Abstract
Objective
To examine the association between traumatic brain injury (TBI) severity; social,
family, and community reintegration outcomes; and return to work status among post-9/11
veterans in Department of Veterans Affairs (VA) care.
Design
Retrospective observational cohort study.
Setting
Mail/online survey fielded to a national sample of veterans.
Participants
Sample of post-9/11 veterans with at least 3 years of VA care stratified according
to TBI severity and comorbidities who completed and returned surveys (N=2023).
Interventions
Not applicable.
Main Outcome Measures
Deployment Risk and Resilience Inventory-2 family functioning and social support subscales;
Military to Civilian Questionnaire; and employment status.
Results
Bivariate analyses revealed that veterans with every classification of TBI severity
reported significantly more difficulty on social, family, and community reintegration
outcomes than those with no TBI. In the fully adjusted model, veterans with unclassified
and moderate/severe TBI reported significantly more difficulty with community reintegration
and were less likely to be employed relative to those with no TBI; those with unclassified
TBI also reported significantly more difficulty with family functioning. Veterans
with mild TBI also reported significantly more difficulty with community reintegration.
Conclusions
This study provides insight into long-term outcomes associated with TBI in post-9/11
veterans and suggests that exposure to TBI has a negative effect on social and family
functioning, community reintegration, and return to work even after controlling for
comorbidity, deployment experiences, and sociodemographic characteristics. Additional
research is required to explicate what appears to be complex interactions among TBI
severity, psychosocial well-being, combat exposures, and socioeconomic resources in
this population.
Keywords
List of abbreviations:
CTBIE (Comprehensive Traumatic Brain Injury Evaluation), DoDTR (Department of Defense Trauma Registry), DRRI-2 (Deployment Risk and Resilience Inventory-2), FY (fiscal year), ICD-9-CM (International Classification of Diseases–9th Revision–Clinical Modifications), mTBI (mild traumatic brain injury), OEF (Operation Enduring Freedom), OIF (Operation Iraqi Freedom), PTSD (posttraumatic stress disorder), TBI (traumatic brain injury), VA (Department of Veterans Affairs)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 22, 2017
Footnotes
Supported by Department of Veterans Affairs Health Services Research & Development Service (grant no. DHI 09-237); the Frankel Foundation; the United Services Automobile Association, who provided the gift card incentive to survey participants; and use of TBI algorithm developed as part of a study funded by the U.S. Army Medical Research and Material Command; and the U.S. Department of Veterans Affairs (Chronic Effects of Neurotrauma Consortium) (award no. W81XWH-13-2-0095).
Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the U.S. Government, or the U.S. Department of Veterans Affairs, and no official endorsement should be inferred.
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
