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Health Outcomes Associated With Military Deployment: Mild Traumatic Brain Injury, Blast, Trauma, and Combat Associations in the Florida National Guard

Health Services Research and Development (HSR&D)/Rehabilitation Research and Development (RR&D) Center of Excellence: Maximizing Rehabilitation Outcomes, James A. Haley Veterans' Hospital, Tampa, FL
Archives of physical medicine and rehabilitation (Impact Factor: 2.44). 06/2012; 93(11). DOI: 10.1016/j.apmr.2012.05.024
Source: PubMed

ABSTRACT Vanderploeg RD, Belanger HG, Horner RD, Spehar AM, Powell-Cope G, Luther SL, Scott SG. Health outcomes associated with military deployment: mild traumatic brain injury, blast, trauma, and combat associations in the Florida National Guard. OBJECTIVES: To determine the association between specific military deployment experiences and immediate and longer-term physical and mental health effects, as well as examine the effects of multiple deployment-related traumatic brain injuries (TBIs) on health outcomes. DESIGN: Online survey of cross-sectional cohort. Odds ratios were calculated to assess the association between deployment-related factors (ie, physical injuries, exposure to potentially traumatic deployment experiences, combat, blast exposure, and mild TBI) and current health status, controlling for potential confounders, demographics, and predeployment experiences. SETTING: Nonclinical. PARTICIPANTS: Members (N=3098) of the Florida National Guard (1443 deployed, 1655 not deployed). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Presence of current psychiatric diagnoses and health outcomes, including postconcussive and non-postconcussive symptoms. RESULTS: Surveys were completed an average of 31.8 months (SD=24.4, range=0-95) after deployment. Strong, statistically significant associations were found between self-reported military deployment-related factors and current adverse health status. Deployment-related mild TBI was associated with depression, anxiety, posttraumatic stress disorder (PTSD), and postconcussive symptoms collectively and individually. Statistically significant increases in the frequency of depression, anxiety, PTSD, and a postconcussive symptom complex were seen comparing single to multiple TBIs. However, a predeployment TBI did not increase the likelihood of sustaining another TBI in a blast exposure. Associations between blast exposure and abdominal pain, pain on deep breathing, shortness of breath, hearing loss, and tinnitus suggested residual barotrauma. Combat exposures with and without physical injury were each associated not only with PTSD but also with numerous postconcussive and non-postconcussive symptoms. The experience of seeing others wounded or killed or experiencing the death of a buddy or leader was associated with indigestion and headaches but not with depression, anxiety, or PTSD. CONCLUSIONS: Complex relationships exist between multiple deployment-related factors and numerous overlapping and co-occurring current adverse physical and psychological health outcomes. Various deployment-related experiences increased the risk for postdeployment adverse mental and physical health outcomes, individually and in combination. These findings suggest that an integrated physical and mental health care approach would be beneficial to postdeployment care.

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    • "Frontiers in Behavioral Neuroscience www.frontiersin.org June 2014 | Volume 8 | Article 213 | 1 BEHAVIORAL NEUROSCIENCE American Psychiatric Association, 2013; see also Vanderploeg et al., 2012; Vasterling et al., 2012 "
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    Frontiers in Behavioral Neuroscience 06/2014; 8:213. DOI:10.3389/fnbeh.2014.00213 · 4.16 Impact Factor
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    • " poly - trauma comorbidities ; that is , though no differences in severity of psychiatric impairments or headaches were observed , these patients respond more negatively to their comorbid headaches and / or PTSD which in turn affect their performance . There are complex relationships between deployment - related factors and current health status ( Vanderploeg et al . , 2012 ) and some patients may be more cognitively vulnerable to such factors ( Larrabee et al . , 2013 ) . In line with this , it is possible that additional variables , such as medication effects , substance abuse , and comorbid medical conditions , have an interaction effect with the TMT B and associated neuropsychological functioning . Fin"
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    Archives of Clinical Neuropsychology 10/2013; DOI:10.1093/arclin/act080 · 1.92 Impact Factor
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