Behavioral and Health Outcomes Associated with Deployment and Non-Deployment Acquisition of Traumatic Brain Injury in Iraq and Afghanistan Veterans

Publication date: Available online 30 May 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Sarah L. Martindale, Erica L. Epstein, Katherine H. Taber, Jared A. Rowland
ObjectiveCharacterize behavioral and health outcomes in veterans with TBI acquired in non-deployment and deployment settings.DesignCross-sectional assessment evaluating TBI acquired during and outside of deployment, mental and behavioral health symptoms, and diagnoses.SettingVeterans Affairs Medical Centers.ParticipantsIraq and Afghanistan Veterans who deployed to a warzone (N = 1399).InterventionsNot applicable.Main Outcome MeasuresComprehensive lifetime TBI interview; Structured Clinical Interview for DSM-IV Disorders; Combat Exposure Scale; behavioral and health measures.ResultsThere was a main effect of deployment TBI on depressive symptoms, posttraumatic stress symptoms, poor sleep quality, substance use, and pain. Veterans with deployment TBI were also more likely to have a diagnosis of bipolar, major depressive, alcohol use, and posttraumatic stress disorders than those who did not have a deployment TBI.ConclusionsTBIs acquired during deployment are associated with different behavioral and health outcomes than TBI acquired in non-deployment environments. The presence of TBI during deployment is associated with poorer behavioral outcomes, as well as a greater lifetime prevalence of behavioral and health problems in contrast to veterans without deployment TBI. These results indicate that problems may persist chronically following a deployment TBI and should be considered when providing care for veterans. Veterans with deployment TBI may require treatment alterations to improve engagement and outcomes.



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