title: Mild Traumatic Brain Injury, PTSD, and Psychosocial Functioning Among Male and Female U.S. OEF/OIF Veterans.
abstract: This study examined the unique and combined relationship between mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) with psychosocial functioning in a cohort of 1,312 U.S. male and female veterans of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF) enrolled in the Veterans After-Discharge Longitudinal Registry (Project VALOR). We assessed mTBI with structured screening questions reflective of current TBI classification standards and PTSD via the SCID-IV PTSD module; all other variables were assessed by self-report questionnaires. We identified significant diagnostic group differences in psychosocial functioning for both sexes. Individuals with PTSD, with or without a history of mTBI, reported significantly worse psychosocial functioning than individuals with mTBI alone or neither mTBI nor PTSD (males, η(2) p = .11, p < .001; females, η(2) p = .14, p < .001), even after adjusting for demographics and severity of chronic pain. The results suggested that veterans experiencing PTSD, regardless of whether they had a history of mTBI, were at increased risk for long-term psychosocial impairment. Further research examining possible benefits from improved access to resources and treatment to address these needs would be valuable.
authors.affiliation: Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA.|Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, Massachusetts, USA.|Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Colleen E
authors.initials: CE
authors.lastname: Jackson
authors.affiliation: Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.|Research Service, VA Boston Healthcare System, Boston, Massachusetts, USA.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Green
authors.affiliation: Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.|National Center for PTSD-Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA.
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Bovin
authors.affiliation: Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.|National Center for PTSD-Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Vasterling
authors.affiliation: Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.|National Center for PTSD-Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA.
authors.forename: Darren W
authors.initials: DW
authors.lastname: Holowka
authors.affiliation: New England Research Institutes, Watertown, Massachusetts, USA.
authors.forename: Gayatri
authors.initials: G
authors.lastname: Ranganathan
authors.affiliation: New England Research Institutes, Watertown, Massachusetts, USA.
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Rosen
authors.affiliation: Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.|National Center for PTSD-Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA.
authors.forename: Terence M
authors.initials: TM
authors.lastname: Keane
authors.affiliation: Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.|National Center for PTSD-Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Marx
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001924:Brain Concussion / Q000453:epidemiology* / Q000523:psychology; D060825:Cognitive Dysfunction / Q000209:etiology; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D057566:Self Report; D017678:Sex Distribution; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D014481:United States; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*