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A Longitudinal Investigation Examining Predictors of Change in Self-Reported Mild Traumatic Brain Injury In National Guard Veterans of the Iraq War
Kehle-Forbes SM, Erbes CR, Polusny MA. A Longitudinal Investigation Examining Predictors of Change in Self-Reported Mild Traumatic Brain Injury In National Guard Veterans of the Iraq War. Poster session presented at: American Academy of Clinical Neuropsychology Annual Meeting; 2012 Jun 20; Seattle, WA.
Although rates of concussion/mild traumatic brain injury (MTBI) among soldiers of the conflicts in Iraq are presumably very high, prevalence varies significantly across studies. In a longitudinal study of self-reported MTBI in OIF National Guard personnel (Polusny et al., 2011), we surveyed 937 participants at one month before return from Iraq (time 1) and one year after return from deployment (time 2). At Time 1, 9% of respondents endorsed a history of MTBI whereas at Time 2, rates increased to 22%. In this follow-up study, we investigated factors that account for inconsistencies in self-reported MTBI over time. Stepwise logistic regression was conducted using disability claim status, economic distress, PTSD symptoms in Iraq (Time1; PTSD checklist; PCL),PTSD symptoms post deployment (Time 2)and somatic symptoms post deployment (Time 2; Patient Health Questionnaire; PHQ) as independent variables. Time 2 PCL (OR = 1.57, p < .001) and Time 2 PHQ (OR = 1.36, p < .02) emerged as the most significant predictors of change in self-reported MTBI status. Among the PCL items, heightened alertness/watchfulness was the most significant PCL predictor of change in self-reported MTBI status. Results suggest that late-stage somatic symptoms and internal hypervigilance impact rates of self-reported MTBI during the post-deployment phase. Misattribution and other cognitive processes that may underlie changes in Time 2 report of MTBI are discussed.