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. 2022 Aug;67(3):356-368.
doi: 10.1037/rep0000400. Epub 2022 Apr 14.

Factors associated with recovery from posttraumatic stress disorder in combat veterans: The role of deployment mild traumatic brain injury (mTBI)

Anna S Ord  1 , Erica L Epstein  1 , Elizabeth R Shull  1 , Katherine H Taber  1 , Sarah L Martindale  1 , Jared A Rowland  1
Affiliations

Factors associated with recovery from posttraumatic stress disorder in combat veterans: The role of deployment mild traumatic brain injury (mTBI)

Anna S Ord et al. Rehabil Psychol. 2022 Aug.

Abstract

Objective: Examine factors associated with recovery from posttraumatic stress disorder (PTSD) and evaluate the role of deployment mild traumatic brain injury (mTBI) in the relationship between PTSD recovery and functional outcomes.

Method: Post 9/11 combat veterans with lifetime history of PTSD (N = 124, 84.7% male) completed the Mid-Atlantic MIRECC Assessment of Traumatic Brain Injury (MMA-TBI), Salisbury Blast Interview (SBI), Clinician Administered PTSD scale (CAPS-5), cognitive assessment battery, and measures of depression, PTSD symptoms, neurobehavioral symptoms, sleep quality, pain interference, and quality of life.

Results: Analyses of variance (ANOVA) results revealed significant differences in most behavioral health outcomes based on PTSD recovery, with participants who have recovered from PTSD showing less severe neurobehavioral and depressive symptoms, better sleep quality, less functional pain interference, and higher quality of life. No differences were found in cognitive functioning between those who have recovered from PTSD and those who have not. History of deployment mTBI did not significantly moderate the relationship between PTSD recovery and most functional and cognitive outcomes with the exception of 2 measures of processing speed. Specifically, among participants with history of deployment mTBI, those who have recovered from PTSD displayed better cognitive functioning than those who have not. Additionally, participants who have not recovered from PTSD had higher levels of blast exposure during military service.

Conclusions: PTSD recovery was associated with better psychological functioning and higher quality of life, but not with objective cognitive functioning. Deployment mTBI history moderated only the relationship between PTSD recovery status and tests of processing speed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

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Conflict of interest statement

Disclosure

There are no conflicts of interest to disclose. This work was supported by grant funding from the Department of Defense, Chronic Effects of Neurotrauma Consortium (CENC) Award W81XWH-13-2-0095 and Department of Veterans Affairs CENC Award I01 CX001135. This work was also supported by resources of the Research & Academic Affairs Service Line, Salisbury Veterans Affairs Healthcare System, Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), and Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness, Research, and Treatment (MIRT).

Figures

Figure 1
Figure 1. PSI Standard Scores Based on PTSD Recovery Status and Deployment Mild TBI History
Note. Standard scores have a mean of 100 and standard deviation of 15, with higher scores indicating better cognitive functioning. PSI = Processing Speed Index of the Wechsler Adult Intelligence Scale, 4th edition; PTSD = posttraumatic stress disorder; Deployment TBI = deployment-related mild traumatic brain injury. Among participants without history of deployment mild TBI, the difference in PSI scores based on PTSD recovery status was not statistically significant. However, among participants with history of deployment mild TBI, the difference between those who have recovered from PTSD (M = 96.81; SD = 12.41) and those who have not recovered (M = 89.48; SD = 11.05) was statistically significant (p = .003) with a medium effect size (Cohen’s d = 0.50). Error bars represent standard error.
Figure 2
Figure 2. TMT-A T-Scores Based on PTSD Recovery Status and Deployment Mild TBI History
Note. T-scores have a mean of 50 and standard deviation of 10, with higher scores indicating better cognitive functioning. TMT-A = Trail Making Test A; PTSD = posttraumatic stress disorder; Deployment TBI = deployment-related mild traumatic brain injury. Among participants without history of deployment mild TBI, the difference in TMT-A scores based on PTSD recovery status was not statistically significant. However, among participants with history of deployment mild TBI, the difference between those who have recovered from PTSD (M = 47.03; SD = 9.62) and those who have not recovered (M = 41.33; SD = 12.30) was statistically significant (p = .018) with a medium effect size (Cohen’s d = 0.52). Error bars represent standard error.
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