Russo Arthur C, Fingerhut Esther C
Psychology Department, VA New York Harbor Healthcare System, Brooklyn Campus, Brooklyn, NY, USA.
Fordham University, Bronx, NY, USA.
Arch Clin Neuropsychol. 2017 Mar 1;32(2):184-197. doi: 10.1093/arclin/acw093.
This study examined the consistency of self-reported symptoms and concussive events in combat veterans who reported experiencing concussive events.
One hundred and forty, single deployed, Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn combat veterans with Veteran Health Administration (VHA) Comprehensive Traumatic Brain Injury Evaluations (CTBIE) and no post-deployment head injury were examined to assess consistency of self-reported (a) traumatic brain injury (TBI)-related symptoms, (b) post-traumatic stress disorder (PTSD)-related symptoms, and (c) TBI-related concussive events from soon after deployment to time of VHA CTBIE.
Compared to their self-report of symptoms and traumatic events at the time of their Post-Deployment Health Assessment, at the time of their comprehensive VHA evaluation, subjects reported significantly greater impairment in concentration, decision making, memory, headache, and sleep. In addition, although half the subjects denied any PTSD symptoms post-deployment, approximately three quarters reported experiencing all four PTSD screening symptoms near the time of the VHA CTBIEs. At the latter time, subjects also reported significantly more TBI-related concussive events, as well as more post-concussive sequelae such as loss of consciousness immediately following these concussive events. Finally, although 84% reported a level of impairment so severe as to render all but the simplest activity doable, the vast majority simultaneously reported working and/or attending college.
These findings raise questions regarding the accuracy of veteran self-report of both near and distant traumatic events, and argue for the inclusion of contemporaneous Department of Defense (DOD) records in veteran assessment and treatment planning.
本研究调查了报告有脑震荡事件的退伍军人自我报告症状与脑震荡事件的一致性。
对140名曾单独部署参加持久自由行动、伊拉克自由行动和新黎明行动的退伍军人进行了检查，这些退伍军人接受了退伍军人健康管理局（VHA）的综合创伤性脑损伤评估（CTBIE）且部署后无头部受伤情况，以评估从部署后不久到VHA进行CTBIE期间，自我报告的（a）创伤性脑损伤（TBI）相关症状、（b）创伤后应激障碍（PTSD）相关症状以及（c）TBI相关脑震荡事件的一致性。
与部署后健康评估时的症状和创伤事件自我报告相比，在VHA综合评估时，受试者报告在注意力、决策、记忆、头痛和睡眠方面的损害明显更大。此外，虽然一半的受试者在部署后否认有任何PTSD症状，但在VHA进行CTBIE时，约四分之三的受试者报告出现了所有四项PTSD筛查症状。在后者这个时间点，受试者还报告了明显更多的TBI相关脑震荡事件，以及更多的脑震荡后后遗症，如这些脑震荡事件后立即出现的意识丧失。最后，虽然84%的受试者报告损伤程度严重到几乎无法进行最简单的活动，但绝大多数人同时报告仍在工作和/或上大学。
这些发现引发了关于退伍军人对近期和远期创伤事件自我报告准确性的问题，并主张在退伍军人评估和治疗计划中纳入国防部同期记录。
