The impact of military service and traumatic brain injury on the substance use norms of Army Reserve and National Guard Soldiers and their spouses

This study examined the impact of service member/veteran (SMV) combat deployment and traumatic brain injury (TBI) on the health and behavior of his or her children. Participants were 104 female spouse caregivers of US SMVs who had sustained a mild, severe, or penetrating TBI. Participants completed the Children’s Health and Behavior Questionnaire (CHBQ; r = .758 to .881) that evaluates school grades, behavior, medical health, emotional health, and social participation: (a) prior to the first combat deployment, (b) in the month prior to the TBI, (c) within 2 years after the TBI, and (d) 2 or more years after the TBI. A substantial number of children experienced a decline in health and behavior following the TBI (41.7%–79.1%). Of those who declined (a) 68.8%–75.5% declined within the first 2 years post-injury, followed by improvement or stabilization; (b) 6.7%–15.6% declined only after 2 or more years post-injury; (c) 15.6%–25.0% declined within the first 2 years post-injury and then again 2 or more years post-injury; and (d) 16.9%–26.5% experienced a decline as a result of deployment, followed by an additional decline after the SMV’s TBI. Services are required for children of SMVs following TBI and deployment, particularly children at risk for poor outcome.

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Assessing the Impact of Military Service on Patient Health Literacy in an Otolaryngology Clinic

Military Medicine ◽

10.1093/milmed/usab260 ◽

2021 ◽

Author(s):

Danielle A Morrison ◽

Charles A Riley ◽

Anthony M Tolisano

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Health Literacy ◽

Military Service ◽

Primary Outcome Measure ◽

Secondary Outcome ◽

Cross Sectional ◽

History Of ◽

The Impact ◽

Inadequate Health Literacy

ABSTRACT Objective To examine the impact of military service on health literacy. Study Design Prospective, cross-sectional study. Subjects and Methods The validated Brief Health Literacy Screen (BHLS) with military supplement was administered to sequential adult patients (military and civilian) treated at two outpatient academic military otolaryngology clinics between November and December 2019. Inadequate health literacy, defined by a BHLS score ≤9, was the primary outcome measure. Secondary outcome measures included comparisons of inadequate BHLS scores with patient demographics and history of military service. Results Three hundred and eighty-two patients were evaluated during the study period. The median age was 48-57 years, with a majority being male (230, 60.2%), White (264, 69.1%), married (268, 70.2%), and active duty military (303, 79.3%). A minority reported history of PTSD (39, 13%) or traumatic brain injury (29, 9.6%). Overall, very few subjects (10, 2.6%) demonstrated inadequate health literacy. Patients with prior (1.6% vs 6.3%, P < .05) or current (0% vs 5.0%, P < .05) military service had lower rates of inadequate health literary as compared to civilians. Gender, race, marital status, history of PTSD, and history of traumatic brain injury did not significantly impact health literacy. In a multivariate regression model exploring history of military service, age was not predictive of inadequate health literacy. Conclusions Both history of and current military service predict higher health literacy rates for patients treated at military otolaryngology clinics. Widely accessible health care and mandatory health evaluations for service members to maintain deployment readiness may contribute to this finding but warrant additional study.

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Drinking as routine practice among re-integrating National Guard and Reservists from Arkansas

Qualitative Research in Medicine & Healthcare ◽

10.4081/qrmh.2020.9001 ◽

2020 ◽

Vol 4 (2) ◽

Author(s):

Traci H. Abraham ◽

Ann M. Cheney ◽

Geoffrey M. Curran ◽

Karen L. Drummond

Keyword(s):

Substance Use ◽

Military Service ◽

National Guard ◽

Active Duty ◽

Routine Practice ◽

Civilian Life ◽

Army Reserve ◽

Implicit Processes ◽

Problematic Drinking ◽

Shared Beliefs

Active duty enlisted military personnel are more likely to misuse alcohol than civilians – a pattern which persists even after the transition to civilian life. We used in-depth, substance use history interviews to elicit drinking trajectories from 54 re-integrating Army National Guard, Air Force Reserve and Army Reserve personnel from Arkansas with a history of problematic substance use. A hybrid inductive-deductive analytic approach revealed institutional norms, shared beliefs about drinking, and social values and expectations among military peers present in the context of military service that Veterans described as having shaped their drinking trajectories. Framing Veterans’ narratives vis-à-vis practice theory revealed the complex processes by which excessive drinking was embodied as routine practice during military service and subsequently reproduced in a very different post-deployment context, often with deleterious results. Elucidating these implicit processes suggested pro-active strategies for preventing problematic drinking by active duty personnel and improving the re-integration experiences of Veterans.

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The association between self-reported traumatic brain injury, neuropsychological function, and compliance among people serving community sentences

Brain Impairment ◽

10.1017/brimp.2021.15 ◽

2021 ◽

pp. 1-17

Author(s):

Emily M. Norman ◽

Nicola J. Starkey ◽

Devon L. L. Polaschek

Keyword(s):

Traumatic Brain Injury ◽

Substance Use ◽

Brain Injury ◽

Neuropsychological Tests ◽

Risk Scores ◽

Neuropsychological Status ◽

Inference Test ◽

History Of ◽

Trail Making ◽

The Impact

Abstract Background: Traumatic brain injury is overrepresented in incarcerated samples and has been linked to a number of poor correctional outcomes. Despite this, no research has explored the impact of a recent TBI on compliance outcomes for individuals serving community-based. Method: We screened for a history of TBI in 106 adults on community sentences and collected compliance (arrests, sentence violations) and related variables (e.g., risk scores, substance use) over 6 months. Sixty-four participants also completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Comprehensive Trail Making Test and Color-Word Inference Test. Results: A TBI in the last year predicted a significantly higher likelihood of arrest, even when controlling for risk of reconviction and current substance use, but was not associated with non-compliance with sentence conditions nor with performance on the neuropsychological tests. In addition, no significant associations were found between performance on neuropsychological tests and measures of non-compliance. Conclusions: TBI in the last year was an independent predictor of arrest. This result suggests that those with a recent TBI on a community sentence may need additional monitoring or support to reduce the risk of reoffending.

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The impact of traumatic brain injury on developmental functioning in children: Mild TBI at home and school

PsycEXTRA Dataset ◽

10.1037/e556572013-079 ◽

2012 ◽

Author(s):

Rosalind Case ◽

Nicola Starkey ◽

Suzanne Barker-Collo ◽

Kelly Jones

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Tbi ◽

Developmental Functioning ◽

The Impact ◽

Home And School ◽

At Home

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Faculty Opinions recommendation of Prognostic value of demographic characteristics in traumatic brain injury: results from the IMPACT study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1087001.539961 ◽

2007 ◽

Author(s):

Donald Marion

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Prognostic Value ◽

Demographic Characteristics ◽

Impact Study ◽

The Impact

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Substance use on admission toxicology screen is associated with peri-injury factors and six-month outcome after traumatic brain injury: A TRACK-TBI Pilot study

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2020.02.021 ◽

2020 ◽

Vol 75 ◽

pp. 149-156

Author(s):

John K. Yue ◽

Ryan R.L. Phelps ◽

Ethan A. Winkler ◽

Hansen Deng ◽

Pavan S. Upadhyayula ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Substance Use ◽

Brain Injury ◽

Pilot Study

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Impact of routine S100B protein assay on CT scan use in children with mild traumatic brain injury

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2020-1293 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Fleur Lorton ◽

Jeanne Simon-Pimmel ◽

Damien Masson ◽

Elise Launay ◽

Christèle Gras-Le Guen ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

University Hospital ◽

S100b Protein ◽

Research Network ◽

Ct Scans ◽

Intermediate Risk ◽

Protein Assay ◽

The Impact

AbstractObjectivesTo evaluate the impact of implementing a modified Pediatric Emergency Care Applied Research Network (PECARN) rule including the S100B protein assay for managing mild traumatic brain injury (mTBI) in children.MethodsA before-and-after study was conducted in a paediatric emergency department of a French University Hospital from 2013 to 2015. We retrospectively included all consecutive children aged 4 months to 15 years who presented mTBI and were at intermediate risk for clinically important traumatic brain injury (ciTBI). We compared the proportions of CT scans performed and of in-hospital observations before (2013–2014) and after (2014–2015) implementation of a modified PECARN rule including the S100B protein assay.ResultsWe included 1,062 children with mTBI (median age 4.5 years, sex ratio [F/M] 0.73) who were at intermediate risk for ciTBI: 494 (46.5%) during 2013–2014 and 568 (53.5%) during 2014–2015. During 2014–2015, S100B protein was measured in 451 (79.4%) children within 6 h after mTBI. The proportion of CT scans and in-hospital observations significantly decreased between the two periods, from 14.4 to 9.5% (p=0.02) and 73.9–40.5% (p<0.01), respectively. The number of CT scans performed to identify a single ciTBI was reduced by two-thirds, from 18 to 6 CT scans, between 2013–2014 and 2014–2015. All children with ciTBI were identified by the rules.ConclusionsThe implementation of a modified PECARN rule including the S100B protein assay significantly decreased the proportion of CT scans and in-hospital observations for children with mTBI who were at intermediate risk for ciTBI.

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