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Symptom complaints following combat-related traumatic brain injury: Relationship to traumatic brain injury severity and posttraumatic stress disorder

Published online by Cambridge University Press:  17 September 2009

HEATHER G. BELANGER*
Affiliation:
Department of Mental Health and Behavioral Sciences, James A. Haley VA, Tampa, Florida Department of Psychology, University of South Florida, Tampa, Florida Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Washington, DC
TRACY KRETZMER
Affiliation:
Department of Mental Health and Behavioral Sciences, James A. Haley VA, Tampa, Florida
RODNEY D. VANDERPLOEG
Affiliation:
Department of Mental Health and Behavioral Sciences, James A. Haley VA, Tampa, Florida Department of Psychology, University of South Florida, Tampa, Florida Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Washington, DC Department of Psychiatry, University of South Florida, Tampa, Florida
LOUIS M. FRENCH
Affiliation:
Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Washington, DC Department of Orthopedics and Rehabilitation, Walter Reed Army Medical Center, Washington, DC Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
*
*Correspondence and reprint requests to: Heather Belanger, Ph.D., James A. Haley Veterans’ Hospital, MHBS – 116B, 13000 Bruce B. Downs Blvd., Tampa, FL 33612, USA. E-mail: [email protected]

Abstract

Patients with a history of mild (n = 134) or moderate-to-severe (n = 91) TBI were asked to complete the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist. Consistent with prior research, significantly more postconcussion symptoms were endorsed by the mild group. After controlling for age, time since injury, and mechanism of injury, TBI severity continued to be significantly related to postconcussion complaints on the NSI. However, after controlling for these same variables, along with posttraumatic stress disorder symptom severity, there no longer were differences between the TBI severity groups. That is, patients with mild TBI did not endorse significantly more complaints (adjusted mean = 22.4) than the moderate-to-severe group (adjusted mean = 21.8). These findings suggest that much of the symptom complaints in mildly injured patients may be due to emotional distress. (JINS, 2010, 16, 194–199.)

Type
Brief Communications
Copyright
Copyright © The International Neuropsychological Society 2009

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References

REFERENCES

Arciniegas, D.B., Anderson, C.A., Topkoff, J., & McAllister, T.W. (2005). Mild traumatic brain injury: A neuropsychiatric approach to diagnosis, evaluation, and treatment. Neuropsychiatric Disease and Treatment, 1, 311327.Google ScholarPubMed
Carroll, L.J., Cassidy, J.D., Peloso, P.M., Borg, J., von Holst, H., Holm, L., et al. (2004). Prognosis for mild traumatic brain injury: Results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, 43(Suppl.), 84105.CrossRefGoogle Scholar
Chamelian, L., & Feinstein, A. (2006). The effect of major depression on subjective and objective cognitive deficits in mild to moderate traumatic brain injury. Journal of Neuropsychiatry Clinical Neuroscience, 18, 3338.CrossRefGoogle ScholarPubMed
Cicerone, K., & Kalmar, K. (1995). Persistent post-concussive syndrome: Structure of subjective complaints after mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 10, 117.CrossRefGoogle Scholar
Gordon, W.A., Haddad, L., Brown, M., Hibbard, M.R., & Sliwinski, M. (2000). The sensitivity and specificity of self-reported symptoms in individuals with traumatic brain injury. Brain Injury, 14, 2133.Google ScholarPubMed
Gunstad, J., & Suhr, J.A. (2004). Cognitive factors in Postconcussion Syndrome symptom report. Archives of Clinical Neuropsychology, 19, 391405.CrossRefGoogle ScholarPubMed
Hanks, R.A., Temkin, N., Machamer, J., & Dikmen, S.S. (1999). Emotional and behavioral adjustment after traumatic brain injury. Archives of Physical Medicine & Rehabilitation, 80, 991997.CrossRefGoogle ScholarPubMed
Hayes, R.L., & Dixon, C.E. (1994). Neurochemical changes in mild head injury. Seminars in Neurology, 14, 2531.CrossRefGoogle ScholarPubMed
Hoge, C.W., McGurk, D., Thomas, J.L., Cox, A.L., Engel, C.C., & Castro, C.A. (2008). Mild traumatic brain injury in U.S. Soldiers returning from Iraq. New England Journal of Medicine, 358, 453463.CrossRefGoogle ScholarPubMed
Johansson, E., Ronnkvist, M., & Fugl-Meyer, A.R. (1991). Traumatic brain injury in northern Sweden. Incidence and prevalence of long-standing impairments and disabilities. Scandinavian Journal of Rehabilitation Medicine, 23, 179185.CrossRefGoogle ScholarPubMed
Kay, T., Harrington, D.E., Adams, R.E., Anderson, T.W., Berrol, S., Cicerone, K., Dahlberg, C., Gerber, D., Goka, R., Harley, P., Hilt, J., Horn, L., Lehmkuhl, D., & Malec, J. (1993). Definition of mild traumatic brain injury: Report from the Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine. Journal of Head Trauma Rehabilitation, 8, 8687.Google Scholar
Lange, R.T., Iverson, G.L., & Franzen, M.D. (2009). Neuropsychological functioning following complicated vs. uncomplicated mild traumatic brain injury. Brain Injury, 23, 8391.CrossRefGoogle ScholarPubMed
Leininger, B.E., Kreutzer, J.S., & Hill, M.R. (1991). Comparison of minor and severe head injury emotional sequelae using the MMPI. Brain Injury, 5, 199205.CrossRefGoogle ScholarPubMed
Masson, F., Maurette, P., Salmi, L.R., Dartigues, J.F., Vecsey, J., Destaillats, J.M., et al. (1996). Prevalence of impairments 5 years after a head injury, and their relationship with disabilities and outcome. Brain Injury, 10, 487497.CrossRefGoogle ScholarPubMed
McLean, A. Jr, Dikmen, S.S., & Temkin, N.R. (1993). Psychosocial recovery after head injury. Archives of Physical Medicine & Rehabilitation, 74, 10411046.CrossRefGoogle ScholarPubMed
Miller, G.A., & Chapman, J.P. (2001). Misunderstanding analysis of covariance. Journal of Abnormal Psychology, 110, 4048.CrossRefGoogle ScholarPubMed
Mittenberg, W., DiGiulio, D.V., Perrin, S., & Bass, A.E. (1992). Symptoms following mild head injury: Expectation as aetiology. Journal of Neurology, Neurosurgery, and Psychiatry, 55, 200204.CrossRefGoogle ScholarPubMed
Ponsford, J., Willmott, C., Rothwell, A., Cameron, P., Kelly, A.M., Nelms, R., et al. (2000). Factors influencing outcome following mild traumatic brain injury in adults. Journal of the International Neuropsychological Society, 6, 568579.CrossRefGoogle ScholarPubMed
Rimel, R.W., Giordani, B., Barth, J.T., Boll, T.J., & Jane, J.A. (1981). Disability caused by minor head injury. Neurosurgery, 9, 221228.Google ScholarPubMed
Sawchyn, J.M., Mateer, C.A., & Suffield, J.B. (2005). Awareness, emotional adjustment, and injury severity in postacute brain injury. Journal of Head Trauma Rehabilitation, 20, 301314.CrossRefGoogle ScholarPubMed
Schell, T.L., & Marshall, G.N. (2008). Survey of Individuals Previously Deployed for OEF/OIF. In Tanielian, T. & Jaycox, L. (Eds.), Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery (pp. 87116). Santa Monica, CA: RAND.Google Scholar
Schwab, K., Caplan, L., Poole, J.H., & Vanderploeg, R.D. (2009). The structure of postconcussive symptoms in three military samples. Unpublished manuscript.Google Scholar
Smith-Seemiller, L., Fow, N.R., Kant, R., & Franzen, M.D. (2003). Presence of post-concussion syndrome symptoms in patients with chronic pain vs mild traumatic brain injury. Brain Injury, 17, 199206.CrossRefGoogle ScholarPubMed
Terrio, H., Brenner, L.A., Ivins, B.J., Cho, J.M., Helmick, K., Schwab, K., et al. (2009). Traumatic brain injury screening: Preliminary findings in a US Army Brigade Combat Team. Journal of Head Trauma Rehabilitation, 24, 1423.CrossRefGoogle Scholar
Uomoto, J.M., & Esselman, P.C. (1993). Traumatic brain injury and chronic pain: Differential types and rates by head injury severity. Archives of Physical Medicine & Rehabilitation, 74, 6164.Google ScholarPubMed
Vanderploeg, R.D., Belanger, H.G., & Curtiss, G. (2009). Mild traumatic brain injury and posttraumatic stress disorder and their associations with health symptoms. Archives of Physical Medicine and Rehabilitation, 90, 10841093.CrossRefGoogle ScholarPubMed
Vanderploeg, R.D., Curtiss, G., Luis, C.A., & Salazar, A.M. (2007). Long-term morbidities following self-reported mild traumatic brain injury. Journal of Clinical & Experimental Neuropsychology, 29, 585598.CrossRefGoogle ScholarPubMed
Weathers, F.W., Huska, J.A., & Keane, T.M. (1991). PTSD CheckList-Military Version (PCLM). Boston: National Center for PTSD – Behavioral Science Division.Google Scholar
Williams, D.H., Levin, H.S., & Eisenberg, H.M. (1990). Mild head injury classification. Neurosurgery, 27, 422428.CrossRefGoogle ScholarPubMed