title: Head injury as a PTSD predictor among Oklahoma City bombing survivors.
abstract: BACKGROUND
  The aim of the Oklahoma City (OKC) bombing retrospective review was to investigate the relationship between physical injury, environmental contributors, and psychiatric disorders such as posttraumatic stress disorder (PTSD) in an event-based, matched design study focused on injury.
  
  
  METHODS
  The 182 selected participants were a random subset of the 1,092 direct survivors from the OKC bombing. Only 124 of these 182 cases had a full complement of medical/clinical data in the OKC database. These 124 cases were assessed to explore relationships among PTSD diagnoses, levels of blast exposure, and physical injuries. Associations among variables were statistically tested using contingency analysis and logistic regression.
  
  
  RESULTS
  Comparison of the PTSD cases to symptoms/diagnoses reported in the medical records reveals a statistically significant association between PTSD and head/brain injuries associated with head acceleration. PTSD was not highly correlated with other injuries. Although blast pressure and impulse were highly correlated with head injuries, the correlation with PTSD was not statistically significant. Thus, a correlation between blast pressure and PTSD may exist, but higher fidelity pressure calculations are required to elucidate this potential relationship.
  
  
  CONCLUSIONS
  This study provides clear evidence that head injury is associated with subsequent PTSD, giving caregivers' information on what physical injuries may suggest the development of psychologic disorders to aid them in developing a profile for the identification of future survivors of terrorist attacks and Warfighters with brain injuries and potential PTSD.
authors.affiliation: Applied Research Associates, San Antonio, Texas, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Walilko
authors.forename: Carol
authors.initials: C
authors.lastname: North
authors.forename: Lee Ann
authors.initials: LA
authors.lastname: Young
authors.forename: Warren E
authors.initials: WE
authors.lastname: Lux
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Warden
authors.forename: Michael S
authors.initials: MS
authors.lastname: Jaffee
authors.forename: David F
authors.initials: DF
authors.lastname: Moore
mesh_terms: D000328:Adult; D054042:Bombs; D016009:Chi-Square Distribution; D006259:Craniocerebral Trauma / Q000150:complications*; D005107:Explosions; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009825:Oklahoma; D012189:Retrospective Studies; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology* / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D023481:Terrorism / Q000523:psychology*