Community Reintegration Problems Among Veterans and Active Duty Service Members With Traumatic Brain Injury.
To examine community reintegration problems among Veterans and military service members with mild or moderate/severe traumatic brain injury (TBI) at 1 year postinjury and to identify unique predictors that may contribute to these difficulties.



VA Polytrauma Rehabilitation Centers.



Participants were 154 inpatients enrolled in the VA TBI Model Systems Program with available injury severity data (mild = 28.6%; moderate/severe = 71.4%) and 1-year postinjury outcome data.



Prospective, longitudinal cohort.



Community reintegration outcomes included independent driving, employability, and general community participation. Additional measures assessed depression, posttraumatic stress, and cognitive and motor functioning.



In the mild TBI (mTBI) group, posttraumatic stress disorder and depressive symptoms were associated with lower levels of various community reintegration outcomes. In the moderate/severe TBI group, cognition and motor skills were significantly associated with lower levels of community participation, independent driving, and employability.



Community reintegration is problematic for Veterans and active duty service members with a history of TBI. Unique comorbidities across injury severity groups inhibit full reintegration into the community. These findings highlight the ongoing rehabilitation needs of persons with TBI, specifically evidence-based mental healthcare, in comprehensive rehabilitation programs consistent with a chronic disease management model.
James A. Haley Veterans Hospital, Department of Medicine, University of South Florida, Tampa.
Suzanne
S
McGarity
Scott D
SD
Barnett
Greg
G
Lamberty
Tracy
T
Kretzmer
Gail
G
Powell-Cope
Nitin
N
Patel
Risa
R
Nakase-Richardson
D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D011379:Prognosis; D011446:Prospective Studies; D012047:Rehabilitation Centers; D062707:Return to Work / Q000523:psychology* / Q000706:statistics & numerical data; D018570:Risk Assessment; D013997:Time Factors; D014728:Veterans / Q000523:psychology*