MTBI Effects on Emotion Symptoms, Neurocognitive Performance, and Functional Impairment: A Longitudinal Study of Deployed and Non-Deployed Army Soldiers

摘要

This prospective/longitudinal study examined the effects of Operation Iraqi Freedom-related emotional symptoms and mTBI exposure on post- deployment function. Both performance-based and self-report outcome measures were collected. Regression analytic strategies examined post-OIF function on objective neurocognitive measures and self-reported cognitive and physical problems, measuring the predictive contribution of self-report of mild TBI; self-report regarding emotional function immediately post-deployment (e.g., symptoms of PTSD and depression); and self-report of combat exposure. A survey of predeployment factors failed to uncover any reliable predictors of deployment-related mild TBI beyond previous occurrence of related TBI. Regression analyses utilizing self-report of PTSD indicate that symptoms of deployment-related emotional distress are significantly related to postdeployment cognitive outcomes. The existence of an analogous depression- cognitive outcome suggests that the impact of deployment is not related strictly to PTSD and instead reflects more global levels of emotional distress. Mild traumatic brain injury (mTBI) was not a significant predictor of cognitive outcome in this sample, despite use of liberal exploratory techniques designed to maximize the likelihood of uncovering meaningful mTBI-cognition effects. However, a significant mTBI/physical complaints relationship suggests that mTBI may be exerting a deleterious effect on the readjustment of deployed troops. This relationship is unlikely to be due solely to demand characteristics, since no relationship was found between mTBI and self-report of cognitive complaints. The congruence between cognitive objective performance and cognitive self- report data in this sample instead is consistent with the possibility that simple self-report of mTBI is tapping a distress factor with unclear consequences. Improved reliability of mTBI measures would assist in further delineating this potential relationship.