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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;

Objectives:
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.

Methods:
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.

Results:
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.

Implications:
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.

Impacts:
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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