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创伤性脑损伤和创伤后应激障碍与9·11事件后女性退伍军人的身体健康负担相关。

Traumatic Brain Injury and Posttraumatic Stress Disorder Are Associated with Physical Health Burden Among Post-9/11 Women Veterans.

作者信息

Pebole Michelle M, Whitworth James W, Iverson Katherine M, Currao Alyssa, Fortier Catherine B

机构信息

The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA.

Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

J Womens Health (Larchmt). 2025 Jan;34(2):221-228. doi: 10.1089/jwh.2024.0147. Epub 2024 Jun 14.

Abstract

Little research focuses on physical health outcomes of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) among post-9/11 women veterans (WVs). This study examined lifetime TBI, current PTSD, and their associations with biomarkers of cardiometabolic health, sleep, pain, and functional disability among post-9/11 WVs. WVs ( = 90) from the Translational Research Center for TBI and Stress Disorders longitudinal cohort study were included in this study. Gold standard clinician administered interviews assessed lifetime TBI (Boston Assessment of TBI-Lifetime) and current PTSD symptoms (Clinician-Administered PTSD Scale-IV). Objective measures of health included waist-hip ratio (WHR) and fasted blood biomarker (high density lipoprotein [HDL], low density lipoprotein [LDL], blood glucose, triglycerides) levels. Self-reported surveys assessed sleep, pain, and functional disability. Just under two-thirds (58.9%) of WVs experienced a lifetime TBI, and just over half (53.3%) of this sample had a current PTSD diagnosis at the time of testing. Lifetime TBI was significantly associated with higher WHR, triglycerides levels, and worse pain and sleep (s = <0.01 to 0.02; ds = 0.01 to 1.12). Current PTSD was significantly associated with higher WHR, lower HDL, and worse pain and sleep (s = <0.01 to 0.02; ds = 0.009 to 1.19). PTSD was significantly associated with lower total functioning and each of its subdomains (βs = -0.58 to 0.63; s = <0.001 to 0.02). Lifetime TBI was significantly associated with total functioning, mobility, and life/work (βs = -0.20 to 0.30; s = <0.01 to 0.02). These findings highlight the importance of screening for lifetime TBI and cardiovascular disease for WVs and support transdiagnostic treatment approaches targeting physical health outcomes.

摘要

针对9·11事件后的女性退伍军人(WVs)中创伤性脑损伤(TBI)和创伤后应激障碍(PTSD)的身体健康结果,相关研究较少。本研究调查了9·11事件后的WVs中一生的TBI、当前的PTSD,以及它们与心脏代谢健康、睡眠、疼痛和功能残疾生物标志物之间的关联。本研究纳入了来自创伤性脑损伤与应激障碍转化研究中心纵向队列研究的WVs(n = 90)。由金标准临床医生进行的访谈评估了一生的TBI(波士顿创伤性脑损伤终生评估)和当前的PTSD症状(临床医生管理的PTSD量表-IV)。健康的客观指标包括腰臀比(WHR)和空腹血液生物标志物(高密度脂蛋白[HDL]、低密度脂蛋白[LDL]、血糖、甘油三酯)水平。自我报告调查评估了睡眠、疼痛和功能残疾情况。近三分之二(58.9%)的WVs经历过一生的TBI,且该样本中略超过一半(53.3%)在测试时被诊断为当前患有PTSD。一生的TBI与较高的WHR、甘油三酯水平以及更严重的疼痛和睡眠显著相关(ps = <0.01至0.02;ds = 0.01至1.12)。当前的PTSD与较高的WHR、较低的HDL以及更严重的疼痛和睡眠显著相关(ps = <0.01至0.02;ds = 0.009至1.19)。PTSD与较低的总体功能及其各个子领域显著相关(βs = -0.58至0.63;ps = <0.001至0.02)。一生的TBI与总体功能、活动能力和生活/工作显著相关(βs = -0.20至0.30;ps = <0.01至0.02)。这些发现凸显了对WVs进行一生的TBI和心血管疾病筛查的重要性,并支持针对身体健康结果的跨诊断治疗方法。

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