Coping strategies and traumatic brain injury in incarcerated youth: a mediation analysis

Abstract

ABSTRACTObjective: Investigation into whether coping strategies mediated the relationship of traumatic brain injury (TBI) on depression/anxiety and alcohol and drug problems within incarcerated youth. Subjects: A non-probability sample of youth (N = 227) adjudicated for a variety of offences. Methods: Cross-sectional study within two long-term residential facilities for youth offenders in Pennsylvania. TBI assessed with question about lifetime head injury with blackout. Coping measured with Coping Strategies Inventory that included domains of acting-out coping, internalised coping, partying coping, prosocial coping, and expressing coping. Outcomes of depression/anxiety as well as alcohol and drug problems measured with Massachusetts Youth Screening Instrument–Version 2. Results: Mediation was suggested for acting-out coping and internalised coping with 45% and 48% of the total effect mediated between TBI and depression/anxiety, respectively. For alcohol and drug problems, mediation was indicated for acting-out coping and partying coping. Acting-out coping mediated 33% and partying coping mediated 51% of the total effect between TBI and alcohol and drug problems. Conclusion: Study results suggest that addressing the use of avoidant coping, such as acting-out coping, internalised coping, or partying coping, by youth with TBI in the criminal justice system could help ameliorate depression/anxiety and abuse of alcohol and drugs.