Post-concussive symptom endorsement and symptom attribution following remote mild traumatic brain injury in combat-exposed Veterans: An exploratory study

Measurement Invariance of the Neurobehavioral Symptom Inventory in Male and Female Million Veteran Program Enrollees Completing the Comprehensive Traumatic Brain Injury Evaluation

“…Although the results of previous research examining the NSI factor structure have been somewhat varied, we elected to examine the 4-factor solution given evidence provided by Meterko et al (2012) and Vanderploeg et al (2015) that the 4-factor solution performed better than the 3-factor solution in military samples. Furthermore, the 4-factor solution has been widely used in clinical research, and several studies have compared symptom reporting patterns across males and females using these domains (Brickell et al, 2017; Gray et al, 2020; Iverson et al, 2011; Lippa et al, 2018; Merritt et al, 2020). Up until this point, measurement invariance of these symptom clusters had not been established and comparisons between males and females were made with the assumption of invariance.…”

“…The NSI is a self-report measure that consists of 22 distinct ''postconcussive'' symptoms including, for example, headaches, dizziness, forgetfulness, and irritability. Although not pathognomonic for TBI, the symptoms listed within the NSI tend to occur at a high frequency in Veterans with a history of TBI (Merritt et al, 2020;Ozturk et al, 2022); thus, providers often inquire about these symptoms during a clinical evaluation and symptom endorsement has direct implications for follow-up care and clinical referrals (The Management of Concussion/mTBI Working Group, 2021).…”

Prevalence and correlates of self‐reported cognitive difficulties in deployment‐injured U.S. military personnel

“…Although most individuals recover within days following mTBI (Nelson et al., 2016; Williams et al., 2015), base rates of frequently reported cognitive difficulties, such as problems with concentration and memory, range from 23% to 78% of military personnel 5–10 years postinjury (Lange, Lippa, et al., 2020; MacDonald et al., 2017; Vanderploeg et al., 2007, 2009). Although providers and military personnel typically have attributed cognitive difficulties to mTBI (Merritt et al., 2020; Roth & Spencer, 2013), these difficulties have been associated with PTSD and depression to a greater degree than a history of mTBI alone (Andrews et al., 2018; Lange, French, et al., 2020; Seal et al., 2016). For example, a recent study of U.S. National Guard personnel found that PTSD explained 64% of the variance on a single item assessing self‐reported concentration difficulties, whereas a history of mTBI did not explain any unique variance (Roberge et al., 2021).…”

Characterizing Sex Differences in Clinical and Functional Outcomes Among Military Veterans With a Comprehensive Traumatic Brain Injury Evaluation: A Million Veteran Program Study

“…In particular, accurate detection and diagnosis of TBI and tracking and monitoring of postinjury sequelae have been two primary areas of scientific exploration. Through these efforts, it has been well established that a host of “post-concussive” or neurobehavioral symptoms, such as headache, sleep difficulties, and forgetfulness, are frequently endorsed following TBI (Merritt et al, 2020; Scholten et al, 2012; Schwab et al, 2017). Although there is ongoing debate regarding the precise etiology of these symptoms, these sequelae have been shown to significantly interfere with service members’ day-to-day functioning and overall quality of life (McMahon et al, 2014; Schiehser et al, 2015).…”