Behavioral and psychological risk factors for traumatic injury.

The objectives of the present study were to determine the behavioral and psychological risk factors associated with injury. The most widely investigated risk factor for injury is alcohol use. However, other behavioral and psychological risk factors may also contribute to injuries. This study examined the association of alcohol use, injury-related risk behaviors, and psychological characteristics with injury status. A hospital-based case control study of 177 patients admitted for treatment of traumatic injury, and 195 general surgery patients as controls, was conducted. Alcohol use, injury-related risk behaviors, impulsivity, sensation seeking, and risk perception were assessed. The results from a multivariate analysis controlling for age, gender, and ethnicity indicated that, in addition to alcohol consumption (OR = 2.2, 95% CI = 1.1-4.5), driving (OR = 2.4, 95% CI = 1.7-3.5) and violence-related risk behaviors (OR = 1.6, 95% CI = 1.0-2.2) are significantly associated with injury. In conclusion, the engagement in injury-related risk behaviors, including alcohol use, is strongly associated with injury status. Brief interventions that directly address these behavioral risk patterns in injured patients may reduce their risk of future injury.

[1]  T. Koepsell,et al.  The effects of alcohol abuse on readmission for trauma. , 1993, JAMA.

[2]  D. Hosmer,et al.  Applied Logistic Regression , 1991 .

[3]  M. Zuckerman Sensation Seeking : Beyond the Optimal Level of Arousal , 1979 .

[4]  F. Buntinx,et al.  Screening properties of questionnaires and laboratory tests for the detection of alcohol abuse or dependence in a general practice population. , 2001, The British journal of general practice : the journal of the Royal College of General Practitioners.

[5]  D. Hoyt,et al.  Characteristics of repeat trauma patients, San Diego County. , 1995, American journal of public health.

[6]  J. Thompson,et al.  Recurrent intentional injury. , 1992, Journal of the National Medical Association.

[7]  R. Woolard,et al.  Brief intervention for harm reduction with alcohol-positive older adolescents in a hospital emergency department. , 1999, Journal of consulting and clinical psychology.

[8]  Deitch Ea,et al.  The incidence of recurrent penetrating trauma in an urban trauma center. , 1991, The Journal of trauma.

[9]  M. Copeland Trauma recidivism: Reiner DS, Pastena JA, Swan KG, et al Am Surgeon 56: 556–560 Sep 1990 , 1991 .

[10]  M. Copass,et al.  The magnitude of acute and chronic alcohol abuse in trauma patients. , 1993, Archives of surgery.

[11]  H. Horst,et al.  Urban trauma: a chronic recurrent disease. , 1988, The Journal of trauma.

[12]  C J Cherpitel,et al.  Alcohol, injury, and risk-taking behavior: data from a national sample. , 1993, Alcoholism, clinical and experimental research.

[13]  K. Witkiewitz,et al.  Harm Reduction: Pragmatic Strategies for Managing High-Risk Behaviors , 2002 .

[14]  T. Buss,et al.  Repeat Victims of Violence in an Urban Trauma Center , 1995, Violence and Victims.

[15]  P. Diehr,et al.  The AUDIT alcohol consumption questions: reliability, validity, and responsiveness to change in older male primary care patients. , 1998, Alcoholism, clinical and experimental research.

[16]  P. London Injury in America. A continuing public health problem , 1986 .

[17]  W R Williford,et al.  Alcohol and risk/sensation seeking: specifying a causal model on high-risk driving. , 1993, Journal of addictive diseases.

[18]  R. Rhodes,et al.  Trauma is a recurrent disease. , 1993, Surgery.

[19]  H. Eysenck,et al.  The place of impulsiveness in a dimensional system of personality description. , 1977, The British journal of social and clinical psychology.

[20]  K. Kraemer,et al.  Three questions can detect hazardous drinkers. , 2001, The Journal of family practice.

[21]  D. Kivlahan,et al.  The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. , 1998, Archives of internal medicine.

[22]  Herb M. Simpson,et al.  Lifestyle correlates of risky driving and accident involvement among youth , 1988 .

[23]  M. Piccinelli,et al.  Alcohol Use Disorders Identification Test (AUDIT) , 1998, Epidemiologia e Psichiatria Sociale.

[24]  D. Webster,et al.  The Injury Fact Book , 1984 .

[25]  R. Jessor,et al.  Problem Behavior and Psychosocial Development: A Longitudinal Study , 1978 .

[26]  P J Gruenewald,et al.  The contribution of drinking patterns to the relative risk of injury in six communities: a self-report based probability approach. , 1997, Journal of studies on alcohol.

[27]  John P. Allen,et al.  The Alcohol Use Disorders Identification Test (AUDIT): a review of recent research. , 2002, Alcoholism, clinical and experimental research.

[28]  McGinnis Jm,et al.  Actual causes of death in the United States. , 1993 .

[29]  C. Cherpitel Drinking patterns and problems and drinking in the event: an analysis of injury by cause among casualty patients. , 1996, Alcoholism, clinical and experimental research.

[30]  C. Cherpitel,et al.  Substance use, injury, and risk-taking dispositions in the general population. , 1999, Alcoholism, clinical and experimental research.

[31]  G A Marlatt,et al.  Harm reduction: come as you are. , 1996, Addictive behaviors.

[32]  G. O’Keefe,et al.  Association of alcohol use and other high-risk behaviors among trauma patients. , 2001, The Journal of trauma.

[33]  C. Kaufmann,et al.  A population-based study of trauma recidivism. , 1998, The Journal of trauma.

[34]  C. R. Cloninger,et al.  A psychobiological model of temperament and character. , 1993, Archives of general psychiatry.

[35]  J. Donovan,et al.  Young adult drinking-driving: behavioral and psychosocial correlates. , 1993, Journal of studies on alcohol.

[36]  M. Copass,et al.  Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence. , 1999, Annals of surgery.