Validity of neurobehavioral symptoms reported in children with traumatic brain injury

1996 ◽  
Vol 2 (3) ◽  
pp. 213-226 ◽  
Author(s):  
Christine T. Barry ◽  
H. Gerry Taylor ◽  
Susan Klein ◽  
Keith Owen Yeates
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Neurobehavioral Symptoms

Neurobehavioral Symptoms in U.S. Special Operations Forces in Rehabilitation After Traumatic Brain Injury: A TBI Model Systems Study

2021 ◽  
Author(s):  
Amanda Garcia ◽  
Shannon R Miles ◽  
Tea Reljic ◽  
Marc A Silva ◽  
Kristen Dams-O’Connor ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Symptom Severity ◽  
Model Systems ◽  
Ptsd Symptoms ◽  
Special Operations ◽  
Comorbidity Burden ◽  
Symptom Intensity ◽  
Neurobehavioral Symptoms ◽  
Special Operations Forces

ABSTRACT Introduction Special Operations Forces (SOF) personnel are at increased risk for traumatic brain injury (TBI), when compared with conventional forces (CF). Prior studies of TBI in military samples have not typically investigated SOF vs. CF as specific subgroups, despite documented differences in premorbid resilience and post-injury comorbidity burden. The aim of the current study was to compare SOF vs. CF on the presence of neurobehavioral symptoms after TBI, as well as factors influencing perception of symptom intensity. Materials and Methods This study conducted an analysis of the prospective veterans affairs (VA) TBI Model Systems Cohort, which includes service members and veterans (SM/V) who received inpatient rehabilitation for TBI at one of the five VA Polytrauma Rehabilitation Centers. Of those with known SOF status (N = 342), 129 participants identified as SOF (average age = 43 years, 98% male) and 213 identified as CF (average age = 38.7 years, 91% male). SOF vs. CF were compared on demographics, injury characteristics, and psychological and behavioral health symptoms. These variables were then used to predict neurobehavioral symptom severity in univariable and multivariable analyses. Results SOF personnel reported significantly greater posttraumatic stress disorder (PTSD) symptoms but less alcohol and drug use than the CF. SOF also reported greater neurobehavioral symptoms. When examining those with TBIs of all severities, SOF status was not associated with neurobehavioral symptom severity, while race, mechanism of TBI, and PTSD symptoms were. When examining only those with mTBI, SOF status was associated with lower neurobehavioral symptoms, while PTSD severity, white race, and certain mechanisms of injury were associated with greater neurobehavioral symptoms. Conclusions Among those receiving inpatient treatment for TBI, SOF SM/V reported higher neurobehavioral and symptom severity. PTSD was the strongest predictor of neurobehavioral symptoms and should be considered an important treatment target in both SOF and CF with co-morbid PTSD/TBI. A proactive human performance approach towards identification and treatment of psychological and neurobehavioral symptoms is recommended for SOF.

scholarly journals A-116 Predicting Chronic Neurobehavioral Symptoms based on Acute Injury Characteristics and Symptoms in U.S. Military Service Members with and without history of TBI

2020 ◽  
Vol 35 (6) ◽  
pp. 909-909
Author(s):  
Lippa S ◽  
Bailie J ◽  
Brickell T ◽  
French L ◽  
Hungerford L ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Military Service ◽  
Service Members ◽  
Injury Characteristics ◽  
Military Service Members ◽  
History Of ◽  
Neurobehavioral Symptoms ◽  
Severe Tbi

Abstract Objective Recovery following traumatic brain injury (TBI) is complex. Often following mild TBI, recovery occurs within days or weeks, though this is not always the case. Following more severe TBI, some recover quickly, while many never fully recover. This study examines acute predictors of chronic neurobehavioral symptoms in U.S. military service members (Age: M = 33.9 years, SD = 10.2) without injury (n = 86), or with history of uncomplicated mild traumatic brain injury (TBI; n = 56), complicated mild, moderate, or severe TBI (mod-sev TBI; n = 43), or bodily injury (n = 25). Method Participants completed the Neurobehavioral Symptom Inventory (NSI), Posttraumatic Stress Disorder Checklist, Alcohol Use Disorder Checklist, Combat Exposure Scale, and TBI Quality of Life and passed symptom validity tests at 0–8 months and ≥ 2 years post-injury. Forward stepwise logistic regression included 26 potential predictors (demographics, injury characteristics, military characteristics, and self-report measures at baseline) of International Statistical Classification of Diseases and Related Health Problems-10 Postconcussional Syndrome (PCSy) at follow-up. Results Cognitive Concerns (Exp(B) = .896, p = .001), Sleep (Exp(B) = 1.874, p < .001), Somatosensory Symptoms (Exp(B) = 1.194, p = .012), and mod-sev TBI (Exp(B) = 2.959, p = .045) significantly predicted follow-up PCSy. When baseline NSI symptoms were removed from the model, Cognitive Concerns (Exp(B) = .902, p < .001), Post-traumatic stress (Exp(B) = 1.173, p = .001), and Resilience (Exp(B) = .950, p < .031) significantly predicted PCSy. For all included measures in both models, higher symptoms at baseline predicted increased likelihood of follow-up PCSy. Both models correctly classified 81.3% of participants. Conclusion Findings suggest patients reporting psychological distress and cognitive concerns acutely should be targeted for treatment to mitigate prolonged neurobehavioral symptoms.

A-123 Characterizing Sex Differences on the Comprehensive Traumatic Brain Injury Evaluation (CTBIE) in U.S. Military Veterans: A Million Veteran Program (MVP) Study

2021 ◽  
Vol 36 (6) ◽  
pp. 1173-1173
Author(s):  
Victoria C Merritt ◽  
Catherine Chanfreau-Coffinier ◽  
McKenna S Sakamoto ◽  
Amy J Jak ◽  
Karen L Hanson ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Sex Differences ◽  
Brain Injury ◽  
Functional Outcomes ◽  
Psychiatric Symptoms ◽  
Clinical Care ◽  
Chi Square ◽  
Neurobehavioral Symptoms ◽  
Validity Measures ◽  
Clinically Significant

Abstract Objective Although emerging data suggest that women with traumatic brain injury (TBI) may suffer greater neurobehavioral dysfunction in both the post-acute and chronic phases of injury, sex differences have been severely understudied within the context of military TBI. Therefore, we examined sex differences on the Comprehensive Traumatic Brain Injury Evaluation (CTBIE) using a diverse sample of Iraq/Afghanistan-era Veterans enrolled in the VA’s Million Veteran Program. Method 14,378 Veterans (n = 1361 females [9.5%]) completed the CTBIE, a clinician-administered TBI interview. Chi-square analyses and logistic regressions (adjusting for age, race/ethnicity, and education) were used to explore associations between sex and CTBIE diagnostics, injury-related characteristics, neurobehavioral symptoms and other psychiatric comorbidities, and functional outcomes. Results Confirmed TBI diagnoses were more frequent among males than females (65% vs. 58%) and significant sex differences were observed across several CTBIE outcomes (p’s ≤ 0.001; $ \phi $/Cramer’s V = 0.03–0.14). Relative to females, a greater proportion of males experienced bullet and blast-related injuries and were employed. In contrast, a greater proportion of females experienced falls, reported clinically significant neurobehavioral symptoms (particularly cognitive and affective-related symptoms as well as symptom interference with daily life), failed symptom validity measures, and endorsed higher comorbid psychiatric symptoms. Conclusions Results indicate that males and females experience differential clinical and functional outcomes on the CTBIE, particularly with respect to injury-related characteristics, symptom endorsement, and employment. Findings underscore the need for female Veteran participation in TBI research in order to improve our understanding of sex-specific experiences with TBI and its sequelae, as well as to improve clinical care targeted to this vulnerable population.

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