title: Traumatic Brain Injury and Suicidal Ideation Among U.S. Operation Enduring Freedom and Operation Iraqi Freedom Veterans.
abstract: Traumatic brain injury (TBI) is associated with suicidal behavior among veterans, and gender differences in the strength of associations may exist. Almost all research has been limited to Veterans Health Administration (VHA) patients, and it is unclear if findings generalize to veterans who do not use VHA services. We examined gender- and VHA-user-specific associations between TBI related to deployment and postdeployment suicidal ideation in a U.S. national sample of 1,041 female and 880 male Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. Path analysis was used to estimate TBI and suicidal ideation association, and examine PTSD and depression symptomatology in these associations. TBI was associated with suicidal ideation among male VHA users, OR = 3.64, 95% CI [2.21, 6.01]; and male and female nonusers, OR = 2.24, 95% CI [1.14, 4.44] and OR = 2.65, 95% CI [1.26, 5.58], respectively, in unadjusted analyses. This association was explained by depression symptoms among male and female nonusers. Among male VHA users an association between TBI and suicidal ideation remained when accounting for depression symptoms, OR = 2.50, 95% CI [1.33, 4.71]. Our findings offered evidence of an association between TBI and suicidal ideation among male OEF/OIF VHA users.
authors.affiliation: Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.|Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.|Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.
authors.forename: Jaimie L
authors.initials: JL
authors.lastname: Gradus
authors.affiliation: Department of Psychology, University of North Carolina, Greensboro, North Carolina, USA.
authors.forename: Blair E
authors.initials: BE
authors.lastname: Wisco
authors.affiliation: Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Luciano
authors.affiliation: Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.|Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Iverson
authors.affiliation: Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.|Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Marx
authors.affiliation: Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.|Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Street
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001930:Brain Injuries / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D059020:Suicidal Ideation; D014481:United States; D014728:Veterans / Q000523:psychology*