Dual diagnosis of TBI and PTSD in combat veterans.

摘要

The purpose of this study was to examine the correlation of dual diagnosis of traumatic brain injuries (TBI) and post-traumatic stress disorder (PTSD) in combat veterans and demographic factors which may correlate with PTSD diagnosis. The study focused on post-9/11 combat veterans from Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) who had completed at least one combat deployment tour to Iraq or Afghanistan and who were medically discharged from active duty service due to injuries sustained. Participants were recruited through Operation TBI Freedom, a program of Rocky Mountain Human Services (RMHS), a nonprofit organization with locations in Denver and Colorado Springs, Colorado. Data collection was completed through the assistance of Psychdata, a secure research-based website. The participants completed two self-report assessments, the Post-traumatic Disorder Checklist: Military Version (PCL-M) and the Defense and Veterans Brain Injury Center TBI (DVBIC TBI) Screening Tool, and a demographic survey. A multiple regression analysis was completed to assess correlation of PTSD and TBI symptoms and to determine correlating demographic variables amongst PTSD diagnosis.;Results of the multiple regression analysis concluded that the number of TBIs and type of discharge from military service significantly correlated with diagnosis of PTSD amongst combat veterans. Specifically, combat veterans who sustained two or more mild to moderate TBIs during combat deployment and who were honorably discharged from active duty military service had a higher incident of PTSD diagnosis.;Demographic factors which correlated with dual diagnosis of TBI/PTSD in combat veterans were marital status, specifically being married. The variables of marital status and type of discharge may have had a positive effect on the veterans' ability to access care for their injuries leading to increase in diagnosis and treatment.;The most common post-injury symptoms of TBI reported amongst participants were headaches, memory loss, memory difficulties, tinnitus, increased irritability, and sleep disturbance. Little variation was observed amongst reported prolonged symptoms of PTSD. On average, participants reported continuous struggles with symptoms of reexperiencing the traumatic event, avoidance of stimuli, and increased arousal. The symptoms include experiencing disturbing memories and dreams; avoidance of thinking about the event, avoidance of discussing the event, feeling distant from others, feeling emotionally numb, having increased irritability, and being easily startled.;Other factors showing significant correlation with reported PTSD symptoms were not having sustained fragment injuries during deployment; having spouse or family report something is different or wrong with the injured veteran; the injured veteran reporting they experienced post-injury headaches, and the injured veteran reporting they experienced being dazed or confused at time of injury. These variables may have correlation due to increased susceptibility to the disorder or increased awareness and access to medical treatment and diagnosis.;Further research is needed on the biopsychosocial and neurological impact of the sustainment of multiple mild TBIs during combat and PTSD diagnosis.