History of Concussion and Nonfatal Suicidal Behaviors in U.S. High School Students: Findings from the 2017 National Youth Risk Behavior Survey

Abstract

Objective To examine the association between concussion history and suicidal behaviors in adolescents from the 2017 National Youth Risk Behavior Survey (YRBS). Background Research indicates that behavioral changes such as impulsivity and lack of emotional control are common following youth concussion. Additional evidence suggests that poor behavioral regulation may contribute to altered mood states that precede possible self-injury or fatality. To date, the relation between adolescent concussion and suicidal behaviors has not been explored on a national scale. Design/Methods Data from 14,765 high school students were cross-sectionally analyzed. Weighted multivariate logistic regressions were conducted to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI) of suicidal behaviors in students with and without a history of concussion. Age, sex, and alcohol use were controlled for in the regression model. Results Adolscents with history of concussion were at greater odds of reporting suicidal ideation (AOR = 1.39, CI 1.16, 1.65), suicide planning (AOR = 1.34, CI 1.14, 1.57), suicidal attempts (AOR = 1.68, CI 1.36, 2.09), and injurious suicidal attempts (AOR = 2.42, CI 1.82, 3.22). In addition, females with a history of concussion demonstrated greater odds of reporting poor mental health than males with history of concussion (p's < 0.05). Further, history of concussion among individuals aged 16 years or older was significantly associated with increased suicidal behaviors, whereas this association was not observed in younger adolescents (p's < 0.05). Conclusions Our findings indicate that adolescents who sustain a concussion have greater odds of suicidality than their uninjured counterparts. Further, suicidality was better predicted by concussion exposure in females than males, and in older students. Consequently, these results indicate the importance of examining mental health following youth concussion, and highlight the need for further longitudinal research.