Agtarap Stephanie, Hungerford Lars D, Ettenhofer Mark L
Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland (Drs Agtarap, Hungerford, and Ettenhofer); Naval Medical Center San Diego, San Diego, California (Drs Agtarap, Hungerford, and Ettenhofer); General Dynamics Information Technology, Falls Church, Virginia (Drs Agtarap, Hungerford, and Ettenhofer); Craig Hospital, Englewood, Colorado (Dr Agtarap); and University of California, San Diego, La Jolla, California (Dr Ettenhofer).
J Head Trauma Rehabil. 2023;38(6):E371-E383. doi: 10.1097/HTR.0000000000000854. Epub 2023 Mar 23.
To identify both shared and unique groups of posttraumatic stress and postconcussive symptoms using bifactor analysis.
Two large military outpatient traumatic brain injury (TBI) rehabilitation clinics in the Southwestern United States.
A sample of 1476 Active Duty Service Members seeking treatment for a mild TBI sustained more than 30 days previously, without history of moderate or severe TBI, who completed measures of postconcussive and posttraumatic stress symptoms assessed at clinic intake.
Observational, correlational study with data taken from an institutional review board-approved clinical registry study.
Neurobehavioral Symptom Inventory (NSI) and Posttraumatic Stress Disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) ( DSM-V ) (PCL-5). Concurrent measures were Patient Health Questionnaire (PHQ-8), Pittsburgh Sleep Quality Index (PSQI), and Headache Impact Test (HIT-6).
Results identified a bifactor model demonstrating unique posttraumatic stress, depressive, cognitive, and neurological/somatic symptom groups that were still evident after accounting for a universal factor representing general distress. These symptom groups were differentially related to concurrently measured clinical outcomes.
Use of a bifactor structure may help derive clinically useful signals from self-reported symptoms among Active Duty Service Members seeking outpatient treatment for mild TBI.
采用双因素分析确定创伤后应激症状和脑震荡后症状的共同组和独特组。
美国西南部的两家大型军事门诊创伤性脑损伤（TBI）康复诊所。
1476名现役军人的样本，他们因30多天前遭受的轻度TBI寻求治疗，无中度或重度TBI病史，在诊所就诊时完成了脑震荡后症状和创伤后应激症状的测量。
观察性、相关性研究，数据取自机构审查委员会批准的临床登记研究。
神经行为症状量表（NSI）和《精神疾病诊断与统计手册》（第五版）（DSM-V）创伤后应激障碍（PTSD）检查表（PCL-5）。同时测量的指标包括患者健康问卷（PHQ-8）、匹兹堡睡眠质量指数（PSQI）和头痛影响测试（HIT-6）。
结果确定了一个双因素模型，该模型显示了独特的创伤后应激、抑郁、认知和神经/躯体症状组，在考虑了代表一般痛苦的通用因素后，这些症状组仍然明显。这些症状组与同时测量的临床结果存在不同的相关性。
使用双因素结构可能有助于从寻求轻度TBI门诊治疗的现役军人的自我报告症状中得出临床上有用的信号。
