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Objective: This study was conducted (1) to examine differences in post-traumatic stress disorder (PTSD) symptoms, perceived quality-of-life (QoL) and post-concussive symptoms (PCS) among veterans who experienced deployment-related mild traumatic brain injuries (mTBIs) with or without loss of consciousness (LOC) and (2) to test the additive role of PCS on QOL. Design: Two hundred and twelve Iraq/Afghanistan veterans who were admitted to a residential programme for PTSD were assessed shortly following intake. A MANCOVA was conducted to examine QoL, PTSD symptom domains and PCS across the No LOC and LOC groups. Multivariate regression models were conducted to examine whether prevalence of PCS might be uniquely linked with veterans’ QoL (physical, psychological and social). Results: When controlling for combat exposure (CE), LOC status was uniquely linked with avoidance symptomatology, Psychological QoL and PCS; LOC status was not significantly linked with other domains of PTSD or QoL. When controlling for CE and PTSD, PCS was similarly linked with QoL in the psychological domain, but not Physical or Social QoL. Conclusion/Implications: LOC associated with a mTBI may contribute to behavioural avoidance and poorer psychological well-being among veterans seeking treatment for PTSD. In addition, PCS associated with mTBI may diminish Psychological QoL for veterans seeking treatment for PTSD. [ABSTRACT FROM PUBLISHER]

Primary objective: To characterize an acute stress reaction (ASR) following an improvised explosive device (IED) blast-related mild traumatic brain injury (mTBI). Research design: Participants were male, US military personnel treated in Afghanistan within 4 days following an IED-related mTBI event ( n = 239). Methods and procedures: Demographics, diagnosis of ASR, injury history and self-reported mTBIs, blast exposures and psychological health histories were recorded. Main outcomes and results: In total, 12.5% of patients met ASR criteria. Patients with ASR were significantly younger and junior in rank ( p < 0.05). Patients with ASR were more likely to experience the IED-blast while dismounted, report a loss of consciousness (LOC) and higher pain levels ( p < 0.05). Adjusting for age and rank, multivariate logistic regression showed an association between mTBI history and ASR (AOR = 1.405; 95% CI = 1.105-1.786, p < 0.01). Adjusting for mechanism of injury (dismounted vs. mounted), LOC and pain, multivariate logistic regression showed an association between mTBI history and ASR (AOR = 1.453; 95% CI = 1.132-1.864, p < 0.01). Prior blast exposure and past psychological health issues were not associated with ASR. Conclusions: A history of multiple mTBIs is associated with increased risk of ASR. Future research is warranted. [ABSTRACT FROM AUTHOR]

Objective: Explore relationships among traumatic brain injury (TBI), substance misuse and other mental health disorders in US service members and to identify risk factors for substance misuse. Participants: Service members ( n = 93 in final sample) injured while deployed to Operation Enduring Freedom or Operation Iraqi Freedom. Methods and materials: Longitudinal survey at 6 and 12 months post-intake. The following measures were used: problem substance use, Alcohol Expectancies Questionnaire-III, MINI International Neuropsychiatric Interview Substance Abuse Modules, Ohio State University TBI Identification Method, Neurobehavioural Symptom Inventory, Rivermead Post-Concussion Symptoms Questionnaire, Buss-Perry Aggression Questionnaire, Post-Traumatic Stress Disorder Checklist-Civilian Version, Beck Depression Inventory-II, Beck Anxiety Inventory. Results: More severe TBI and post-traumatic stress disorder (PTSD) symptoms at 6 months post-enrolment were associated with decreased odds of substance misuse 12 months after study enrolment. Alcohol expectancies and incurring a TBI at a younger age increased the odds of substance misuse. Conclusions: While the ability to generalize the current findings to a larger population is limited, the results provide direction for future studies on the prevention and treatment of substance misuse following TBI. The unexpected protective effect of more severe TBI may result from prospective attention to the injury and its consequences. Greater preventive benefit may result from identifying more service members with elevated risk. Lifetime history of TBI and alcohol expectancies may be candidate indicators for greater attention. [ABSTRACT FROM AUTHOR]