scholarly journals Increases in the Service Connection Disability and Treatment Costs Associated With Posttraumatic Stress Disorder and/or Traumatic Brain Injury in United States Veterans Pre- and Post-9/11: The Strong Need for a Novel Therapeutic Approach

2018 ◽  
Vol 08 (04) ◽  
Author(s):  
Hemant Thakur ◽  
Olurinde Oni ◽  
Vikas Singh ◽  
Rishi Sharma ◽  
Mukut Sharma ◽  
...  
2015 ◽  
Vol 26 (1) ◽  
pp. 35-50 ◽  
Author(s):  
Sara C. Schroeder ◽  
Ronald M. Ruff ◽  
Lutz Jäncke

The aim of this study was to examine the effect of posttraumatic stress disorder (PTSD) on (a) neuropsychological test performance and (b) self-reported emotional complaints within individuals suffering from postconcussional disorder (PCD) after a mild traumatic brain injury (MTBI). A two-group comparative research design was employed. Two MTBI samples with and without PTSD were assessed with a neuropsychological test battery and the Ruff Neurobehavioral Inventory (RNBI). On the neurocognitive test performances no significant between group differences were found, but the MTBI group with PTSD endorsed a significantly greater number of emotional complaints, especially in the RNBI subscales of anxiety and depression. The patients with PTSD also endorsed a significantly greater number of premorbid sequelae in the RNBI emotional composite scale as well as the RNBI premorbid subscales of pain, anxiety and abuse. In sum, PTSD has a negative impact on emotional but not cognitive functioning within individuals suffering from PCD after a mild TBI.


Neurology ◽  
2018 ◽  
Vol 91 (8) ◽  
pp. e732-e745 ◽  
Author(s):  
Ryan J. Andrews ◽  
Jennifer R. Fonda ◽  
Laura K. Levin ◽  
Regina E. McGlinchey ◽  
William P. Milberg

ObjectiveThis study assessed the strength of military-related concussion-, psychological-, and behavioral-related measures to predict neurobehavioral symptom (NBS) reporting in order to help clarify the extent to which persistent NBS reflect lingering effects of concussion vs other psychological/behavioral factors among veterans.MethodsBaseline analysis included 351 consecutively enrolled veterans in the Translational Research Center for Traumatic Brain Injury and Stress Disorders longitudinal cohort study. One hundred eighty-six returned for a follow-up evaluation averaging 24 months post baseline. The Neurobehavioral Symptom Inventory (NSI) was used to measure NBS reporting. Predictor variables included diagnosis of military-related mild traumatic brain injury (M-mTBI), psychological measures, including posttraumatic stress disorder, mood, anxiety, and substance abuse disorders, and behavioral measures, including self-reported current pain and sleep impairment. Hierarchical and multivariable regression analyses examined the relationships between the predictor variables and NSI scores. The k-fold cross-validation assessed generalizability and validity of the regressions.ResultsBaseline analysis revealed that psychological and behavioral conditions independently accounted for 42.5% of variance in the NSI total score compared to 1.5% for M-mTBI after controlling for psychological and behavioral conditions. Prospective analysis revealed that M-mTBI at baseline did not significantly predict NSI score at follow-up, while psychological and behavioral measures at baseline independently accounted for 24.5% of NSI variance. Posttraumatic stress disorder was the most consistent predictor. Cross-validation analyses supported generalizability of the results.ConclusionsPsychological and behavioral-related measures are strong predictors of persistent NBS reporting in veterans, while M-mTBI is negligible. NBS more likely reflect influential comorbidities as opposed to brain injury, per se.


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