Factors Associated With Orofacial Injury and Willingness to Participate in Interventions Among Adolescents Treated in Trauma Centers
Purpose
Assault is the most common cause of facial injuries in adolescents treated at inner-city trauma centers, yet little is known about the behavioral and environmental antecedents of these injuries or the willingness of such at-risk adolescents to participate in behavioral interventions to minimize reinjury. The purpose of this study was to identify possible risk and protective factors among adolescents with assault-related facial injury and to assess their willingness to participate in prospective observational research and behavioral interventions.
Patients and Methods
Interviews were conducted with 67 adolescents (range 14 to 20 yrs) who were treated in trauma centers for facial injuries. Most of these injuries were assault-related (59%), followed by motor vehicle or other accidents (29%), gunshot wounds (9%), and sports injuries (3%). The subjects were predominantly male (86%) and of ethnic minorities (91%).
Results
The adolescents showed high rates of intentional injuries in the past 6 months (56%), unhealthy alcohol use, and in more than half (55%) problem levels of substance use. Compared with those with unintentional injuries, adolescents who experienced assault-related injuries were more likely to report using alcohol, tobacco, and other substances. Although a significant segment of the sample (55%) had been arrested previously, no differences in arrest rates or types of crimes for which adolescents were arrested were observed by injury type. Most subjects were unwilling to participate in interventions that involved multiple sessions; however, greater family cohesion predicted the likelihood of being willing to participate.
Conclusions
Most facial injuries in inner-city adolescents result from assault. Unhealthy alcohol use, problem levels of substance use behaviors, and family history of alcohol problems are associated markers of assault-related injuries that can be useful for risk assessment and targeted intervention. Interventions need to be brief if they are to engage these at-risk youth.
⁎Research Psychologist, Health Risk Reduction Projects, Integrated Substance Abuse Programs, Department of Psychiatry, University of California, Los Angeles, CA
†Professor, Section of Oral and Maxillofacial Surgery, University of California, Los Angeles, CA
‡Statistician, Section of Oral and Maxillofacial Surgery, University of California, Los Angeles, CA
§Project Director, Health Risk Reduction Projects, Integrated Substance Abuse Programs, Department of Psychiatry, University of California, Los Angeles, CA
∥Project Director, Health Risk Reduction Projects, Integrated Substance Abuse Programs, Department of Psychiatry, University of California, Los Angeles, CA
¶Division Head, Division of Plastic and Maxillofacial Surgery, Children's Hospital of Los Angeles, CA
#Director and Chairman, Department of Oral and Maxillofacial Surgery, University of Southern California, Los Angeles, CA
Address correspondence and reprint requests to Dr Murphy: Department of Psychiatry, UCLA, 11075 Santa Monica Blvd, Suite 200, Los Angeles, CA 90025-7539
This research was supported by Grant #DE 16490 from the National Institute of Dental and Craniofacial Research (to D.A.M.).
ABSTRACT