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. 2022 Aug;31(8):2411-2422.
doi: 10.1007/s11136-022-03092-4. Epub 2022 Jan 25.

Clinical utility of PTSD, resilience, sleep, and blast as risk factors to predict poor neurobehavioral functioning following traumatic brain injury: A longitudinal study in U.S. military service members

Rael T Lange  1   2   3   4   5 , Louis M French  6   7   8   9 , Jason M Bailie  6   10   11 , Victoria C Merritt  12   13 , Cassandra L Pattinson  14 , Lars D Hungerford  6   15   11 , Sara M Lippa  7   8 , Tracey A Brickell  6   7   8   9   11
Affiliations

Clinical utility of PTSD, resilience, sleep, and blast as risk factors to predict poor neurobehavioral functioning following traumatic brain injury: A longitudinal study in U.S. military service members

Rael T Lange et al. Qual Life Res. 2022 Aug.

Abstract

Purpose: This study examined the clinical utility of post-traumatic stress disorder (PTSD), low resilience, poor sleep, and lifetime blast exposure as risk factors for predicting future neurobehavioral outcome following traumatic brain injury (TBI).

Methods: Participants were 591 U.S. military service members and veterans who had sustained a TBI (n = 419) or orthopedic injury without TBI (n = 172). Participants completed the Neurobehavioral Symptom Inventory, PTSD Checklist, and the TBI-Quality of Life (TBI-QOL) scale at baseline and follow-up.

Results: Using the four risk factors at baseline, 15 risk factor combinations were examined by calculating odds ratios to predict poor neurobehavioral outcome at follow-up (i.e., number of abnormal scores across five TBI-QOL scales [e.g., Fatigue, Depression]). The vast majority of risk factor combinations resulted in odds ratios that were considered to be clinically meaningful (i.e., ≥ 2.5) for predicting poor outcome. The risk factor combinations with the highest odds ratios included PTSD singularly, or in combination with poor sleep and/or low resilience (odds ratios = 4.3-72.4). However, poor sleep and low resilience were also strong predictors in the absence of PTSD (odds ratios = 3.1-29.8).

Conclusion: PTSD, poor sleep, and low resilience, singularly or in combination, may be valuable risk factors that can be used clinically for targeted early interventions.

Keywords: Military; Posttraumatic stress; Resilience; Sleep disturbance; Traumatic brain injury.

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References

    1. Traumatic Brain Injury Center of Excellence. (2021). DoD worldwide numbers for traumatic brain injury. Retrieved July 1, 2021, from https://dvbic.dcoe.mil/dod-worldwide-numbers-tbi
    1. Cole, W. R., & Bailie, J. M. (2016). Neurocognitive and psychiatric symptoms following mild traumatic brain injury. In D. Laskowitz & G. Grant (Eds.), Translational research in traumatic brain injury. Boca Raton: CRC Press/Taylor and Francis Group.
    1. Iverson, G. L. (2012). A biopsychosocial conceptualization of poor outcome from mild traumatic brain injury. In J. J. Vasterling, R. A. Bryant, & T. M. Keane (Eds.), PTSD and mild traumatic brain injury. The Guilford Press.
    1. Lange, R. T., French, L. M., Lippa, S. M., Bailie, J. M., & Brickell, T. A. (2020). Posttraumatic stress disorder is a stronger predictor of long-term neurobehavioral outcomes than traumatic brain injury severity. Journal of Traumatic Stress, 33(3), 318–329. - PubMed - DOI
    1. Pogoda, T. K., Levy, C. E., Helmick, K., & Pugh, M. J. (2017). Health services and rehabilitation for active duty service members and veterans with mild TBI. Brain Injury, 31(9), 1220–1234. - PubMed - DOI

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