4.3 Article

Self-perceived irritability among OEF/OIF/OND veterans with a history of deployment-related mTBI: Associations with prospective memory and quality of life

Journal

CLINICAL NEUROPSYCHOLOGIST
Volume 36, Issue 6, Pages 1384-1404

Publisher

TAYLOR & FRANCIS INC
DOI: 10.1080/13854046.2020.1856413

Keywords

Brain concussion; negative mood; military; cognition; neuropsychological functioning; social support

Funding

  1. Department of Veterans Affairs Rehabilitation Research and Development Service Merit Review Award [I01RX003087]
  2. VA Clinical Science Research and Development Career Development Award [IK2 CX000516]
  3. VA Northwest MIRECC

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This study aimed to examine the relationships between self-perceived irritability, prospective memory (PM), and quality of life (QOL) after mild traumatic brain injury (mTBI). The findings revealed that veterans with a history of mTBI reported higher levels of self-perceived irritability, and higher irritability was associated with poorer PM performance. Additionally, higher irritability was also associated with more depressive symptoms and reduced QOL in various domains, with social support being the only significant factor after adjusting for PTSD severity. These results suggest that PM and irritability may be related through their mutual reliance on cognitive control.
Objective Examine relationships between self-perceived irritability, prospective memory, and quality of life (QOL) following mild traumatic brain injury (mTBI). Methods: 75 OEF/OIF/OND-era Veterans (56 deployment-related mTBI; 19 no history of TBI), were administered a battery of neuropsychological tests and self-report measures of mood and QOL. Self-perceived irritability was measured using the Neurobehavioral Symptom Inventory. Prospective memory (PM) was measured using the Memory for Intentions Test (MIST). Results: Self-perceived irritability was significantly higher for Veterans with, versus without, a history of deployment-related mTBI. Among Veterans with a history of mTBI, self-perceived irritability was inversely associated with PM performance, even after adjusting for PTSD severity. Greater self-perceived irritability was also associated with higher depressive symptoms and reduced QOL for perceived physical health, psychological health, social support, and environmental factors; however, only social support remained significant after adjusting for PTSD severity. Depression symptom severity was not significantly associated with PM, suggesting that PM may be uniquely related to self-perceived irritability rather than mood dysregulation more generally. Conclusions: Findings provide preliminary evidence of a relationship between PM and self-perceived irritability in Veterans with a history of mTBI. PM and irritability may be related via their mutual reliance on high-level cognitive control. Results illustrate possible cognitive and affective factors contributing to psychological and interpersonal challenges for this population. Future investigations with larger and more diverse samples are needed to replicate findings and explore potential mechanisms linking irritability and PM following mTBI.

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