ImportanceChildhood exposure to mild traumatic brain injury (mTBI) is common. Individuals with a childhood history of mTBI experience more frequent criminal justice involvement in mid to late adolescence and adulthood. No study had been conducted to examine whether the link is causal or spurious.ObjectiveTo determine whether mTBI in childhood causes criminal justice involvement in mid to late adolescence.Design, Setting, and ParticipantsThis cohort study used population-based data for all children born between 1995 and 2000 in Denmark, with data linked to emergency department (ED) visits and hospitalizations before age 10 years and all criminal charges and convictions from ages 15 to 20 years. The exposure group contained all individuals diagnosed with mTBI before age 10 years without other intracranial or extracranial injuries; the comparison group was individuals not diagnosed with mTBI or intracranial or extracranial injuries. Sibling and twin fixed-effects models were used to evaluate the association after controlling for family-level confounding. Data were analyzed from May 2021 to July 2024.ExposuresMild TBI before age 10 years without other intracranial or extracranial injuries before or at the time of diagnosis.Main Outcomes and MeasuresAssociations between mTBI before age 10 years and criminal charges and convictions from ages 15 to 20 for the entire study population and separately by sex at birth, controlling for additional covariates.ResultsThe final analytic sample consisted of 343 027 individuals, 13 514 in the exposure group and 329 513 in the comparison group. Of the total sample, 166 455 (49%) were female and 176 572 were male (51%). A total of 326 191 participants (95%) had at least 1 parent with Danish citizenship, and 79 386 mothers (23%) held a college degree. There was a positive association between mTBI and criminal charges (odds ratio [OR], 1.26; 95% CI, 1.19-1.34) and convictions (OR, 1.24; 95% CI, 1.16-1.33). When controlling for family-level confounding, the associations became statistically insignificant and, in most models, greatly reduced. Results were robust across multiple model specifications.Conclusions and RelevanceThis study found that although mTBI in childhood was predictive of adolescent criminal justice involvement, there was no evidence that mTBI caused criminal charges or convictions.

中文翻译：

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轻度创伤性脑损伤以及青春期中晚期的刑事指控和定罪


重要性童年时期轻度创伤性脑损伤 （mTBI） 很常见。有 mTBI 童年史的个体在青春期中后期和成年期更频繁地参与刑事司法。没有进行任何研究来检查这种联系是因果关系还是虚假的。目的确定儿童期 mTBI 是否会导致青春期中后期的刑事司法参与。设计、设置和参与者这项队列研究使用了 1995 年至 2000 年间在丹麦出生的所有儿童的基于人群的数据，数据与 10 岁之前的急诊科 （ED） 就诊和住院治疗以及 15 至 20 岁的所有刑事指控和定罪有关。暴露组包含所有在 10 岁之前诊断为 mTBI 且无其他颅内或颅外损伤的个体;对照组是未诊断为 mTBI 或颅内或颅外损伤的个体。在控制了家庭水平的混杂因素后，使用兄弟姐妹和双胞胎固定效应模型来评估相关性。数据分析时间为 2021 年 5 月至 2024 年 7 月。暴露10 岁前轻度 TBI，诊断前或诊断时无其他颅内或颅外损伤。主要结局和措施 10 岁之前的 mTBI 与整个研究人群 15 至 20 岁的刑事指控和定罪之间的关联，并分别按出生时的性别划分，控制额外的协变量。结果最终分析样本为 343 027 例，其中暴露组 13 514 例，对照组 329 513 例。在总样本中，166 455 名 （49%） 为女性，176 572 名为男性 （51%）。 共有 326 191 名参与者 （95%） 至少有 1 名父母拥有丹麦公民身份，79 386 名母亲 （23%） 拥有大学学位。mTBI 与刑事指控 （比值比 [OR]，1.26;95% CI，1.19-1.34）和定罪 （OR，1.24;95% CI，1.16-1.33） 之间存在正相关。当控制家庭水平的混杂因素时，关联在统计学上变得不显著，并且在大多数模型中，关联大大减少。结果在多个模型规格中都是稳健的。结论和相关性本研究发现，尽管儿童时期的 mTBI 可以预测青少年刑事司法的参与，但没有证据表明 mTBI 会导致刑事指控或定罪。