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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

3138 — Co-Occurrence of Military Sexual Trauma and Deployment-Related Traumatic Brain Injury among Women OEF/OIF Veterans

Iverson KM, National Center for PTSD, VA Boston Healthcare System; Meterko M, Center for Organization, Leadership and Management Research (COLMR), VA Boston Healthcare System; Pogoda TK, COLMR, VA Boston Healthcare System; Stolzmann KL, COLMR, VA Boston Healthcare System; Baker E, COLMR, VA Boston Healthcare System; Krengel M, VA Boston Healthcare System; Kimerling R, National Center for PTSD, Palo Alto VAMC;

18.5% of women OEF/OIF VA patients screen positive for military sexual trauma (MST) and 10.5% screen positive for traumatic brain injury (TBI). However, mental health conditions among women VA patients with both MST and deployment-related TBI remains unknown. This study calculated the proportion of OEF/OIF women with deployment-related TBI who screened positive for MST and compared this group to women with deployment-related TBI only on likelihood of several psychiatric diagnoses and postconcussive symptom severity.

Data: VA administrative screening and utilization records. Population: Women OEF/OIF VA patients judged to have deployment-related TBI based on a Comprehensive TBI Evaluation (CTE) and were screened for MST as of FY08. Analyses: Women in the deployment-related TBI sample who had a positive MST screen (n = 66) were compared to those with TBI-only (n = 203) on 1) likelihood of psychiatric diagnoses based on two or more diagnosis assignments from separate VA outpatient/inpatient visits between FY07-FY09, and 2) severity on scales from the Neurobehavioral Symptom Inventory-22 (from the CTE) using chi-square analyses and MANOVAs.

24.5% of women with confirmed deployment-related TBI reported MST. The TBI+MST group was significantly more likely than the TBI-only group to have depression diagnoses (68.2% vs. 49.8%, p <.01). Additionally, 74.2% of the TBI+MST group was diagnosed with multiple conditions (>=2) during the observation period compared to 59.6% of the TBI-only group (p <0.05). There were no differences between groups in proportions of diagnoses for PTSD, non-PTSD anxiety disorders, adjustment disorders, or substance-use disorders. The TBI+MST group reported more severe cognitive (p <.001) and vestibular (p <.001) symptoms than the TBI-only group.

Nearly 25% of the sample of women with deployment-related TBI screened positive for MST. Compared to women who experienced TBI-only, those exposed to both traumas were more likely to be depressed, have multiple psychiatric diagnoses, and report more severe cognitive and vestibular postconcussive symptoms.

VA clinicians should be aware that MST is a substantial mental health issue among female VA patients with deployment-related TBI, and should consider the need for additional assessment and coordination of care to comprehensively address the mental health needs of dually exposed women.

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