title: Responses to Traumatic Brain Injury Screening Questions and Suicide Attempts among Those Seeking Veterans Health Administration Mental Health Services.
abstract: BACKGROUND
  Psychometrically sound screening tools available to aid in the identification of lifetime history of traumatic brain injury (TBI) are limited. As such, the Traumatic Brain Injury-4 (TBI-4) was developed and implemented in a Veterans Health Administration (VHA) mental health clinic. To provide information regarding both the predictive validity and clinical utility of the TBI-4, the relationship between screening results and future suicide attempts was evaluated.
  
  
  OBJECTIVE
  The aim of this study was to determine whether a positive screen on the TBI-4 was associated with increased risk for suicide attempt within 1-year post screening.
  
  
  METHODS
  The TBI-4 was administered to 1,097 Veterans at the time of mental health intake. Follow-up data regarding suicide attempts for the year post-mental health intake were obtained from suicide behavior reports (SBRs) in Veteran electronic medical records (EMRs). Fisher's exact tests were used to determine the proportion of suicide attempts by TBI-4 status.
  
  
  RESULTS
  In the year post TBI-4 screening, significantly more Veterans who screened positive had a documented suicide attempt as compared to those who screened negative (p = 0.003).
  
  
  CONCLUSIONS
  Those with a positive TBI screen at mental health intake had a higher proportion of SBRs than those who screened negative for TBI. Findings provided further psychometric support for the TBI-4. Moreover, results suggest the inclusion of this screen could prove to be helpful in identifying those who may be at risk for future suicide attempt within 1-year post screening.
authors.affiliation: Rocky Mountain Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs , Denver, CO , USA.
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Schneider
authors.affiliation: Rocky Mountain Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs , Denver, CO , USA.
authors.forename: Trisha A
authors.initials: TA
authors.lastname: Hostetter
authors.affiliation: Rocky Mountain Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs, Denver, CO, USA; Department of Psychiatry, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Beeta Y
authors.initials: BY
authors.lastname: Homaifar
authors.affiliation: Rocky Mountain Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs, Denver, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO, USA; Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA.
authors.forename: Jeri E
authors.initials: JE
authors.lastname: Forster
authors.affiliation: Rocky Mountain Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs, Denver, CO, USA; Department of Psychiatry, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Olson-Madden
authors.affiliation: Rocky Mountain Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs, Denver, CO, USA; Department of Psychiatry, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Bridget B
authors.initials: BB
authors.lastname: Matarazzo
authors.affiliation: Rocky Mountain Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs , Denver, CO , USA.
authors.forename: Joe
authors.initials: J
authors.lastname: Huggins
authors.affiliation: Rocky Mountain Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs, Denver, CO, USA; Department of Psychiatry, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO, USA; Department of Neurology, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Brenner
keywords: Veteran; predictive validity; psychometrics; screening; suicide; traumatic brain injury