Consistency of Self-Reported Neurocognitive Symptoms, Post-Traumatic Stress Disorder Symptoms, and Concussive Events From End of First Deployment to Veteran Health Administration Comprehensive Traumatic Brain Injury Evaluation by Operations Enduring Freedom/Iraqi Freedom/New Dawn Veterans

Russo, Arthur C.; Fingerhut, Esther C.

doi:10.1093/arclin/acw093

Cited by 14 publications

(8 citation statements)

References 31 publications

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“…In fact, a number of recent studies have raised serious concerns regarding the reliability of self-reported concussion in some military and veteran samples (cf., Alosco et al, 2015; Polusny et al, 2011; Russo & Fingerhut, 2017; Van Dyke, Axelrod, & Schutte, 2010), and some research (e.g., Alosco et al, 2015; Nelson, Anderson, et al, 2015) suggests that chronic emotional symptoms, including but not limited to PTSD symptoms, may diminish veterans’ abilities to represent combat-related concussions reliably over time. Future research that integrates acute-stage injury characteristics documented through medical record systems (e.g., through the Department of Defense) with accounts of BRC during postdeployment (e.g., through the VHA) may afford a greater ability to assess the reliability of self-reported concussion and the impact that this factor has on outcomes neuropsychological and otherwise.…”

Section: Discussionmentioning

confidence: 99%

Blast concussion and posttraumatic stress as predictors of postcombat neuropsychological functioning in OEF/OIF/OND veterans.

Nelson¹,

Disner²,

Anderson³

et al. 2020

Neuropsychology

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Objectives: Many combat Veterans exhibit cognitive limitations of uncertain origin. In this study, we examined factors that predict cognitive functioning by considering effects of blastrelated concussion (BRC), non-blast-related concussion (NBRC), and posttraumatic stress disorder (PTSD) symptoms. Analyses specifically tested whether: (a) BRC and NBRC were distinct in their prediction of cognitive performance; (b) a dose-response relationship existed between recurrent concussion (BRC and NBRC) and cognitive impairment; and (c) PTSD symptoms mediated the relationship between BRC and cognitive performance.Method: Two-hundred eighty Veterans with combat zone deployment histories completed semistructured clinical interviews to define BRC and NBRC histories, current and past mental health disorders, and dimensional ratings of PTSD symptomatology. Participants were also administered a number of neuropsychological measures to appraise cognitive functioning.Results: A structural equation model (SEM) suggested that BRC and NBRC were not distinct in their prediction of cognitive performance, and there was no evidence that recurrent concussion (blast or non-blast) was directly associated with cognitive performance. BRC was significantly associated with PTSD symptoms (r = .24), PTSD symptoms were significantly associated with cognitive performance in the SEM (r = −.27), and PTSD symptoms significantly mediated the link between BRC and cognitive performance (p = .03).Conclusions: These results suggest that concussion history fails to directly contribute to cognitive performance, regardless of mechanism (blast or non-blast) and recurrence. BRC is nonetheless unique in its contribution to PTSD and PTSD-related cognitive deficits. Results support interventions specific to PTSD management in the interest of promoting neuropsychological functioning among war Veterans.

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Section: Discussionmentioning

confidence: 99%

Blast concussion and posttraumatic stress as predictors of postcombat neuropsychological functioning in OEF/OIF/OND veterans.

Nelson¹,

Disner²,

Anderson³

et al. 2020

Neuropsychology

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“…In other words, studying the genetic liability of PheRS in combination with a directly ascertained quantitative symptom count may help reduce analytic noise associated with self-reported symptoms. 41…”

Section: Discussionmentioning

confidence: 99%

Comorbid-phenome prediction and phenotype risk scores enhance gene discovery for generalized anxiety disorder and posttraumatic stress disorder

Wendt

Pathak

Deak

et al. 2021

Preprint

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UK Biobank (UKB) is a key contributor in mental health genome-wide association studies (GWAS) but only ~31% of participants completed the Mental Health Questionnaire (MHQ responders). We predicted generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and major depression symptoms using elastic net regression in the ~69% of UKB participants lacking MHQ data (MHQ non-responders; NTraining=50%; NTest=50%), maximizing the informative sample for these traits. MHQ responders were more likely to be female, from higher socioeconomic positions, and less anxious than non-responders. Genetic correlation of GAD and PTSD between MHQ responders and non-responders ranged from 0.636-1.08; both were predicted by polygenic scores generated from independent cohorts. In meta-analyses of GAD (N=489,579) and PTSD (N=497,803), we discovered many novel genomic risk loci (13 for GAD and 40 for PTSD). Transcriptomic analyses converged on altered regulation of prenatal dorsolateral prefrontal cortex in these disorders.

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“…Studies have found that PTSD may increase PCS in a TBI population. [4][5][6] Bryant and colleagues found specifically that PCS were more present in mTBI patients with PTSD than those without PTSD, and symptoms of concentration difficulty and headaches were significantly correlated with overall PTSD symptoms. 7 In Schwab's study of service members with mTBI, a positive screen for posttraumatic stress at baseline was an independent predictor of positive NSI PCS at the 3-month follow-up.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Affective States on Postconcussive Symptoms in a TBI Population

et al. 2019

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The occurrence of persistent postconcussive symptoms (PCS) associated with traumatic brain injury (TBI) is an increasing cause of disability and lost productivity. The reasons for these persistent symptoms in a percentage of even mild TBI are poorly understood. The existence of comorbid conditions such as post-traumatic stress disorder or other traumatic injuries may be factors that impact the presence of PCS. We expect that greater levels of affective symptoms will be associated with increases in PCS assessed on the Neurobehavioral Symptom Inventory (NSI). TBI subjects (N = 69) who were seen 1 year post-injury were recruited from a larger cohort study of TBI. Subjects were administered the NSI, Brief Symptom Inventory-18 (BSI-18) and the Post Traumatic Stress Disorder Checklist (PCL). Data were analyzed using Spearman’s rho correlations and analysis of variances. We found significant correlations between the four NSI factors and the three BSI factors and the PCL total score. Mild TBI subjects were found to have the highest correlations between affective and somatic symptoms. These findings support our hypothesis that affective states are associated with higher PCS reporting and that early identification and treatment may decrease PCS.

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Consistency of Self-Reported Neurocognitive Symptoms, Post-Traumatic Stress Disorder Symptoms, and Concussive Events From End of First Deployment to Veteran Health Administration Comprehensive Traumatic Brain Injury Evaluation by Operations Enduring Freedom/Iraqi Freedom/New Dawn Veterans

Abstract: These findings raise questions regarding the accuracy of veteran self-report of both near and distant traumatic events, and argue for the inclusion of contemporaneous Department of Defense (DOD) records in veteran assessment and treatment planning.

Cited by 14 publications

References 31 publications

Blast concussion and posttraumatic stress as predictors of postcombat neuropsychological functioning in OEF/OIF/OND veterans.

Blast concussion and posttraumatic stress as predictors of postcombat neuropsychological functioning in OEF/OIF/OND veterans.

Comorbid-phenome prediction and phenotype risk scores enhance gene discovery for generalized anxiety disorder and posttraumatic stress disorder

The Impact of Affective States on Postconcussive Symptoms in a TBI Population

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