Defense Date

2021

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Paul Perrin

Second Advisor

Shawn Jones

Third Advisor

Natalie Dautovich

Fourth Advisor

Juan Carlos Arango Lasprilla

Fifth Advisor

Daniel Klyce

Abstract

Traumatic Brain Injury (TBI) is one of the leading causes of disability across the globe, and epidemiological studies have documented a rise in this condition over the recent years. Post-TBI functional impairments can persist beyond the acute phase of the injury, and specific psychosocial and injury-related factors have predicted variability in these outcomes. Previous literature has documented profound racial/ethnic disparities in TBI risk, cause, treatment, and rehabilitation. Prior investigation has revealed an overlap between incarceration and TBI, which showed that incarcerated persons typically endorsed a history of TBI. Criminal justice literature has shown stark racial/ethnic differences in incarceration rates, which are consistent among TBI populations. The current study included participants from the national TBI Model System’s study. An aim of the current study was to evaluate whether racial/ethnic disparities in traumatic brain injury acquisition and rehabilitation, which have been supported by previous literature, occurred within the current study sample. An additional aim of this research was to examine racial/ethnic disparities in arrest probability trajectories and whether injury and sociodemographic characteristics contributed to these longitudinal arrest trajectories. This study utilized a series of hierarchical linear models (HLMs) to assess longitudinal trajectories of arrest probability over the span of ten years post-injury, racial/ethnic disparities longitudinal arrest trajectories, and socio-demographic and injury-related predictors of these identified disparities. Preliminary study results supported previous literature which has shown racial/ethnic disparities in TBI cause and rehabilitation. Arrest probability trajectories generally decreased over the course of ten years post-discharge. White persons with TBI had lower arrest probability trajectories than Black and Native American persons, and Asian individuals with TBI had lower arrest probability trajectories than White, Black, Latinx, and Native American persons. When sociodemographic and injury related characteristics were entered in the models, the racial/ethnic differences in longitudinal arrest probability trajectories were no longer significant for the White vs. Black, Latinx vs. Asian, White vs. Native American, and Latinx vs. Native American comparisons. However, disparities remained in the White vs. Asian, Black vs. Asian, and Asian vs. Native American comparisons. These findings suggest that arrest probability trajectories occur differentially as a function of racial/ethnic group membership, though these differences can only in part be accounted for by injury and sociodemographic considerations. As such, the current study findings yield clinical, public health, and criminal justice implications, aimed to lessen arrest probability outcomes for persons with TBI who possess certain sociodemographic features in addition to racial/ethnic minority group membership.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

1-12-2022

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