Heather G Belanger1,2,3, Rael T Lange3,4,5,6, Jason Bailie3,7, Grant L Iverson3,8,9,10, Jacques P Arrieux3,11, Brian J Ivins3, Wesley R Cole3,11. 1. a Department of Mental Health and Behavioral Sciences , James A. Haley VAMC , Tampa , FL , USA. 2. b Department of Psychiatry & Behavioral Neurosciences , University of South Florida , Tampa , FL , USA. 3. c Defense and Veterans Brain Injury Center , Silver Spring , MD , USA. 4. d National Intrepid Center of Excellence , Bethesda , MD , USA. 5. e Walter Reed National Military Medical Center , Bethesda , MD , USA. 6. f University of British Columbia , Vancouver , Canada. 7. g Naval Hospital , Camp Pendleton , CA , USA. 8. h Harvard Medical School , Boston , MA , USA. 9. i Spaulding Rehabilitation Hospital , Charlestown , MA , USA. 10. j Red Sox Foundation and Massachusetts General Hospital Home Base Program , Boston , MA , USA. 11. k Womack Army Medical Center , Fort Bragg , NC , USA.
Abstract
OBJECTIVE: The purpose of this study was to examine the prevalence and stability of symptom reporting in a healthy military sample and to develop reliable change indices for two commonly used self-report measures in the military health care system. PARTICIPANTS AND METHOD: Participants were 215 U.S. active duty service members recruited from Fort Bragg, NC as normal controls as part of a larger study. Participants completed the Neurobehavioral Symptom Inventory (NSI) and Posttraumatic Checklist (PCL) twice, separated by approximately 30 days. RESULTS: Depending on the endorsement level used (i.e. ratings of 'mild' or greater vs. ratings of 'moderate' or greater), approximately 2-15% of this sample met DSM-IV symptom criteria for Postconcussional Disorder across time points, while 1-6% met DSM-IV symptom criteria for Posttraumatic Stress Disorder. Effect sizes for change from Time 1 to Time 2 on individual symptoms were small (Cohen's d = .01 to .13). The test-retest reliability for the NSI total score was r = .78 and the PCL score was r = .70. An eight-point change in symptom reporting represented reliable change on the NSI total score, with a seven-point change needed on the PCL. CONCLUSIONS: Postconcussion-like symptoms are not unique to mild TBI and are commonly reported in a healthy soldier sample. It is important for clinicians to use normative data when evaluating a service member or veteran and when evaluating the likelihood that a change in symptom reporting is reliable and clinically meaningful.
OBJECTIVE: The purpose of this study was to examine the prevalence and stability of symptom reporting in a healthy military sample and to develop reliable change indices for two commonly used self-report measures in the military health care system. PARTICIPANTS AND METHOD:Participants were 215 U.S. active duty service members recruited from Fort Bragg, NC as normal controls as part of a larger study. Participants completed the Neurobehavioral Symptom Inventory (NSI) and Posttraumatic Checklist (PCL) twice, separated by approximately 30 days. RESULTS: Depending on the endorsement level used (i.e. ratings of 'mild' or greater vs. ratings of 'moderate' or greater), approximately 2-15% of this sample met DSM-IV symptom criteria for Postconcussional Disorder across time points, while 1-6% met DSM-IV symptom criteria for Posttraumatic Stress Disorder. Effect sizes for change from Time 1 to Time 2 on individual symptoms were small (Cohen's d = .01 to .13). The test-retest reliability for the NSI total score was r = .78 and the PCL score was r = .70. An eight-point change in symptom reporting represented reliable change on the NSI total score, with a seven-point change needed on the PCL. CONCLUSIONS: Postconcussion-like symptoms are not unique to mild TBI and are commonly reported in a healthy soldier sample. It is important for clinicians to use normative data when evaluating a service member or veteran and when evaluating the likelihood that a change in symptom reporting is reliable and clinically meaningful.
Authors: Paul G Harch; Susan R Andrews; Cara J Rowe; Johannes R Lischka; Mark H Townsend; Qingzhao Yu; Donald E Mercante Journal: Med Gas Res Date: 2020 Jan-Mar