Journal
QUALITY OF LIFE RESEARCH
Volume 31, Issue 8, Pages 2411-2422Publisher
SPRINGER
DOI: 10.1007/s11136-022-03092-4
Keywords
Traumatic brain injury; Posttraumatic stress; Sleep disturbance; Resilience; Military
Categories
Funding
- DHA Contracting Office (CO-NCR) [HT0014-19-C-0004, HT0014]
- VA Clinical Science Research & Development Service [IK2 CX001952]
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This study demonstrates the clinical utility of post-traumatic stress disorder (PTSD), low resilience, and poor sleep as risk factors for predicting neurobehavioral outcomes following traumatic brain injury (TBI). These risk factors, both individually and in combination, can be used for targeted early interventions in clinical practice.
Purpose This study examined the clinical utility of post-traumatic stress disorder (PTSD), low resilience, poor sleep, and lifetime blast exposure as risk factors for predicting future neurobehavioral outcome following traumatic brain injury (TBI). Methods Participants were 591 U.S. military service members and veterans who had sustained a TBI (n = 419) or orthopedic injury without TBI (n = 172). Participants completed the Neurobehavioral Symptom Inventory, PTSD Checklist, and the TBI-Quality of Life (TBI-QOL) scale at baseline and follow-up. Results Using the four risk factors at baseline, 15 risk factor combinations were examined by calculating odds ratios to predict poor neurobehavioral outcome at follow-up (i.e., number of abnormal scores across five TBI-QOL scales [e.g., Fatigue, Depression]). The vast majority of risk factor combinations resulted in odds ratios that were considered to be clinically meaningful (i.e., >= 2.5) for predicting poor outcome. The risk factor combinations with the highest odds ratios included PTSD singularly, or in combination with poor sleep and/or low resilience (odds ratios = 4.3-72.4). However, poor sleep and low resilience were also strong predictors in the absence of PTSD (odds ratios = 3.1-29.8). Conclusion PTSD, poor sleep, and low resilience, singularly or in combination, may be valuable risk factors that can be used clinically for targeted early interventions.
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