Posttraumatic Stress Disorder Mediates the Relationship Between Mild Traumatic Brain Injury and Health and Psychosocial Functioning in Veterans of Operations Enduring Freedom and Iraqi Freedom

被引:121
作者
Pietrzak, Robert H. [1 ,2 ]
Johnson, Douglas C. [3 ,4 ]
Goldstein, Marc B. [5 ]
Malley, James C. [6 ]
Southwick, Steven M. [2 ]
机构
[1] Yale Univ, Sch Med, Natl Ctr PTSD, VA Connecticut Healthcare Syst, West Haven, CT 06516 USA
[2] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA
[3] Univ Calif San Diego, Dept Psychiat, Sch Med, San Diego, CA 92103 USA
[4] VA San Diego Healthcare Syst, San Diego, CA USA
[5] Cent Connecticut State Univ, Dept Psychol, New Britain, CT 06050 USA
[6] Cent Connecticut State Univ, Dept Counseling & Family Therapy, New Britain, CT 06050 USA
关键词
Veterans; combat; soldiers; posttraumatic stress disorder; mild traumatic brain injury; psychosocial; functioning; barriers to care; POSTCONCUSSIVE SYMPTOMS; AFGHANISTAN; DEPLOYMENT; BARRIERS; WAR;
D O I
10.1097/NMD.0b013e3181b97a75
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
This study evaluated whether posttraumatic stress disorder (PTSD) mediated the relationship between mild traumatic brain injury (MTBI) and general health ratings, psychosocial functioning, and perceived barriers to receiving mental healthcare 2 years following return from deployment in veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). A total of 277 OEF/OIF veterans completed the Connecticut OEF/OIF Veterans Needs Assessment Survey; 18.8% of the sample screened positive for MTBI. Compared with respondents who screened negative for MTBI, respondents who screened positive for MTBI were younger, more likely to have PTSD, more likely to report fair/poor overall health and unmet medical and psychological needs, and scored higher on measures of psychosocial difficulties and perceived barriers to mental healthcare. Injuries involving loss of consciousness were associated with greater work-related difficulties and unmet psychological needs. PTSD mediated the relationship between MTBI and all of these outcomes. These results underscore the importance of assessing PTSD in OEF/OIF veterans who screen positive for MTBI.
引用
收藏
页码:748 / 753
页数:6
相关论文
共 20 条
[1]   THE MODERATOR MEDIATOR VARIABLE DISTINCTION IN SOCIAL PSYCHOLOGICAL-RESEARCH - CONCEPTUAL, STRATEGIC, AND STATISTICAL CONSIDERATIONS [J].
BARON, RM ;
KENNY, DA .
JOURNAL OF PERSONALITY AND SOCIAL PSYCHOLOGY, 1986, 51 (06) :1173-1182
[2]   Perceived stigma and barriers to care for psychological treatment: Implications for reactions to stressors in different contexts [J].
Britt, Thomas W. ;
Greene-Shortridge, Tiffany M. ;
Brink, Sarah ;
Nguyen, Quyen B. ;
Rath, Jaclyn ;
Cox, Anthony L. ;
Hoge, Charles W. ;
Castro, Carl Andrew .
JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY, 2008, 27 (04) :317-335
[3]   Postconcussive symptoms and posttraumatic stress disorder after mild traumatic brain injury [J].
Bryant, RA ;
Harvey, AG .
JOURNAL OF NERVOUS AND MENTAL DISEASE, 1999, 187 (05) :302-305
[4]   Posttraumatic stress disorder and mild brain injury: controversies, causes and consequences [J].
Bryant, RA .
JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY, 2001, 23 (06) :718-728
[5]  
Cohen J., 1988, Statistical power analysis for the behavioural sciences, V2nd
[6]   Symptoms of post-concussional syndrome are non-specifically related to mild traumatic brain injury in UK Armed Forces personnel on return from deployment in Iraq: an analysis of self-reported data [J].
Fear, N. T. ;
Jones, E. ;
Groom, M. ;
Greenberg, N. ;
Hull, L. ;
Hodgetts, T. J. ;
Wessely, S. .
PSYCHOLOGICAL MEDICINE, 2009, 39 (08) :1379-1387
[7]  
*GOV ACC OFF, 2008, GAO08276
[8]   Separating Deployment-Related Traumatic Brain Injury and Posttraumatic Stress Disorder in Veterans Preliminary Findings from the Veterans Affairs Traumatic Brain Injury Screening Program [J].
Hill, James J., III ;
Mobo, Ben Hur P., Jr. ;
Cullen, Mark R. .
AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION, 2009, 88 (08) :605-614
[9]   Mild traumatic brain injury in US Soldiers returning from Iraq [J].
Hoge, Charles W. ;
McGurk, Dennis ;
Thomas, Jeffrey L. ;
Cox, Anthony L. ;
Engel, Charles C. ;
Castro, Carl A. .
NEW ENGLAND JOURNAL OF MEDICINE, 2008, 358 (05) :453-463
[10]   Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care [J].
Hoge, CW ;
Castro, CA ;
Messer, SC ;
McGurk, D ;
Cotting, DI ;
Koffman, RL .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 351 (01) :13-22