title: Associations Between Traumatic Brain Injury, Suspected Psychiatric Conditions, and Unemployment in Operation Enduring Freedom/Operation Iraqi Freedom Veterans.
abstract: To examine the relations among demographic characteristics, traumatic brain injury (TBI) history, suspected psychiatric conditions, current neurobehavioral health symptoms, and employment status in Veterans evaluated for TBI in the Department of Veterans Affairs.
  
  
  
  Retrospective cross-sectional database review of comprehensive TBI evaluations documented between October 2007 and June 2009.
  
  
  
  Operation Enduring Freedom/Operation Iraqi Freedom Veterans (n = 11 683) who completed a comprehensive TBI evaluation.
  
  
  
  Veterans Affairs clinicians use the comprehensive TBI evaluations to obtain information about TBI-related experiences, current neurobehavioral symptoms, and to identify suspected psychiatric conditions.
  
  
  
  Approximately one-third of Veterans in this sample were unemployed, and of these, the majority were looking for work. After simultaneously adjusting for health and deployment-related variables, significant factors associated with unemployment included one or more suspected psychiatric conditions (eg, posttraumatic stress disorder, anxiety, depression), neurobehavioral symptom severity (ie, affective, cognitive, vestibular), former active duty status, injury etiology, age, lower education, and marital status. The associations of these factors with employment status varied by deployment-related TBI severity.
  
  
  
  Simultaneously addressing health-related, educational, and/or vocational needs may fill a critical gap for helping Veterans readjust to civilian life and achieve their academic and vocational potential.
authors.affiliation: Center for Healthcare Organization and Implementation Research (Drs Pogoda, Baker, Iverson, and Meterko and Ms Stolzmann), National Center for Posttraumatic Stress Disorder (Dr Iverson), and Research and Development Service (Dr Krengel), VA Boston Healthcare System, Boston, Massachusetts; Department of Health Policy & Management, Boston University School of Public Health, Boston, Massachusetts (Drs Pogoda and Meterko); Departments of Psychiatry (Dr Iverson) and Neurology (Dr Krengel), Boston University School of Medicine, Boston, Massachusetts; Department of Physical Medicine and Rehabilitation, Defense and Veterans Brain Injury Center (DVBIC), Virginia Commonwealth University, Richmond (Dr Lew); Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu (Dr Lew); and Defense Resources Management Institute, Naval Postgraduate School, Monterey, California (Dr Amara).
authors.forename: Terri K
authors.initials: TK
authors.lastname: Pogoda
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Stolzmann
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Iverson
authors.forename: Errol
authors.initials: E
authors.lastname: Baker
authors.forename: Maxine
authors.initials: M
authors.lastname: Krengel
authors.forename: Henry L
authors.initials: HL
authors.lastname: Lew
authors.forename: Jomana H
authors.initials: JH
authors.lastname: Amara
authors.forename: Mark
authors.initials: M
authors.lastname: Meterko
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D000070642:Brain Injuries, Traumatic / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D012189:Retrospective Studies; D014478:Unemployment; D014728:Veterans / Q000523:psychology*; D055815:Young Adult