Psychosocial outcomes in young adults with childhood traumatic brain injury: A 20-year follow-up study.

We assessed the proportion of childhood TBI survivors who experienced favourable or less favourable psychosocial outcomes (defined as less favourable when 20% or more of the sample report difficulties or unmet needs) compared to controls and to explore factors associated with these outcomes at 20 years post-TBI. Participants included 54 young adults (age 22-34 years) who sustained mild (n = 14), moderate (n = 27), or severe (n = 13) TBI during childhood, and age and sex-matched 13 typically developing controls. Outcomes assessed: employment, quality of life, relationships, mental health, offending behaviours, and substance use outcomes. Study-designed and validated questionnaires (e.g., World Health Organization Quality of Life Bref) were used. Analyses involved descriptive statistics and generalised linear models. A high proportion of TBI participants reported favourable outcomes for offending behaviours (90.7%-94.3%). However, a substantial proportion (24%-87%) of participants reported less favourable outcomes in education, employment, overall QoL, general health, relationships, anxiety, tobacco use, and alcohol use. The TBI group reported significantly lower Overall QoL compared to controls, and the mild TBI group was at a greater risk of reporting less favourable outcomes. Other significant predictors of outcomes were younger age at injury and lower SES at the time of injury. These findings highlight that some psychosocial domains (e.g., relationships) are more affected than others (e.g., offending behaviours) in young adults with childhood TBI. Further research is needed to identify factors influencing psychosocial outcomes and to develop targeted interventions for young adults with childhood TBI.