Article

Deployment-related TBI, persistent postconcussive symptoms, PTSD, and depression in OEF/OIF veterans.

Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas, USA.
Rehabilitation Psychology (Impact Factor: 1.91). 11/2011; 56(4):340-50. DOI: 10.1037/a0025462
Source: PubMed

ABSTRACT A substantial proportion of the more than 2 million service members who have served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) have experienced a traumatic brain injury (TBI). Understanding the long-term impact of TBI is complicated by the nonspecific nature of postconcussive symptoms (PCSs) and the high rates of co-occurrence among TBI, posttraumatic stress disorder (PTSD), and depression. The goal of the present research was to examine the relations among TBI, persistent PCSs, and symptoms of PTSD and depression among returning OEF/OIF veterans.
213 OEF/OIF veterans (87% male) completed a semistructured screening interview assessing deployment-related TBI and current, persistent PCSs. Participants also completed self-report measures of combat exposure and current symptoms of PTSD and depression.
Nearly half (46%) of sampled veterans screened positive for TBI, the majority of whom (85%) reported at least one persistent PCS after removing PCSs that overlapped with PTSD and depression. Veterans with deployment-related TBI reported higher levels of combat exposure and symptoms of PTSD and depression. Structural equation modeling was used to assess the fit of 3 models of the relationships among TBI, combat exposure, persistent PCSs, PTSD, and depression. Consistent with hypotheses, the best-fitting model was one in which the effects of TBI on both PTSD and depression were fully mediated by nonoverlapping persistent PCSs.
These findings highlight the importance of addressing persistent PCSs in order to facilitate the functional recovery of returning war veterans.

Download full-text

Full-text

Available from: Sara L Dolan, Apr 11, 2014
3 Followers
 · 
426 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are presenting with high rates of co-occurring posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). The purpose of this study was to compare the clinical presentations of combat-veterans with PTSD and TBI (N=40) to those with PTSD only (N=56). Results suggest that the groups present two distinct clinical profiles, with the PTSD+TBI group endorsing significantly higher PTSD scores, higher overall anxiety, and more functional limitations. The higher PTSD scores found for the PTSD+TBI group appeared to be due to higher symptom intensity, but not higher frequency, across PTSD clusters and symptoms. Groups did not differ on additional psychopathology or self-report of PTSD symptoms or executive functioning. Further analysis indicated PTSD severity, and not TBI, was responsible for group differences, suggesting that treatments implicated for PTSD would likely be effective for this population.
    Journal of anxiety disorders 04/2013; DOI:10.1016/j.janxdis.2013.04.003 · 2.68 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Traumatic brain injury (TBI) is a frequent occurrence in the United States, and has been given particular attention in the veteran population. Recent accounts have estimated TBI incidence rates as high as 20 % among US veterans who served in Afghanistan or Iraq, and many of these veterans experience a host of co-morbid concerns, including psychiatric complaints (such as depression and post-traumatic stress disorder), sleep disturbance, and substance abuse which may warrant referral to behavioral health specialists working in primary care settings. This paper reviews many common behavioral health concerns co-morbid with TBI, and suggests areas in which behavioral health specialists may assess, intervene, and help to facilitate holistic patient care beyond the acute phase of injury. The primary focus is on sequelae common to mild and moderate TBI which may more readily present in primary care clinics.
    Journal of Clinical Psychology in Medical Settings 11/2012; 19(4). DOI:10.1007/s10880-012-9345-9 · 1.49 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Few studies have sought to explore the subjective experience of reintegration for veterans of the current Operations Enduring Freedom/Iraqi Freedom/New Dawn military campaigns, and even less attention has been given to discover strategies used by veterans to overcome difficulties with transitioning from life in a combat zone to life at home. Findings of this mixed-method study describe reintegration challenges faced by a sample of student veterans as well as some of the strategies they used in response to those challenges. This study provides direction for nurses and postsecondary educators to support veterans who struggle with their personal experience of coming home from the war.
    ANS. Advances in nursing science 36(3):186-199. DOI:10.1097/ANS.0b013e31829edcbe · 0.87 Impact Factor