Traumatic brain injury and violent behavior in females: A systematic review

Abstract Background Research on causes and consequences of neurodisability has established a positive link between traumatic brain injury (TBI) and risk of violence among males. The nature and contribution of TBI to violence risk in females is equivocal and research with females is under-represented in the domain. The primary objective of this paper was to systematically review the strength of results of empirical research into the relationship between TBI and violence in females. Methods Three databases were searched (PsychINFO, Scopus, and PubMed) and supplemented with citation searches (until February, 2013). Methodological rigor was appraised using the Cochrane Handbook's general guidance on non-experimental studies. Results: Only six of 153 identified papers met inclusion criteria. Three studies provided evidence of a positive relationship between violence and TBI in females specifically. The remaining found no significant gender differences between levels of post-TBI violence, suggesting females exhibit similar levels of violence to males. The studies contribute knowledge of other factors that may influence post-TBI violence in females, including psychiatric comorbidities and childhood abuse. It was concluded that the strength of evidence suggesting a relationship between TBI and violence in females is poor considering methodological limitations and scarcity of research. However, key findings herein indicate utility of further research to inform intervention and management. Results Only six of 153 identified papers met inclusion criteria. Three studies provided evidence of a positive relationship between violence and TBI in females specifically. The remaining found no significant gender differences between levels of post-TBI violence, suggesting females exhibit similar levels of violence to males. The studies contribute knowledge of other factors that may influence post-TBI violence in females, including psychiatric comorbidities and childhood abuse. It was concluded that the strength of evidence suggesting a relationship between TBI and violence in females is poor considering methodological limitations and scarcity of research. However, key findings herein indicate utility of further research to inform intervention and management.