title: Perspectives of veterans with mild traumatic brain injury on community reintegration: Making sense of unplanned separation from service.
abstract: For veterans separated from the military as a result of acquired mild traumatic brain injury (mTBI), the transition from a military identity to a civilian one is complicated by health, cognitive, and psychosocial factors. We conducted in-depth interviews with 8 veterans with mTBI to understand how they perceived the experience of departure from the military, rehabilitation services provided at a Department of Veterans Affairs (VA) Polytrauma Network Site, and reentry into civilian life. Two distinct patterns of thinking about community reintegration emerged. The first pattern was characterized by the perception of a need to fade one's military identity. The second pattern, conversely, advanced the perception of a need to maintain the integrity of one's military identity though living in a civilian world. These perceptions may be linked to individuals' roles while in the military and whether violent acts were committed in carrying out the mission of service, acts not consonant with positive self-appraisal in the civilian world. The crisis of unplanned, involuntary separation from the military was universally perceived as a crisis equal to that of the precipitating injury itself. The perception that civilians lacked understanding of veterans' military past and their current transition set up expectations for interactions with health care providers, as well as greatly impacting relationships with friend and family. Our veterans' shared perceptions support existing mandates for greater dissemination of military culture training to health care providers serving veterans both at VA and military facilities as well as in the civilian community at large. (PsycINFO Database Record
authors.affiliation: Washington DC Veterans Affairs Medical Center.
authors.forename: Alexander V
authors.identifier: 0000-0001-7847-3463
authors.initials: AV
authors.lastname: Libin
authors.affiliation: Washington DC Veterans Affairs Medical Center.
authors.forename: Manon Maitland
authors.initials: MM
authors.lastname: Schladen
authors.affiliation: Washington DC Veterans Affairs Medical Center.
authors.forename: Ellen
authors.initials: E
authors.lastname: Danford
authors.affiliation: Washington DC Veterans Affairs Medical Center.
authors.forename: Samantha
authors.initials: S
authors.lastname: Cichon
authors.affiliation: Washington DC Veterans Affairs Medical Center.
authors.forename: Dwan
authors.initials: D
authors.lastname: Bruner
authors.affiliation: Washington DC Veterans Affairs Medical Center.
authors.forename: Joel
authors.initials: J
authors.lastname: Scholten
authors.affiliation: Washington DC Veterans Affairs Medical Center.
authors.forename: Maria
authors.initials: M
authors.lastname: Llorente
authors.affiliation: Washington DC Veterans Affairs Medical Center.
authors.forename: Slavomir
authors.initials: S
authors.lastname: Zapata
authors.affiliation: MedStar National Rehabilitation Hospital.
authors.forename: Alexander W
authors.initials: AW
authors.lastname: Dromerick
authors.affiliation: Washington DC Veterans Affairs Medical Center.
authors.forename: Marc R
authors.initials: MR
authors.lastname: Blackman
authors.affiliation: Department of Psychiatry, Medical University of South Carolina.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Magruder
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000523:psychology*; D062309:Community Integration / Q000523:psychology*; D005190:Family / Q000523:psychology; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D014481:United States; D014728:Veterans / Q000523:psychology*