Brain injuries in teens were linked to cannabis use and other risky behaviors, with sex differences
Among 9,288 Ontario students, those with a history of traumatic brain injury were more likely to use cannabis and engage in other risky behaviors, with sex and age moderating specific associations.
Quick Facts
What This Study Found
In a population-based survey of 9,288 Ontario students in grades 7-12, lifetime traumatic brain injury (TBI) was reported by 23.1% of males and 17.1% of females. TBI was associated with cannabis use, cannabis dependence, drug use problems, cigarette smoking, psychological distress, suicidal ideation, bullying, and poor academic performance.
Sex moderated the relationship between TBI and cigarette smoking. Sex and age together moderated TBI's relationship with daily smoking, alcohol use, and physical injuries. Late adolescent males with TBI showed elevated daily smoking and injuries, while their female counterparts showed elevated past-year drinking.
Key Numbers
9,288 students. TBI prevalence: 23.1% males, 17.1% females. Cannabis use, cannabis dependence, and drug use problems were all associated with TBI history. Sex moderated TBI-smoking; sex and age moderated TBI-alcohol and TBI-injury relationships.
How They Did This
Population-based cross-sectional survey of 9,288 Ontario 7th-12th graders (62% response rate). TBI was defined as a head blow resulting in at least 5 minutes of unconsciousness or overnight hospitalization. Thirteen behavioral and psychological correlates were examined with moderation analyses for sex and age.
Why This Research Matters
TBI is common in adolescents and is a known risk factor for substance use. Understanding that the TBI-substance use relationship differs by sex and age helps target prevention and intervention efforts more precisely.
The Bigger Picture
The high prevalence of TBI in this school-based sample (approximately 1 in 5 students) underscores that brain injury is not rare in adolescence. The association with substance use and mental health problems suggests TBI should be routinely screened for in youth presenting with these issues.
What This Study Doesn't Tell Us
Cross-sectional design cannot determine whether TBI preceded or followed substance use. Self-reported TBI may be subject to recall bias. The 62% response rate raises questions about non-response bias, though preliminary analyses found no evidence of bias in TBI reporting.
Questions This Raises
- ?Does TBI causally increase cannabis use risk, or do risk-taking youth sustain more TBIs?
- ?Would TBI-informed substance use prevention programs be more effective?
- ?Do the sex differences reflect biological vulnerability differences or behavioral exposure differences?
Trust & Context
- Key Stat:
- About 1 in 5 students reported lifetime traumatic brain injury
- Evidence Grade:
- Large population-based school survey with appropriate moderation analyses, though cross-sectional design limits causal inference.
- Study Age:
- Published in 2014.
- Original Title:
- The moderating effects of sex and age on the association between traumatic brain injury and harmful psychological correlates among adolescents.
- Published In:
- PloS one, 9(9), e108167 (2014)
- Authors:
- Ilie, Gabriela(2), Adlaf, Edward M, Mann, Robert E(11), Boak, Angela, Hamilton, Hayley, Asbridge, Mark, Colantonio, Angela, Turner, Nigel E, Rehm, Jürgen, Cusimano, Michael D
- Database ID:
- RTHC-00807
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Are teens with brain injuries more likely to use cannabis?
In this study of over 9,000 students, those with a history of traumatic brain injury were more likely to report cannabis use, cannabis dependence, and drug use problems. However, the direction of causation could not be determined.
How common are brain injuries in teenagers?
In this Ontario school sample, 23% of males and 17% of females reported a lifetime head injury resulting in at least 5 minutes of unconsciousness or overnight hospitalization.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-00807APA
Ilie, Gabriela; Adlaf, Edward M; Mann, Robert E; Boak, Angela; Hamilton, Hayley; Asbridge, Mark; Colantonio, Angela; Turner, Nigel E; Rehm, Jürgen; Cusimano, Michael D. (2014). The moderating effects of sex and age on the association between traumatic brain injury and harmful psychological correlates among adolescents.. PloS one, 9(9), e108167. https://doi.org/10.1371/journal.pone.0108167
MLA
Ilie, Gabriela, et al. "The moderating effects of sex and age on the association between traumatic brain injury and harmful psychological correlates among adolescents.." PloS one, 2014. https://doi.org/10.1371/journal.pone.0108167
RethinkTHC
RethinkTHC Research Database. "The moderating effects of sex and age on the association bet..." RTHC-00807. Retrieved from https://rethinkthc.com/research/ilie-2014-the-moderating-effects-of
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.