sex matched controls). Just over a third of mTBI cases (64, 34.8%) reported that they were still affected by their index mTBI 10 years later. After adjusting for education and ethnicity, the mTBI group had statistically higher overall symptom burden (F=22.32, P<.001, hp2=0.07) compared with controls. This difference remained after excluding those who experienced a recurrent TBI. The mTBI group were more than 3 times as likely to have engaged in anti -social behavior during the previous 12 months (F=5.89, P=.02). There were no group differences in health status, functioning, or problematic alcohol or substance use 10 years post -injury. Conclusions: This study provides evidence of potential longer -term associations between mTBI, post -concussion symptoms, and anti -social behavior which warrants further evaluation. Future research should also examine if longer-term effects may be preventable with access to early rehabilitation post-injury. (c) 2023 by the American Congress of Rehabilitation Medicine. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)