Abstract
Objective
To examine the relationship between staff perceived irritability, anger, and aggression
and posttraumatic stress disorder (PTSD) in veterans with traumatic brain injury (TBI)
of all severity levels.
Design
Longitudinal cohort design.
Setting
Veterans Affairs Polytrauma Transitional Rehabilitation Programs.
Participants
Veterans and service members with TBI of all severity levels enrolled in the Veterans
Affairs Polytrauma Rehabilitation Centers’ Traumatic Brain Injury Model System national
database (N=240).
Interventions
Not applicable.
Main Outcome Measure
Univariable and multivariable logistic regression modeling was used to examine the
association between irritability, anger, and aggression and potential risk factors,
including PTSD symptoms. Irritability, anger, and aggression was measured as a single
construct using an item from the Mayo-Portland Adaptability Inventory-4 that was rated
by program staff at admission and discharge from the inpatient rehabilitation program.
PTSD symptoms were assessed using the PTSD Checklist–Civilian Version.
Results
PTSD symptoms uniquely predicted program staff-rated irritability, anger, and aggression
at discharge even after controlling for severity of TBI, age, male sex, education,
and annual earnings. The model explained 19% of the variance in irritability, anger,
and aggression.
Conclusions
When TBI severity and PTSD symptoms were considered simultaneously in a sample of
veterans, only PTSD symptoms predicted staff-rated irritability, anger, and aggression.
Given the negative outcomes linked with irritability, anger, and aggression, veterans
may benefit from assessment and treatment of PTSD symptoms within rehabilitation settings.
Keywords
List of abbreviations:
MPAI-4 (Mayo-Portland Adaptability Inventory-4), PCL-C (PTSD Checklist–Civilian Version), PTRP (Polytrauma Transitional Rehabilitation Program), PTSD (posttraumatic stress disorder), TBI (traumatic brain injury), TBIMS (TBI Model Systems), VA (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: September 09, 2019
Footnotes
The Polytrauma Rehabilitation Center Traumatic Brain Injury (TBI) Model System collaboration is funded collaboration between the Department of Veterans Affairs and the Department of Health and Human Services (National Institute on Disability, Independent Living, and Rehabilitation Research). This research is sponsored by VHA Central Office VA TBI Model System Program of Research and Subcontract from General Dynamics Health Solutions (W91YTZ-13-C-0015) from the Defense and Veterans Brain Injury Center within the Defense Health Agency. The views, opinions, and/or findings contained in this article are those of the authors and should not be construed as an official Department of Defense position or any other federal agency, policy, or decision unless so designated by other official documentation. The participating agencies’ institutional review boards approved this study, and informed consent was obtained after the details of the study were thoroughly explained to participants.
Disclosures: none.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
