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BACKGROUND/RATIONALE:
Traumatic Brain Injury (TBI) due to explosive blasts is considered the "signature injury" of Operations Enduring Freedom (OEF) and Operations Iraqi Freedom (OIF), with the majority of TBI's sustained being mild in severity (mTBI). Data regarding rates of mTBI in military personnel is very limited with only one published study suggesting that as many as 15% of recently returned OIF soldiers reported mTBI while serving in Iraq. MTBI is strongly associated with co-morbid posttraumatic stress disorder (PTSD) and poorer physical outcomes. Despite increasing attention from DoD and VA calling for the urgent need to identify and provide appropriate follow up care for blast injuries, mTBI, and PTSD in returning OEF/OIF veterans, the evidence base for best practices in the identification or treatment of both mTBI and mTBI/PTSD comorbidity remains in its infancy. The primary goal of this project is to longitudinally examine rates of mTBI/PTSD comorbidity and associated TBI/PTSD screening and health care utilization experiences in new veterans one year following deployment to Iraq.
OBJECTIVE(S):
Among a large existing cohort of male and female National Guard soldiers who provided in-theater screening data on blast exposure and PTSD symptoms, we will: 1) Describe rates of mTBI and PTSD comorbidity one year following deployment; 2) Identify the proportion of OIF veterans with previously reported (in-theater) blast exposure and PTSD symptoms who in the first year following deployment: a) accessed VA health care services, b) were screened for TBI and PTSD, respectively, and c) were referred for follow-up care; and 3) Determine if new OIF veterans with mTBI/PTSD comorbidity (compared to veterans with mTBI alone, PTSD alone, and no mTBI or PTSD) report different outcomes in mental and physical health as well as health care utilization.
METHODS:
We will longitudinal survey of an existing representative sample of 2,677 National Guard soldiers deployed to Iraq from March 2006 to July 2007 who completed in-theater screenings of blast exposure and PTSD symptoms. Using a mailed survey methodology, we will collect valid and reliable self-report measures of combat exposure, experiences with explosive blasts and other injuries during deployment, mTBI and post-concussive symptoms, current mental and physical health, and post-deployment health care utilization. We will assess veterans' self-reported access and use of VA and non-VA health care services, TBI and PTSD screening experiences and outcomes, and current mental/physical health needs.
FINDINGS/RESULTS:
This project is ongoing and we have no findings to date.
IMPACT:
This project will provide information about the scope of mTBI/PTSD comorbidity in returning veterans, examine VA's TBI screening practices and associated outcomes, and define health care utilization outcomes for veterans with mTBI/PTSD comorbidity. This information may assist VA providers, researchers and policy makers in improving practices that will enhance outcomes for veterans. Findings will also lay the foundation for future research to examine mTBI/PTSD comorbidity outcomes over time and identify best practices for recovery and reintegration of OEF/OIF veterans.
PUBLICATIONS:
None at this time.
DRA:
none
DRE:
none
Keywords:
none
MeSH Terms:
none
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