Alcohol Use and History of Traumatic Brain Injury in College Students: An Analysis of Neuropsychological and Behavioral Factors

Approximately 69,000,000 individuals sustain TBIs each year worldwide. Alcohol use is a known risk factor for TBI. Nearly 50% of individuals with TBI endorse binge drinking, alcohol-related negative consequences, or meet criteria for AUDs. One of the most pressing issues within the alcohol-TBI literature is predicting post-TBI alcohol-related problems, as this results in poorer recovery, rehabilitation, and functioning. Evidence for TBIs causing post-injury alcohol use in those without pre-injury problematic alcohol use is mixed; not all TBI survivors experience alcohol-related problems post-injury. Evidence is mounting that one of the most robust predictors of post-injury alcohol problems is childhood or adolescent TBI, including samples of adolescents and adults who sustained a TBI prior to initiating alcohol use. Informed by the dual process model, the study aimed to examine how adolescent/young adult mTBI predicts the following: post-injury alcohol use; self-reported impulsivity and risk-taking; behavioral risk-taking; and alcohol demand in college students who engage in binge drinking. The study also examined whether neuropsychological functioning mediated these relationships and how induced cognitive depletion interacted with mTBI history to impact these variables. 93 college students who reported engaging in binge drinking consented to participate in research. During the study, participants were assessed for TBI history, were randomly assigned to a cognitive depletion or placebo, and completed a series of behavioral, self-report, and neuropsychological measures. A series of regression analyses were conducted to test study hypotheses, including tests of mediation and moderation. TBI did not significantly predict alcohol use/alcohol-related negative consequences, nor did it significantly predict neuropsychological functioning. TBI significantly predicted greater behavioral, but not self-reported risk-taking/impulsivity. Cognitive depletion manipulation did not significantly impact behavioral impulsivity or alcohol demand. Further, mediation and moderation hypotheses were not supported. In sum, the results do not suggest that mTBI impacts alcohol use/alcohol-related consequences or neuropsychological functioning in college binge drinkers. Various study limitations and implications are identified. Further research is needed to elucidate the factors that cause post-mTBI alcohol-related problems