PTSD and Neurobehavioral Symptoms in Combat Veterans Diagnosed with mTBI in Relation to Type of Blast Trauma and location of Blast -- Judith F. Legault
Judith Legault is currently finishing her clinical psychology internship at the William Jennings Bryan Dorn Veterans Administration Medical Center.
The purpose of this study was to determine whether type of blast injury effects PTSD/neurobehavioral symptomatology. Nearly 20% of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) are estimated to experience symptoms of PTSD and/or depression, while more than 320,000 OIF/OEF service members have sustained a TBI (Van Boven et al., 2009).
Current research employed a correlational design to examine associations between type of blast trauma, localization of blast trauma, and PTSD symptoms. In order to reveal these associations, a crosssectional descriptive, design was used. 582 U.S. military service members who had received mTBIs from explosive/blast munitions or other mechanisms while deployed in Iraq or Afghanistan were separated into groups by type of blast injury: primary (P), secondary (S), tertiary (T), or quaternary (Q), alone and in combinations, and by location of injury relative to the person’s head. Groups were compared with respect to symptom clusters and overall scores on the PCL-C and the NSI.
Results indicate that veterans with Q injuries had the lowest PCL-C mean scores, while those who had PST, PQ, and SQ injuries had the highest. The NBSI mean scores using a 4-factor model was highest for P, PQ, and SQ, while Q and QT injuries were among the lowest scores. Using a 3-factor model, it was found that Q and QT injuries had the lowest scores, while PST and SQ injuries had the highest mean scores. Results indicate that blast injury to the back of the head resulted in significantly higher PCL-C and NBSI total scores along with lower PCL-C Avoidance and higher NBSI-Sensory factor in the 4-factor model of the NBSI. Chi-square analyses indicate statistically significant relationships between type of blast injury and PTSD, but not between localization of blast injury and PTSD.
Key Words: PTSD, mTBI, Neurobehavioral Symptoms, PCL, NBSI, Blast Injury, OIF/IEF.