Research and Psychology Services (Drs Sorg, Merritt, Clark, Hanson, Jak, Schiehser, and Delano-Wood) and Center of Excellence for Stress and Mental Health (Drs Jak, Schiehser, and Delano-Wood), VA San Diego Healthcare System, San Diego, California; SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California (Ms Holiday); Department of Psychiatry, University of California San Diego (Drs Sorg, Merritt, Clark, Hanson, Jak, Schiehser, and Delano-Wood); and Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Dr Werhane).
J Head Trauma Rehabil. 2021;36(6):418-423. doi: 10.1097/HTR.0000000000000659.
The evaluation of memory complaints in mild traumatic brain injury (mTBI) remains an important clinical consideration, especially in the context of comorbid psychiatric symptoms such as posttraumatic stress disorder (PTSD). We compared subjective memory complaints in veterans with and without a history of mTBI, examined ratings between those with single versus multiple mTBIs, and investigated associations between memory complaints and PTSD symptom severity.
117 outpatient veterans (mTBI: n = 79 [single mTBI: n = 22, multiple mTBI: n = 57], military controls [MCs]: n = 38) completed a TBI history assessment, the Prospective-Retrospective Memory Questionnaire (PRMQ), and the PTSD Checklist-Military Version (PCL-M).
Hierarchical multiple regression showed that greater PCL-M scores significantly predicted elevated PRMQ-Total scores, accounting for 38% of the variance explained (P < .001). mTBI status predicted an additional 5% of variance in memory complaints (P < .01). The multiple-mTBI group endorsed more memory complaints than either MCs (P < .01) or the single-mTBI group (P < .05), who did not differ from MCs (P > .50).
Comorbid PTSD symptoms are an important factor when considering memory complaints in veterans with a reported history of mTBI. However, independent of comorbid PTSD symptoms, mTBI status-particularly in the context of repetitive neurotrauma-uniquely contributes to memory complaints. Findings suggest that veterans with a history of multiple mTBIs may be a particularly vulnerable group in need of specialized interventions and/or psychoeducation.
在轻度创伤性脑损伤(mTBI)中,对记忆主诉的评估仍然是一个重要的临床考虑因素,尤其是在创伤后应激障碍(PTSD)等合并精神症状的情况下。我们比较了有和无 mTBI 病史的退伍军人的主观记忆主诉,检查了单发与多发 mTBI 之间的评分,并调查了记忆主诉与 PTSD 症状严重程度之间的关联。
117 名门诊退伍军人(mTBI:n=79[单发 mTBI:n=22,多发 mTBI:n=57],军事对照组[n=38])完成了 TBI 病史评估、前瞻性-回顾性记忆问卷(PRMQ)和 PTSD 检查表-军事版本(PCL-M)。
分层多元回归显示,PCL-M 评分越高显著预测 PRMQ-总分升高,占解释方差的 38%(P<.001)。mTBI 状态额外预测记忆主诉的 5%的方差(P<.01)。多发 mTBI 组的记忆主诉比任何对照组(均 P<.01)或单发 mTBI 组(P<.05)都多,而后者与对照组无差异(P>.50)。
当考虑有报告 mTBI 病史的退伍军人的记忆主诉时,合并的 PTSD 症状是一个重要因素。然而,独立于合并的 PTSD 症状,mTBI 状态-特别是在重复神经创伤的情况下-独特地导致记忆主诉。研究结果表明,有多发 mTBI 病史的退伍军人可能是一个特别脆弱的群体,需要专门的干预和/或心理教育。