Association between combat stress and post-concussive symptom reporting in OEF/OIF service members with mild traumatic brain injuries.
OBJECTIVE
The relationship between combat stress and post-concussive symptoms in service members with mild traumatic brain injuries (mTBI) is poorly understood. It was hypothesized that the co-occurrence of combat stress would have a significant effect on the severity of post-concussive complaints, specifically on emotional and cognitive symptoms.


METHODS
Four hundred and seventy-two combat-deployed service members with mTBI completed self-report inventories of post-traumatic stress and post-concussive symptoms. Two groups were formed based on post-traumatic stress symptoms (High Combat Stress and Low Combat Stress).


RESULTS
A 3-8-fold increase in post-concussive symptoms was observed when comparing the High and Low Combat Stress Groups. Elevations in post-concussive symptom reporting were not limited to emotional and/or cognitive symptoms, but rather were inclusive of all measured post-concussive symptoms.


CONCLUSIONS
The findings of the present study suggest that non-brain injury-related factors, such as high-levels of combat stress, may impact post-concussive symptom reporting in this population, further confounding the accuracy of the post-concussion syndrome (PCS) diagnosis. Considerable caution should be exercised in making the diagnosis of PCS in concussed service members with co-occurring combat-stress disorders.
Department of Orthopedics & Rehabilitation, Brooke Army Medical Center, Ft. Sam Houston, TX, USA. douglas.cooper2@amedd.army.mil
Douglas B
DB
Cooper
Jan E
JE
Kennedy
Maren A
MA
Cullen
Edan
E
Critchfield
Ricardo R
RR
Amador
Amy O
AO
Bowles
D000328:Adult; D001753:Blast Injuries / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D015331:Cohort Studies; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data; D038223:Post-Concussion Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires