Alosco Michael L, Aslan Mihaela, Du Mengtian, Ko John, Grande Laura, Proctor Susan P, Concato John, Vasterling Jennifer J
Psychology Service, VA Boston Healthcare System, Boston, Massachusetts (Dr Alosco and Drs Grande and Vasterling); Clinical Epidemiology Research Center, VA Connecticut Healthcare System, West Haven (Drs Aslan and Concato and Mr Ko); Department of Medicine, Yale University School of Medicine, New Haven, Connecticut (Drs Aslan and Concato and Mr Ko); Department of Public Health, Yale Graduate School of Arts and Sciences, New Haven, Connecticut (Mr Du); Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts (Drs Grande and Vasterling); US Army Research Institute of Environmental Medicine, Natick, Massachusetts (Dr Proctor); Research Service, VA Boston Healthcare System, Boston, Massachusetts (Dr Proctor); Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts (Dr Proctor); and National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts (Dr Vasterling).
J Head Trauma Rehabil. 2016 Sep-Oct;31(5):360-8. doi: 10.1097/HTR.0000000000000201.
To examine the temporal consistency of self-reported deployment-related traumatic brain injury (TBI) and its association with posttraumatic stress disorder (PTSD) symptom severity.
In-person interviews at US Army installations (postdeployment); phone interviews (long-term follow-up).
A total of 378 US Army soldiers and veterans deployed to Iraq; 14.3% (n = 54) reported TBI with loss of consciousness during an index deployment.
Participants were evaluated after returning from deployment and again 5 to 9 years later.
Temporal consistency of TBI endorsement based on TBI screening interviews; PTSD Checklist, Civilian Version.
The concordance of deployment-related TBI endorsement from the postdeployment to long-term follow-up assessment was moderate (κ = 0.53). Of the 54 participants reporting (predominantly mild) TBI occurring during an index deployment, 32 endorsed TBI inconsistently over time. More severe PTSD symptoms at postdeployment assessment were independently associated with discordant reporting (P = .0004); each 10-point increase in PCL scores increasing odds of discordance by 69% (odds ratio = 1.69; 95% confidence interval, 1.26-2.26).
Deployment-related TBI may not be reported reliably over time, particularly among war-zone veterans with greater PTSD symptoms. Results of screening evaluations for TBI history should be viewed with caution in the context of PTSD symptom history.
研究自我报告的与部署相关的创伤性脑损伤（TBI）的时间一致性及其与创伤后应激障碍（PTSD）症状严重程度的关联。
在美国陆军基地进行面对面访谈（部署后）；电话访谈（长期随访）。
总共378名部署到伊拉克的美国陆军士兵和退伍军人；14.3%（n = 54）报告在首次部署期间发生TBI并伴有意识丧失。
参与者在部署归来后接受评估，并在5至9年后再次评估。
基于TBI筛查访谈的TBI认可的时间一致性；PTSD检查表，民用版。
从部署后到长期随访评估，与部署相关的TBI认可的一致性为中等（κ = 0.53）。在54名报告在首次部署期间发生（主要为轻度）TBI的参与者中，32人随着时间的推移对TBI的认可不一致。部署后评估中更严重的PTSD症状与不一致的报告独立相关（P = .0004）；PCL分数每增加10分，不一致的几率增加69%（优势比 = 1.69；95%置信区间，1.26 - 2.26）。
与部署相关的TBI可能无法随时间可靠报告，尤其是在PTSD症状更严重的战区退伍军人中。在PTSD症状病史的背景下，应谨慎看待TBI病史筛查评估的结果。
