A methodology for assessing deployment trauma and its consequences in OEF/OIF/OND veterans: The TRACTS longitudinal prospective cohort study

Abstract

Many US veterans of Afghanistan and Iraq have multiple physical and psychiatric problems. A major focus of research has been on determining the effects of mild Traumatic Brain Injury (mTBI), but mTBI is rarely diagnosed in the absence of co-occurring conditions such as blast exposure, post-traumatic stress disorder (PTSD), depression, substance abuse, etc. These potentially interactive psychological and physical conditions produce complex patterns of cognitive, psychological, and physical symptoms that impede civilian reintegration and complicate efficient and effective treatment planning. The Translational Research Center for TBI and Stress Disorders (TRACTS) has developed a multidisciplinary approach to the assessment of deployment trauma and its consequences in veterans of these wars. The prospective TRACTS longitudinal cohort study conducts state-of-the-art assessments in the domains of biomedical function, lifetime head trauma, psychological function encompassing deployment experience and lifetime exposure to traumatic events, neuropsychological function, and structural and functional neuroimaging. The TRACTS longitudinal cohort study is the first of its kind to comprehensively evaluate lifetime incidence of TBI and PTSD in these veterans, in addition to those incurred during military deployment. The protocol has begun to reveal information that will help improve understanding of the complex pathophysiology associated with co-occurring mTBI and related stress disorders.

Individual differences in sustained attention are associated with cortical thickness

“…Participants were from all branches of the military having served in Operation Enduring Freedom, Operation Iraqi Freedom, and/or Operation New Dawn. The larger TRACTS cohort has been described elsewhere (Lippa et al, ; McGlinchey, Milberg, Fonda, & Fortier, ). Exclusion criteria for TRACTS includes: (a) history of neurological illness (other than TBI); (b) history of seizures; (c) current diagnosis of schizophrenia spectrum or other psychotic disorders (not related to PTSD); (d) current active suicidal and/or homicidal ideation, intent, or plan requiring crisis intervention; or (e) cognitive disorder due to general medical condition other than TBI.…”

“…Severity of PTSD symptoms was assessed through CAPS (Blake et al, ) interviews by a doctoral‐level psychologist. These assessments are described in further detail elsewhere (McGlinchey et al, ). In this report, total symptom severity scores were included as covariates in the analysis to control for PTSD.…”

Verbal Memory Deficits in OEF/OIF/OND Veterans Exposed to Blasts at Close Range

“…The full details of the clinical assessment for TRACTS have been described elsewhere (McGlinchey et al, 2017). In brief, current PTSD was diagnosed using the Clinician Administered PTSD Scale [CAPS, (Blake et al, 2006)].…”

Characterization of Differences in Functional Connectivity Associated with Close-Range Blast Exposure

“…Participants, image acquisition, and behavioral covariates have been described in detail elsewhere. 6,38 Briefly, individuals in this report were the first 400 participants in the Translational Research Center for TBI and Stress Disorders (TRACTS), a VA Rehabilitation Research and Development National Research Center. Although individuals with major medical and mental health issues not addressed by the study were excluded (n = 21), the cohort is notable for prevalent psychiatric conditions including PTSD, chronic pain, sleep disorder, and depression at rates that are representative of this veteran population (see Table 2).…”