title: The Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) semistructured interview: evidence of research utility and validity.
abstract: OBJECTIVE
  Report the prevalence of lifetime and military-related traumatic brain injuries (TBIs) in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans and validate the Boston Assessment of TBI-Lifetime (BAT-L).
  
  
  METHODS
  The BAT-L is the first validated, postcombat, semistructured clinical interview to characterize head injuries and diagnose TBIs throughout the life span.
  
  
  METHODS
  Community-dwelling convenience sample of 131 OEF/OIF veterans.
  
  
  METHODS
  TBI criteria (alteration of mental status, posttraumatic amnesia, and loss of consciousness) were evaluated for all possible TBIs, including a novel evaluation of blast exposure.
  
  
  METHODS
  BAT-L, Ohio State University TBI Identification Method (OSU-TBI-ID).
  
  
  RESULTS
  About 67% of veterans incurred a TBI in their lifetime. Almost 35% of veterans experienced at least 1 military-related TBI; all were mild in severity, 40% of them were due to blast, 50% were due to some other (ie, blunt) mechanism, and 10% were due to both types of injuries. Predeployment TBIs were frequent (45% of veterans). There was strong correspondence between the BAT-L and the OSU-TBI-ID (Cohen κ = 0.89; Kendall τ-b = 0.95). Interrater reliability of the BAT-L was strong (κs >0.80).
  
  
  CONCLUSIONS
  The BAT-L is a valid instrument with which to assess TBI across a service member's lifetime and captures the varied and complex nature of brain injuries across OEF/OIF veterans' life span.
authors.affiliation: Translational Research Center for TBI and Stress Disorders and Geriatric Research, Education and Clinical Center (Drs Fortier, Amick, Kenna, Milberg, and McGlinchey and Mss Clark and Morra), Psychology Service (Dr Grande), and Physical Medicine & Rehabilitation Service (Dr McGlynn), VA Boston Healthcare System; Department of Psychiatry, Harvard Medical School (Drs Fortier, Milberg, and McGlinchey); and Department of Psychiatry, Boston University Medical School (Drs Amick, Grande, and McGlynn), Boston, Massachusetts.
authors.forename: Catherine Brawn
authors.initials: CB
authors.lastname: Fortier
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Amick
authors.forename: Laura
authors.initials: L
authors.lastname: Grande
authors.forename: Susan
authors.initials: S
authors.lastname: McGlynn
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kenna
authors.forename: Lindsay
authors.initials: L
authors.lastname: Morra
authors.forename: Alexandra
authors.initials: A
authors.lastname: Clark
authors.forename: William P
authors.initials: WP
authors.lastname: Milberg
authors.forename: Regina E
authors.initials: RE
authors.lastname: McGlinchey
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D035843:Biomedical Research; D001753:Blast Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D001900:Boston; D001930:Brain Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult
references.citation: Am J Epidemiol. 2008 Jun 15;167(12):1446-52
references.pmid: 18424429
references.citation: Br J Psychiatry. 2012 Sep;201(3):186-92
references.pmid: 22743844
references.citation: JAMA. 2003 Nov 19;290(19):2549-55
references.pmid: 14625331
references.citation: J Int Neuropsychol Soc. 2012 May;18(3):595-605
references.pmid: 22459022
references.citation: Arch Clin Neuropsychol. 2009 Feb;24(1):3-10
references.pmid: 19395352
references.citation: Arch Phys Med Rehabil. 2007 Apr;88(4):418-26
references.pmid: 17398241
references.citation: J Head Trauma Rehabil. 2009 Jan-Feb;24(1):14-23
references.pmid: 19158592
references.citation: N Engl J Med. 2005 Mar 31;352(13):1335-42
references.pmid: 15800229
references.citation: J Neuropsychiatry Clin Neurosci. 2006 Spring;18(2):141-5
references.pmid: 16720789
references.citation: Neurosurgery. 2001 Jan;48(1):26-45; discussion 45-6
references.pmid: 11152359
references.citation: J Head Trauma Rehabil. 2007 Nov-Dec;22(6):318-29
references.pmid: 18025964
references.citation: J Rehabil Res Dev. 2012;49(4):545-56
references.pmid: 22773258
references.citation: N Engl J Med. 2011 Jun 2;364(22):2091-100
references.pmid: 21631321
references.citation: Rehabil Psychol. 2011 Feb;56(1):26-31
references.pmid: 21401283
references.citation: J Head Trauma Rehabil. 2011 Nov-Dec;26(6):439-53
references.pmid: 21386716
references.citation: N Engl J Med. 2008 Jan 31;358(5):453-63
references.pmid: 18234750
references.citation: J Orthop Trauma. 2007 Apr;21(4):254-7
references.pmid: 17414553
references.citation: J Int Neuropsychol Soc. 2009 Jan;15(1):1-8
references.pmid: 19128523