Mild Traumatic Brain Injury and Posttraumatic Stress Disorder and Their Associations With Health Symptoms
Abstract
Vanderploeg RD, Belanger HG, Curtiss G. Mild traumatic brain injury and posttraumatic stress disorder and their associations with health symptoms.
Objective
To determine the association of various symptoms and psychiatric diagnoses with a remote history of mild traumatic brain injury (MTBI) and a current diagnosis of posttraumatic stress disorder (PTSD).
Design
Cross-sectional cohort study.
Setting
Nonclinical.
Participants
Three groups of randomly selected community dwelling male U.S. Army Vietnam-era veterans: healthy control (n=3218), those injured in a motor vehicle collision (MVC) but without a head injury (MVC injury control; n=548), and those who had an MTBI (n=278).
Interventions
None.
Main Outcome Measures
Prevalence of psychiatric diagnoses, physical, cognitive, and emotional symptoms, and course of PTSD across time.
Results
Logistic regression procedures were used to determine group association with symptoms and psychiatric diagnosis after controlling for demographic variables, combat intensity, medical disorders, and other current psychiatric conditions. MTBI was associated with headaches, memory problems, sleep problems, and fainting even after controlling for current psychiatric problems (including PTSD), as well as demographic variables, combat intensity, and comorbid medical conditions. MTBI also was associated with a current diagnosis of PTSD even controlling for other demographic, psychiatric, and medical covariates. MTBI did not moderate or mediate the relationship between PTSD and current symptomatology. However, MTBI did adversely affect long-term recovery from PTSD (odds ratio=1.59, 95% CI, 1.07–2.37). PTSD also was associated with physical, cognitive, and emotional symptoms, and had a larger effect size than MTBI.
Conclusions
MTBI, even in the chronic phase years postinjury, is not a benign condition. It is associated with increased rates of headaches, sleep problems, and memory difficulties. Furthermore, it can complicate or prolong recovery from preexisting or comorbid conditions such as PTSD. Similarly, PTSD is a potent cocontributor to physical, cognitive, and emotional symptoms.
aDepartment of Mental Health and Behavioral Sciences and Defense and Veterans Brain Injury Center, James A. Haley Veterans Affairs Medical Center, Tampa, FL
bDepartment of Psychiatry and Behavioral Medicine, University of South Florida, Tampa, FL
cDepartment of Psychology, University of South Florida, Tampa, FL
Reprint requests to Rodney D. Vanderploeg, PhD, Psychology Service (116B), James A. Haley Veterans' Hospital, Tampa, FL 33612
Supported by the Department of Veterans Affairs, Veterans Health Administration; the Defense and Veterans Brain Injury Center; and James A. Haley Veterans Hospital where the study was completed. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
ABSTRACT