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. 2011 Nov;56(4):340-50.
doi: 10.1037/a0025462.

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

Sandra B Morissette  1 , Matthew Woodward, Nathan A Kimbrel, Eric C Meyer, Marc I Kruse, Sara Dolan, Suzy Bird Gulliver
Affiliations

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

Sandra B Morissette et al. Rehabil Psychol. 2011 Nov.

Abstract

Objective: 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.

Method: 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.

Results: 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.

Conclusions: These findings highlight the importance of addressing persistent PCSs in order to facilitate the functional recovery of returning war veterans.

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Figures

Figure 1
Figure 1
Hypothesized structural equation model (Model 1) designed to test the hypothesis that persistent PCS fully mediate the effects of TBI on PTSD and depression symptoms. Standardized maximum likelihood estimates are shown (N = 213).
Figure 2
Figure 2
Alternative structural equation model (Model 3) designed to test the competing hypothesis that PTSD and depression symptoms fully mediate the effects of TBI on persistent PCS. Standardized maximum likelihood estimates are shown (N = 213).
See this image and copyright information in PMC

References

    1. Alderfer BS, Arciniegas DB, Silver JM. Treatment of depression following traumatic brain injury. Journal of Head Trauma and Rehabilitation. 2005;20:544–562. - PubMed
    1. American Psychiatric Association . Diagnostic and statistical manual of mental disorders. Revised 4th ed. Author; Washington, DC: 2000.
    1. Arbuckle J. Amos 7.0 User's Guide. Amos Development Corporation; Spring House, PA: 2006.
    1. Armed Forces Health Surveillance Center DoD numbers for traumatic brain injury [data file] 2011 Retrieved from http://www.dvbic.org/TBI-Numbers.aspx.
    1. Bagozzi RP, Heatherton TF. A general approach to representing multifaceted personality constructs: Application to state self-esteem. Structural Equation Modeling. 1994;1:35–67.

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