Factors associated with alcohol-related problems following moderate to severe traumatic brain injury

Postinjury alcohol use is a common problem within the traumatic brain injury (TBI) population. Given the association between heavy drinking and the development of alcohol-related consequences, we attempted to understand the contribution of postinjury coping strategies and other risk factors to alcohol-related problems following moderate to severe TBI.

Participants were enrolled in a longitudinal study and followed up to 15 years following TBI; only persons with moderate to severe TBI (N = 278) were recruited. Participants completed questionnaires assessing preinjury alcohol use, demographic variables, postinjury alcohol-related problems (Short Michigan Alcohol Screening Test; SMAST; Selzer, Vinokus, & Van Rooijan, 1975), and postinjury coping strategies (Coping Inventory for Stressful Situations; CISS; Endler & Parker, 1990). Only those who completed the SMAST were included in this investigation.

The overall regression model, with time to follow commands, age at the time of TBI, education, time since injury, and task-oriented coping style, was statistically significant. After accounting for other factors, specific postinjury coping strategies were not associated with post-TBI alcohol-related problems. Time to follow commands, education, and time since injury independently explained a unique portion of the variance in SMAST score. A second multiple regression analysis was conducted for a subset of the sample that provided information about premorbid binge drinking (n = 95). The overall model was not significant, likely due to the reduced power to detect an effect, but premorbid binge drinking explained 4% of the variance in SMAST scores.

Injury severity, education, and time since injury should be assessed, and at-risk patients should be informed of the consequences of alcohol use among those with TBI.