Murray B Stein1, Ronald C Kessler1, Steven G Heeringa1, Sonia Jain1, Laura Campbell-Sills1, Lisa J Colpe1, Carol S Fullerton1, Matthew K Nock1, Nancy A Sampson1, Michael Schoenbaum1, Xiaoying Sun1, Michael L Thomas1, Robert J Ursano1. 1. From the Department of Psychiatry, University of California San Diego, La Jolla, Calif.; the Department of Family Medicine and Public Health, University of California San Diego, La Jolla, Calif.; the VA San Diego Healthcare System, San Diego; the Department of Health Care Policy, Harvard Medical School, Boston; the University of Michigan, Institute for Social Research, Ann Arbor, Mich.; the National Institute of Mental Health, Bethesda, Md.; the Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Md.; and the Department of Psychology, Harvard College, Cambridge, Mass.
Abstract
OBJECTIVE: Traumatic brain injury (TBI) is increasingly recognized as a risk factor for deleterious mental health and functional outcomes. The purpose of this study was to examine the strength and specificity of the association between deployment-acquired TBI and subsequent posttraumatic stress and related disorders among U.S. Army personnel. METHOD: A prospective, longitudinal survey of soldiers in three Brigade Combat Teams was conducted 1-2 months prior to an average 10-month deployment to Afghanistan (T0), upon redeployment to the United States (T1), approximately 3 months later (T2), and approximately 9 months later (T3). Outcomes of interest were 30-day prevalence postdeployment of posttraumatic stress disorder (PTSD), major depressive episode, generalized anxiety disorder, and suicidality, as well as presence and severity of postdeployment PTSD symptoms. RESULTS: Complete information was available for 4,645 soldiers. Approximately one in five soldiers reported exposure to mild (18.0%) or more-than-mild (1.2%) TBI(s) during the index deployment. Even after adjusting for other risk factors (e.g., predeployment mental health status, severity of deployment stress, prior TBI history), deployment-acquired TBI was associated with elevated adjusted odds of PTSD and generalized anxiety disorder at T2 and T3 and of major depressive episode at T2. Suicidality risk at T2 appeared similarly elevated, but this association did not reach statistical significance. CONCLUSIONS: The findings highlight the importance of surveillance efforts to identify soldiers who have sustained TBIs and are therefore at risk for an array of postdeployment adverse mental health outcomes, including but not limited to PTSD. The mechanism(s) accounting for these associations need to be elucidated to inform development of effective preventive and early intervention programs.
OBJECTIVE:Traumatic brain injury (TBI) is increasingly recognized as a risk factor for deleterious mental health and functional outcomes. The purpose of this study was to examine the strength and specificity of the association between deployment-acquired TBI and subsequent posttraumatic stress and related disorders among U.S. Army personnel. METHOD: A prospective, longitudinal survey of soldiers in three Brigade Combat Teams was conducted 1-2 months prior to an average 10-month deployment to Afghanistan (T0), upon redeployment to the United States (T1), approximately 3 months later (T2), and approximately 9 months later (T3). Outcomes of interest were 30-day prevalence postdeployment of posttraumatic stress disorder (PTSD), major depressive episode, generalized anxiety disorder, and suicidality, as well as presence and severity of postdeployment PTSD symptoms. RESULTS: Complete information was available for 4,645 soldiers. Approximately one in five soldiers reported exposure to mild (18.0%) or more-than-mild (1.2%) TBI(s) during the index deployment. Even after adjusting for other risk factors (e.g., predeployment mental health status, severity of deployment stress, prior TBI history), deployment-acquired TBI was associated with elevated adjusted odds of PTSD and generalized anxiety disorder at T2 and T3 and of major depressive episode at T2. Suicidality risk at T2 appeared similarly elevated, but this association did not reach statistical significance. CONCLUSIONS: The findings highlight the importance of surveillance efforts to identify soldiers who have sustained TBIs and are therefore at risk for an array of postdeployment adverse mental health outcomes, including but not limited to PTSD. The mechanism(s) accounting for these associations need to be elucidated to inform development of effective preventive and early intervention programs.
Authors: Holly J Ramsawh; Carol S Fullerton; Holly B Herberman Mash; Tsz Hin H Ng; Ronald C Kessler; Murray B Stein; Robert J Ursano Journal: J Affect Disord Date: 2014-03-25 Impact factor: 4.839
Authors: Robert J Ursano; Lisa J Colpe; Steven G Heeringa; Ronald C Kessler; Michael Schoenbaum; Murray B Stein Journal: Psychiatry Date: 2014 Impact factor: 2.458
Authors: Paul McMahon; Allison Hricik; John K Yue; Ava M Puccio; Tomoo Inoue; Hester F Lingsma; Sue R Beers; Wayne A Gordon; Alex B Valadka; Geoffrey T Manley; David O Okonkwo Journal: J Neurotrauma Date: 2013-10-31 Impact factor: 5.269
Authors: Richard A Bryant; Angela Nickerson; Mark Creamer; Meaghan O'Donnell; David Forbes; Isaac Galatzer-Levy; Alexander C McFarlane; Derrick Silove Journal: Br J Psychiatry Date: 2015-02-05 Impact factor: 9.319
Authors: James C Jackson; Pratik P Pandharipande; Timothy D Girard; Nathan E Brummel; Jennifer L Thompson; Christopher G Hughes; Brenda T Pun; Eduard E Vasilevskis; Alessandro Morandi; Ayumi K Shintani; Ramona O Hopkins; Gordon R Bernard; Robert S Dittus; E Wesley Ely Journal: Lancet Respir Med Date: 2014-04-07 Impact factor: 30.700
Authors: Madeleine Goodkind; Simon B Eickhoff; Desmond J Oathes; Ying Jiang; Andrew Chang; Laura B Jones-Hagata; Brissa N Ortega; Yevgeniya V Zaiko; Erika L Roach; Mayuresh S Korgaonkar; Stuart M Grieve; Isaac Galatzer-Levy; Peter T Fox; Amit Etkin Journal: JAMA Psychiatry Date: 2015-04 Impact factor: 21.596
Authors: Hohui E Wang; Laura Campbell-Sills; Ronald C Kessler; Xiaoying Sun; Steven G Heeringa; Matthew K Nock; Robert J Ursano; Sonia Jain; Murray B Stein Journal: Sleep Date: 2019-02-01 Impact factor: 5.849
Authors: Murray B Stein; Robert J Ursano; Laura Campbell-Sills; Lisa J Colpe; Carol S Fullerton; Steven G Heeringa; Matthew K Nock; Nancy A Sampson; Michael Schoenbaum; Xiaoying Sun; Sonia Jain; Ronald C Kessler Journal: J Neurotrauma Date: 2016-04-08 Impact factor: 5.269
Authors: G Bandoli; L Campbell-Sills; R C Kessler; S G Heeringa; M K Nock; A J Rosellini; N A Sampson; M Schoenbaum; R J Ursano; M B Stein Journal: Psychol Med Date: 2017-04-26 Impact factor: 7.723
Authors: Murray B Stein; Chia-Yen Chen; Robert J Ursano; Tianxi Cai; Joel Gelernter; Steven G Heeringa; Sonia Jain; Kevin P Jensen; Adam X Maihofer; Colter Mitchell; Caroline M Nievergelt; Matthew K Nock; Benjamin M Neale; Renato Polimanti; Stephan Ripke; Xiaoying Sun; Michael L Thomas; Qian Wang; Erin B Ware; Susan Borja; Ronald C Kessler; Jordan W Smoller Journal: JAMA Psychiatry Date: 2016-07-01 Impact factor: 21.596
Authors: Murray B Stein; Laura Campbell-Sills; Joel Gelernter; Feng He; Steven G Heeringa; Matthew K Nock; Nancy A Sampson; Xiaoying Sun; Sonia Jain; Ronald C Kessler; Robert J Ursano Journal: Alcohol Clin Exp Res Date: 2016-11-24 Impact factor: 3.455
Authors: Jonathon R Howlett; Laura Campbell-Sills; Sonia Jain; Steven G Heeringa; Matthew K Nock; Xiaoying Sun; Robert J Ursano; Murray B Stein Journal: J Trauma Stress Date: 2018-11-21
Authors: Lauren Anderson; Laura Campbell-Sills; Robert J Ursano; Ronald C Kessler; Xiaoying Sun; Steven G Heeringa; Matthew K Nock; Paul D Bliese; Oscar I Gonzalez; Gary H Wynn; Sonia Jain; Murray B Stein Journal: Depress Anxiety Date: 2019-01-29 Impact factor: 6.505
Authors: Murray B Stein; Sonia Jain; Joseph T Giacino; Harvey Levin; Sureyya Dikmen; Lindsay D Nelson; Mary J Vassar; David O Okonkwo; Ramon Diaz-Arrastia; Claudia S Robertson; Pratik Mukherjee; Michael McCrea; Christine L Mac Donald; John K Yue; Esther Yuh; Xiaoying Sun; Laura Campbell-Sills; Nancy Temkin; Geoffrey T Manley; Opeolu Adeoye; Neeraj Badjatia; Kim Boase; Yelena Bodien; M Ross Bullock; Randall Chesnut; John D Corrigan; Karen Crawford; Ramon Diaz-Arrastia; Sureyya Dikmen; Ann-Christine Duhaime; Richard Ellenbogen; V Ramana Feeser; Adam Ferguson; Brandon Foreman; Raquel Gardner; Etienne Gaudette; Joseph T Giacino; Luis Gonzalez; Shankar Gopinath; Rao Gullapalli; J Claude Hemphill; Gillian Hotz; Sonia Jain; Frederick Korley; Joel Kramer; Natalie Kreitzer; Harvey Levin; Chris Lindsell; Joan Machamer; Christopher Madden; Alastair Martin; Thomas McAllister; Michael McCrea; Randall Merchant; Pratik Mukherjee; Lindsay D Nelson; Florence Noel; David O Okonkwo; Eva Palacios; Daniel Perl; Ava Puccio; Miri Rabinowitz; Claudia S Robertson; Jonathan Rosand; Angelle Sander; Gabriela Satris; David Schnyer; Seth Seabury; Mark Sherer; Murray B Stein; Sabrina Taylor; Arthur Toga; Nancy Temkin; Alex Valadka; Mary J Vassar; Paul Vespa; Kevin Wang; John K Yue; Esther Yuh; Ross Zafonte Journal: JAMA Psychiatry Date: 2019-03-01 Impact factor: 21.596