Abstract
Vanderploeg RD, Belanger HG, Horner RD, Spehar AM, Powell-Cope G, Luther SL, Scott
SG. Health outcomes associated with military deployment: mild traumatic brain injury,
blast, trauma, and combat associations in the Florida National Guard.
Objectives
To determine the association between specific military deployment experiences and
immediate and longer-term physical and mental health effects, as well as examine the
effects of multiple deployment-related traumatic brain injuries (TBIs) on health outcomes.
Design
Online survey of cross-sectional cohort. Odds ratios were calculated to assess the
association between deployment-related factors (ie, physical injuries, exposure to
potentially traumatic deployment experiences, combat, blast exposure, and mild TBI)
and current health status, controlling for potential confounders, demographics, and
predeployment experiences.
Setting
Nonclinical.
Participants
Members (N=3098) of the Florida National Guard (1443 deployed, 1655 not deployed).
Interventions
Not applicable.
Main Outcome Measures
Presence of current psychiatric diagnoses and health outcomes, including postconcussive
and non–postconcussive symptoms.
Results
Surveys were completed an average of 31.8 months (SD=24.4, range=0−95) after deployment.
Strong, statistically significant associations were found between self-reported military
deployment-related factors and current adverse health status. Deployment-related mild
TBI was associated with depression, anxiety, posttraumatic stress disorder (PTSD),
and postconcussive symptoms collectively and individually. Statistically significant
increases in the frequency of depression, anxiety, PTSD, and a postconcussive symptom
complex were seen comparing single to multiple TBIs. However, a predeployment TBI
did not increase the likelihood of sustaining another TBI in a blast exposure. Associations
between blast exposure and abdominal pain, pain on deep breathing, shortness of breath,
hearing loss, and tinnitus suggested residual barotrauma. Combat exposures with and
without physical injury were each associated not only with PTSD but also with numerous
postconcussive and non–postconcussive symptoms. The experience of seeing others wounded
or killed or experiencing the death of a buddy or leader was associated with indigestion
and headaches but not with depression, anxiety, or PTSD.
Conclusions
Complex relationships exist between multiple deployment-related factors and numerous
overlapping and co-occurring current adverse physical and psychological health outcomes.
Various deployment-related experiences increased the risk for postdeployment adverse
mental and physical health outcomes, individually and in combination. These findings
suggest that an integrated physical and mental health care approach would be beneficial
to postdeployment care.
Key Words
List of Abbreviations:
CI (confidence interval), OR (odds ratio), PCS (postconcussion symptom), PTSD (posttraumatic stress disorder), TBI (traumatic brain injury)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 15, 2012
Footnotes
Supported by the Department of Veterans Affairs, Veterans Health Administration, and Veterans Administration HSR&D (grant no. CCN 06-164). Further support was provided by the James A. Haley Veterans' Hospital and its HSR&D/RR&D Center of Excellence. The views expressed herein are those of the authors and do not necessarily reflect the views or the official policy of the Department of Veterans Affairs or the US government.
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.
In-press corrected proof published online on Jul 24, 2012, at www.archives-pmr.org.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
