A comparison of adult outcomes for males compared to females following pediatric traumatic brain injury.

OBJECTIVE

To identify the association between traumatic brain injury (TBI) and internalizing and externalizing problem behaviors and determine if these apply equally to males and females.

METHOD: The association between adult psychosocial functioning and childhood TBI for males and females was examined using groups with a history of childhood TBI (mild or moderate/severe) or orthopedic injury (injury age, 1-17, assessed 18-31 at >5 years postinjury), including rates of depression and anxiety disorders, substance abuse/dependence and offending behavior. Repeated-measures logistic regression was used to determine if the rates of internalizing and externalizing problem behaviors varied by group and sex.

RESULTS

Overall rates of problem behaviors were significantly greater for both moderate/severe TBI (OR = 4.00) and mild TBI (OR = 3.60) groups compared with orthopedic controls. Females were significantly more likely than males to report a history of internalizing problems (OR = 2.22), whereas males were more likely than females to report externalizing problems (OR = 2.10). The sex difference in internalizing/externalizing problems was found consistently across TBI groups and controls.

CONCLUSIONS

Childhood TBI is associated with psychosocial problems in adulthood, regardless of injury severity. How deficits are expressed differs between the sexes, with important implications for interventions strategies.