Abstract
Objective
To examine demographic, psychiatric symptom, and neuropsychological performance factors
associated with duration of unemployment in Iraq/Afghanistan Veterans with a history
of mild-to-moderate traumatic brain injury (TBI).
Design
Cross-sectional, secondary data analysis of baseline measures in a supported employment
study.
Setting
VA medical center.
Participants
Participants (N=50) were veterans with a history of mild-to-moderate TBI who were
unemployed, stating a goal of returning to work, and had documented impairment in
at least 1 neuropsychological domain. Participants were referred from VA vocational
and assessment-based clinics.
Interventions
Not applicable.
Main Outcome Measures
Duration of unemployment, neuropsychological, and psychiatric symptom assessments.
Results
Bivariate correlations revealed that longer duration of unemployment was associated
with greater posttraumatic stress disorder (P<.10) and depressive (P<.05) symptom severity, worse executive functioning (P<.05), and racial/ethnic minority status (P<.05). A multiple linear regression analysis including these independent variables
explained 26.5% of the variance in duration of unemployment. Worse executive functioning,
specifically reasoning and set-shifting, and minority status were each associated
with longer duration of unemployment in the context of multiple independent variables.
Conclusions
Our results underscore the importance of objective assessment of cognitive functioning
in job-seeking Veterans with TBI histories. It may be useful to target aspects of
executive functioning in vocational rehabilitation interventions and to provide additional
assistance to Veterans from racial/ethnic minority groups.
Keywords
List of abbreviations:
CAPS (Clinician-Administered Posttraumatic Stress Disorder Scale), HAM-D (Hamilton Depression Rating Scale), mTBI (mild traumatic brain injury), PTSD (posttraumatic stress disorder), TBI (traumatic brain injury), WCST-64 (Wisconsin Card Sorting Test 64-card version), WRAT-3 (Wide Range Achievement Test-3rd edition)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: May 13, 2020
Footnotes
Supported by the Department of Defense (award no. W81XWH-08-2-0193 to Dr Elizabeth Twamley) and the VA Center of Excellence for Stress and Mental Health (CESAMH) and the Office of Academic Affiliations, CESAMH Advanced Fellowship Program in Mental Illness Research and Treatment, Department of Veterans Affairs.
Disclosures: none.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
