Journal of Rehabilitation Research & Development (JRRD)

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Volume 51 Number 7, 2014
   Pages 1023 — 1034

Abstract — Factors associated with neurocognitive performance in OIF/OEF servicemembers with postconcussive complaints in postdeployment clinical settings

Douglas B. Cooper, PhD;1–2* Rodney D. Vanderploeg, PhD;1,3 Patrick Armistead-Jehle, PhD;4 Jeffrey D. Lewis, MD, PhD;5 Amy O. Bowles, MD6

1Defense and Veterans Brain Injury Center, Silver Spring, MD; 2Department of Neurology, San Antonio Military Medical Center, Fort Sam Houston, TX; 3James A. Haley Veterans’ Hospital, Tampa, FL; and Departments of Psychiatry and Neurosciences, and Psychology, University of South Florida, Tampa, FL; 4Concussion Clinic, Munson Army Health Center, Fort Leavenworth, KS; 5Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD; 6Department of Orthopedics & Rehabilitation, Traumatic Brain Injury Service, San Antonio Military Medical Center, Fort Sam Houston, TX

Abstract — Cognitive difficulties are frequently reported by Operation Iraqi Freedom/Operation Enduring Freedom military personnel who sustained mild traumatic brain injuries (TBIs). The current study examined several potential factors that may contribute to self-reported cognitive difficulties in postdeployment clinical settings. Eighty-four subjects who sustained a mild or moderate TBI and reported cognitive difficulties underwent neurocognitive testing. Multiple regression analyses were used to determine the amount of variance in neurocognitive performance accounted for by the predictor variables (demographic, mechanism of injury, time since injury, headache severity, combat stress, postconcussive complaints, and effort/performance validity). The predictor variables collectively accounted for 51.7% of the variance in cognitive performance (F (8,72) = 11/99, p < 0.001). The most potent predictor of cognitive functioning was performance validity/effort, which uniquely accounted for 16.3% of the variance (p < 0.01). Self-reported symptom severity, including postconcussive complaints, combat stress, and headache intensity, accounted for 7.2% of the variance (p < 0.05). Demographic factors and injury characteristics, such as time since injury and mechanism of injury, were not significant predictive factors of cognitive performance. The findings of the current study underscore the need to include measurement of effort as part of neurocognitive evaluation in postdeployment settings when evaluating cognitive complaints associated with mild TBI.

Key words: blast injuries, cognitive complaints, combat veterans, mild traumatic brain injury, neuropsychological assessment, OIF/OEF, performance validity, postconcussive symptoms, postdeployment, posttraumatic stress disorder.

View HTML ¦ View PDF ¦ Contents Vol. 51, No.7

This article and any supplementary material should be cited as follows:
Cooper DB, Vanderploeg RD, Armistead-Jehle P, Lewis JD, Bowles AO. Factors associated with neurocognitive performance in OIF/OEF servicemembers with postconcussive complaints in postdeployment clinical settings. J Rehabil Res Dev. 2014;51(7):1023–34.

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Last Reviewed or Updated  Wednesday, November 12, 2014 11:16 AM

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