Factors Influencing Postconcussion and Posttraumatic Stress Symptom Reporting Following Military-Related Concurrent Polytrauma and Traumatic Brain Injury

The purpose of this study was to identify factors that are predictive of, or associated with, high endorsement of postconcussion and posttraumatic stress symptoms following military-related traumatic brain injury (TBI). Participants were 1,600 U.S. service members (age: M = 27.1, SD = 7.1; 95.4% mal...

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Bibliographic Details
Published in:	Archives of clinical neuropsychology Vol. 29; no. 4; pp. 329 - 347
Main Authors:	LANGE, Rael T, BRICKELL, Tracey A, KENNEDY, Jan E, BAILIE, Jason M, SILLS, Cheryl, ASMUSSEN, Sarah, AMADOR, Ricardo, DILAY, Angelica, IVINS, Brian, FRENCH, Louis M
Format:	Journal Article
Language:	English
Published:	Oxford Oxford University Press 01-06-2014
Subjects:	Adult Adult and adolescent clinical studies Anxiety disorders. Neuroses Biological and medical sciences Brain Injuries - complications Female Glasgow Coma Scale Hospitals, Military Humans Injuries of the nervous system and the skull. Diseases due to physical agents Logistic Models Male Medical sciences Military Personnel Multiple trauma Multiple Trauma - complications Neuropsychological Tests Organic mental disorders. Neuropsychology Post-Concussion Syndrome - etiology Post-traumatic stress disorder Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Retrospective Studies Risk Factors Stress Disorders, Post-Traumatic - etiology Trauma Severity Indices Traumas. Diseases due to physical agents United States Young Adult United States Mood disorder Human Nervous system diseases Traumatic brain injury Anxiety disorder Depression Posttraumatic stress disorder Late effects of head injury Trauma Posttraumatic stress Postconcussion Symptomatology Concomitant disease Central nervous system disease Complication Head trauma Multiple injury Military
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Summary:	The purpose of this study was to identify factors that are predictive of, or associated with, high endorsement of postconcussion and posttraumatic stress symptoms following military-related traumatic brain injury (TBI). Participants were 1,600 U.S. service members (age: M = 27.1, SD = 7.1; 95.4% male) who had sustained a mild-to-moderate TBI and who had been evaluated by the Defense and Veterans Brain Injury Center at one of six military medical centers. Twenty-two factors were examined that included demographic, injury circumstances/severity, treatment/evaluation, and psychological/physical variables. Four factors were statistically and meaningfully associated with clinically elevated postconcussion symptoms: (i) low bodily injury severity, (ii) posttraumatic stress, (iii) depression, and (iv) military operation where wounded (p < .001, 43.2% variance). The combination of depression and posttraumatic stress symptoms accounted for the vast majority of unique variance (41.5%) and were strongly associated with, and predictive of, clinically elevated postconcussion symptoms [range: odds ratios (OR) = 4.24-7.75; relative risk (RR) = 2.28-2.51]. Five factors were statistically and meaningfully associated with clinically elevated posttraumatic stress symptoms: (i) low bodily injury severity, (ii) depression, (iii) a longer time from injury to evaluation, (iv) military operation where wounded, and (v) current auditory deficits (p < .001; 65.6% variance accounted for). Depression alone accounted for the vast majority of unique variance (60.0%) and was strongly associated with, and predictive of, clinically elevated posttraumatic stress symptoms (OR = 38.78; RR = 4.63). There was a very clear, strong, and clinically meaningful association between depression, posttraumatic stress, and postconcussion symptoms in this sample. Brain injury severity, however, was not associated with symptom reporting following TBI.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0887-6177 1873-5843
DOI:	10.1093/arclin/acu013