Journal of Rehabilitation Research & Development (JRRD)

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Volume 49 Number 7, 2012
   Pages 1115 — 1126

Abstract — Relationship of screen-based symptoms for mild traumatic brain injury and mental health problems in Iraq and Afghanistan veterans: Distinct or overlapping symptoms?

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Shira Maguen, PhD;1-2* Karen M. Lau, MA;1 Erin Madden, MPH;1 Karen Seal, MD, MPH1-2

1San Francisco Department of Veterans Affairs (VA) Medical Center, San Francisco, CA; 2University of California, San Francisco, San Francisco, CA; and Health Services Research and Development Research Enhancement Award Program, San Francisco VA Medical Center, San Francisco, CA

Abstract — This study used factor analytic techniques to differentiate distinct from overlapping screen-based symptoms of traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and depression in Iraq and Afghanistan veterans. These symptoms were derived from screen results of 1,549 veterans undergoing Department of Veterans Affairs postdeployment screening between April 2007 and January 2010. Veterans with positive TBI screens were approximately twice as likely to also screen positive for depression and PTSD (adjusted relative risks = 1.9 and 2.1, respectively). Irritability was a shared symptom between TBI and PTSD, and emotional numbing was a shared symptom between PTSD and depression. Symptoms unique to TBI included dizziness, headaches, memory problems, and light sensitivity. Four separate constructs emerged: TBI, PTSD, depression, and a fourth construct consisting of hypervigilance and sleep problems. These findings illuminate areas of overlap between TBI and common postdeployment mental health problems. Discriminating symptoms of TBI from mental health problems may facilitate diagnosis, triage to specialty care, and targeted symptom management. The emergence of a fourth factor consisting of sleep problems and hypervigilance highlights the need to attend to specific symptoms in the postdeployment screening process.

Key words: depression, factor analysis, hypervigilance, insomnia, mental health, OIF/OEF, posttraumatic stress disorder, screen, traumatic brain injury, veteran.


View HTML  ¦  View PDF  ¦  Contents Vol. 49, No. 7

This article and any supplementary material should be cited as follows:
Maguen S, Lau KM, Madden E, Seal K. Relationship of screen-based symptoms for mild traumatic brain injury and mental health problems in Iraq and Afghanistan veterans: Distinct or overlapping symptoms? J Rehabil Res Dev. 2012;49(7):1115-26.
http://dx.doi.org/10.1682/JRRD.2011.02.0015

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