The Effects of Mild Traumatic Brain Injury, Post-Traumatic Stress Disorder, and Combined Mild Traumatic Brain Injury/Post-Traumatic Stress Disorder on Returning Veterans

Hannah L Combs, David T R Berry, Theresa Pape, Judith Babcock-Parziale, Bridget Smith, Randal Schleenbaker, Anne Shandera-Ochsner, Jordan P Harp, Walter M High

Research output: Contribution to journalArticle

56 Scopus citations

Abstract

United States veterans of the Iraqi (Operation Iraqi Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]) conflicts have frequently returned from deployment after sustaining mild traumatic brain injury (mTBI) and enduring stressful events resulting in post-traumatic stress disorder (PTSD). A large number of returning service members have been diagnosed with both a history of mTBI and current PTSD. Substantial literature exists on the neuropsychological factors associated with mTBI and PTSD occurring separately; far less research has explored the combined effects of PTSD and mTBI. The current study employed neuropsychological and psychological measures in a sample of 251 OIF/OEF veterans to determine whether participants with a history of mTBI and current PTSD (mTBI+PTSD) have poorer cognitive and psychological outcomes than participants with mTBI only (mTBI-o), PTSD only (PTSD-o), or veteran controls (VC), when groups are comparable on intelligence quotient, education, and age. The mTBI+PTSD group performed more poorly than VC, mTBI-o, and PTSD-o groups on several neuropsychological measures. Effect size comparisons suggest small deleterious effects for mTBI-o on measures of processing speed and visual attention and small effects for PTSD-o on measures of verbal memory, with moderate effects for mTBI+PTSD on the same variables. Additionally, the mTBI+PTSD group was significantly more psychologically distressed than the PTSD-o group, and PTSD-o group was more distressed than VC and mTBI-o groups. These findings suggest that veterans with mTBI+PTSD perform significantly lower on neuropsychological and psychiatric measures than veterans with mTBI-o or PTSD-o. The results also raise the possibility of mild but persisting cognitive changes following mTBI sustained during deployment.

Original languageEnglish (US)
Pages (from-to)956-66
Number of pages11
JournalJournal of Neurotrauma
Volume32
Issue number13
DOIs
StatePublished - Jul 1 2015

Keywords

  • Adult
  • Afghan Campaign 2001-
  • Brain Injuries/epidemiology
  • Cognition Disorders/epidemiology
  • Comorbidity
  • Female
  • Humans
  • Iraq War, 2003-2011
  • Male
  • Neuropsychological Tests
  • Stress Disorders, Post-Traumatic/epidemiology
  • United States
  • Veterans/psychology
  • Young Adult

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