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  1. E Pickelsimer,
  2. P Ferguson,
  3. M Cornelius
  1. Medical University of South Carolina, Division of Biostatistics & Epidemiology, Charleston, South Carolina, USA


    Background Ongoing traumatic brain injury (TBI)-related symptoms, post-traumatic stress disorder (PTSD), and substance dependency (SuD) can greatly affect an offender's ability to function while incarcerated and upon community reentry.

    Aims/Objectives/Purpose To identify factors associated with ongoing TBI-related symptoms among female offenders.

    Methods 275 female offenders were asked whether they experienced any of 19 ongoing symptoms after TBI. Variables (aggression, PTSD, mental health treatment, SuD, childhood victimisation, lack of parental/caregiver support, intimate partner violence, free or reduced lunch (ie, SES proxy) were entered into a Robust Poisson model (p≤0.25) to identify factors associated with having symptoms. Race did not meet criteria for model entry.

    Results/Outcomes (1) 154 of 275 (56%) offenders reported ongoing TBI-related symptoms. (2) SuD and PTSD were associated with having symptoms. An interaction was found between SuD and PTSD (p=0.0236). (3) An association was further found between females with PTSD and TBI-related symptoms among those without SuD (adjusted prevalence ratio (APR)=2.58; CI 1.49 to 4.45, p=0.0006), but not among those with SuD (APR=1.30; CI 0.98 to 1.73, p=0.0662). (4) Compared to having neither condition, the APR for the association between SuD and TBI-related symptoms was 2.32 (CI 1.34 to 4.01). The APR for the association with TBI-related symptoms among offenders with both SuD and PTSD, compared to having neither, was 3.03 (CI 1.80 to 5.08).

    Significance/Contribution to the Field PTSD and SuD are closely associated with ongoing TBI-related symptoms. Treating and managing all three conditions concurrently, as well as prevention efforts, would likely be cost effective and benefit both the female offenders and society.

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