PSYCHOPATHOLOGICAL RISK-FACTORS FOR INTENTIONAL AND NONINTENTIONAL INJURY

Objective: Trauma has a high rate of recurrence, suggesting that some people are more injury-prone than others, This study was performed to evaluate some of the psychological and social factors that might influ ence the likelihood of traumatic injury, Methods: A case-control study was conducted to evaluate the relationship between selected psychosoc ial factors and traumatic injury, At a Level I trauma center, victims of intentional trauma (excluding attempted suicide), victims of nonint entional trauma, and patients undergoing elective surgery were intervi ewed by a person blinded to the purposes of the study, They were given an intelligence test and underwent a structured interview, yielding p sychiatric diagnostic categories established in the third edition of t he Diagnostic and Statistical Manual of Mental Disorders, Revised (DSM -III-R), Results: Trauma patients were younger than elective surgery p atients (p < 0.01) and were more likely to be men (p < 0.01), Victims of intentional injury had a higher probability of alcohol use (p < 0.0 1) and admitted illicit drug use (p < 0.001) than either nonintentiona l injury victims or elective surgery patients, Victims of intentional injury were more likely to be unemployed than those in the other two g roups (p < 0.02), whereas elective surgery patients were more likely t o be retired (p < 0.05) or to be disabled (p < 0.0001), The average in telligence score was slightly above the median in the nonintentional t rauma group and in the control group (55th percentile and 54th percent ile, respectively), compared with a mean intelligence score equivalent to the 35th percentile in the victims of intentional trauma (p < 0.00 1), Thirty percent of elective surgery patients met diagnostic criteri a for at least one category of psychopathology, compared with 50% of n onintentional trauma patients, and 63% of intentional trauma patients (p < 0.01, trauma vs, elective surgery), Logistic regression analysis identified six variables that were independently associated with an in creased tendency to be a victim of trauma: younger age, lower intellig ence, antisocial personality, mental retardation, depression, and low income, Conclusions: Victims of trauma, both nonintentional, and espec ially intentional, have a high incidence of psychopathology. Victims o f intentional trauma have significantly lower intelligence scores than either nonintentional injury or elective surgery patients, The high i ncidence of unemployment, alcohol abuse, and illicit drug use in victi ms of intentional injury might provide several opportunities for traum a prevention programs, Underlying psychological disorders will have to be addressed to reduce the likelihood of becoming a victim of trauma.