Neuropsychological effects of self-reported deployment-related mild TBI and current PTSD in OIF/OEF veterans

Anne L. Shandera-Ochsner; David T.R. Berry; Jordan P. Harp; Maryanne Edmundson; Lili O. Graue; Abbey Roach; Walter M. High

doi:10.1080/13854046.2013.802017

Neuropsychological effects of self-reported deployment-related mild TBI and current PTSD in OIF/OEF veterans

Anne L. Shandera-Ochsner, David T.R. Berry, Jordan P. Harp, Maryanne Edmundson, Lili O. Graue, Abbey Roach, Walter M. High

Neurology

Research output: Contribution to journal › Article › peer-review

50 Scopus citations

Abstract

Current combat veterans are exposed to many incidents that may result in mild traumatic brain injury (mTBI) and/or posttraumatic stress disorder (PTSD). While there is literature on the neuropsychological consequences of PTSD only (PTSD-o) and mTBI alone (mTBI-o), less has been done to explore their combined (mTBI+PTSD) effect. The goal of this study was to determine whether Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans with mTBI+PTSD have poorer cognitive and psychological outcomes than veterans with PTSD-o, mTBI-o, or combat exposure-only. The final sample included 20 OIF/OEF veterans with histories of self-reported deployment mTBI (mTBI-o), 19 with current PTSD (PTSD-o), 21 with PTSD and self-reported mTBI (mTBI+PTSD), and 21 combat controls (CC) (no PTSD and no reported mTBI). Groups were formed using structured interviews for mTBI and PTSD. All participants underwent comprehensive neuropsychological testing, including neurocognitive and psychiatric feigning tests. Results of cognitive tests revealed significant differences in performance in the mTBI+PTSD and PTSD-o groups relative to mTBI-o and CC. Consistent with previous PTSD literature, significant differences were found on executive (switching) tasks, verbal fluency, and verbal memory. Effect sizes tended to be large in both groups with PTSD. Thus, PTSD seems to be an important variable affecting neuropsychological profiles in the post-deployment time period. Consistent with literature on civilian mTBI, the current study did not find evidence that combat-related mTBI in and of itself contributes to objective cognitive impairment in the late stage of injury.

Original language	English
Pages (from-to)	881-907
Number of pages	27
Journal	Clinical Neuropsychologist
Volume	27
Issue number	6
DOIs	https://doi.org/10.1080/13854046.2013.802017
State	Published - Aug 1 2013

Bibliographical note

Funding Information:
This material is based upon work supported in part by grant number VA ORD HSR&D SDR 08-377 from the Health Services Administration of the Department of Veterans Affairs. The views expressed in this publication do not represent the views of the Department of Veterans Affairs or the United States Government. The authors gratefully acknowledge Frederick Schmitt, Ph.D., Shonna Jenkins, M.S., Randal Schleen-baker, M.D., and Ian Abney for their valuable insight and assistance with this project. This manuscript is based on a dissertation submitted by Anne L. Shandera-Ochsner in partial fulfillment of the requirements for a doctoral degree in clinical psychology at the University of Kentucky. David T. R. Berry holds the copyright to the Letter Memory Test. All proceeds from the Letter Memory Test are donated to the Harris Psychological Services Center at the University of Kentucky Address correspondence to: Walter M. High, Jr, Cardinal Hill Rehabilitation Hospital, 2050 Versailles Rd., Lexington, KY 40504, USA. Email: [email protected] Accepted for publication 17 September 2012. First published online 7 June 2013

Funding

This material is based upon work supported in part by grant number VA ORD HSR&D SDR 08-377 from the Health Services Administration of the Department of Veterans Affairs. The views expressed in this publication do not represent the views of the Department of Veterans Affairs or the United States Government. The authors gratefully acknowledge Frederick Schmitt, Ph.D., Shonna Jenkins, M.S., Randal Schleen-baker, M.D., and Ian Abney for their valuable insight and assistance with this project. This manuscript is based on a dissertation submitted by Anne L. Shandera-Ochsner in partial fulfillment of the requirements for a doctoral degree in clinical psychology at the University of Kentucky. David T. R. Berry holds the copyright to the Letter Memory Test. All proceeds from the Letter Memory Test are donated to the Harris Psychological Services Center at the University of Kentucky Address correspondence to: Walter M. High, Jr, Cardinal Hill Rehabilitation Hospital, 2050 Versailles Rd., Lexington, KY 40504, USA. Email: [email protected] Accepted for publication 17 September 2012. First published online 7 June 2013

Funders	Funder number
U.S. Department of Veterans Affairs

Keywords

Assessment
Concussion
Mild TBI
PTSD
Veterans

ASJC Scopus subject areas

Neuropsychology and Physiological Psychology
Psychiatry and Mental health
Clinical Psychology
Developmental and Educational Psychology
Arts and Humanities (miscellaneous)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1080/13854046.2013.802017

Cite this

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title = "Neuropsychological effects of self-reported deployment-related mild TBI and current PTSD in OIF/OEF veterans",

abstract = "Current combat veterans are exposed to many incidents that may result in mild traumatic brain injury (mTBI) and/or posttraumatic stress disorder (PTSD). While there is literature on the neuropsychological consequences of PTSD only (PTSD-o) and mTBI alone (mTBI-o), less has been done to explore their combined (mTBI+PTSD) effect. The goal of this study was to determine whether Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans with mTBI+PTSD have poorer cognitive and psychological outcomes than veterans with PTSD-o, mTBI-o, or combat exposure-only. The final sample included 20 OIF/OEF veterans with histories of self-reported deployment mTBI (mTBI-o), 19 with current PTSD (PTSD-o), 21 with PTSD and self-reported mTBI (mTBI+PTSD), and 21 combat controls (CC) (no PTSD and no reported mTBI). Groups were formed using structured interviews for mTBI and PTSD. All participants underwent comprehensive neuropsychological testing, including neurocognitive and psychiatric feigning tests. Results of cognitive tests revealed significant differences in performance in the mTBI+PTSD and PTSD-o groups relative to mTBI-o and CC. Consistent with previous PTSD literature, significant differences were found on executive (switching) tasks, verbal fluency, and verbal memory. Effect sizes tended to be large in both groups with PTSD. Thus, PTSD seems to be an important variable affecting neuropsychological profiles in the post-deployment time period. Consistent with literature on civilian mTBI, the current study did not find evidence that combat-related mTBI in and of itself contributes to objective cognitive impairment in the late stage of injury.",

keywords = "Assessment, Concussion, Mild TBI, PTSD, Veterans",

author = "Shandera-Ochsner, {Anne L.} and Berry, {David T.R.} and Harp, {Jordan P.} and Maryanne Edmundson and Graue, {Lili O.} and Abbey Roach and High, {Walter M.}",

note = "Funding Information: This material is based upon work supported in part by grant number VA ORD HSR&D SDR 08-377 from the Health Services Administration of the Department of Veterans Affairs. The views expressed in this publication do not represent the views of the Department of Veterans Affairs or the United States Government. The authors gratefully acknowledge Frederick Schmitt, Ph.D., Shonna Jenkins, M.S., Randal Schleen-baker, M.D., and Ian Abney for their valuable insight and assistance with this project. This manuscript is based on a dissertation submitted by Anne L. Shandera-Ochsner in partial fulfillment of the requirements for a doctoral degree in clinical psychology at the University of Kentucky. David T. R. Berry holds the copyright to the Letter Memory Test. All proceeds from the Letter Memory Test are donated to the Harris Psychological Services Center at the University of Kentucky Address correspondence to: Walter M. High, Jr, Cardinal Hill Rehabilitation Hospital, 2050 Versailles Rd., Lexington, KY 40504, USA. Email: [email protected] Accepted for publication 17 September 2012. First published online 7 June 2013",

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AU - Edmundson, Maryanne

AU - Graue, Lili O.

AU - Roach, Abbey

AU - High, Walter M.

N1 - Funding Information: This material is based upon work supported in part by grant number VA ORD HSR&D SDR 08-377 from the Health Services Administration of the Department of Veterans Affairs. The views expressed in this publication do not represent the views of the Department of Veterans Affairs or the United States Government. The authors gratefully acknowledge Frederick Schmitt, Ph.D., Shonna Jenkins, M.S., Randal Schleen-baker, M.D., and Ian Abney for their valuable insight and assistance with this project. This manuscript is based on a dissertation submitted by Anne L. Shandera-Ochsner in partial fulfillment of the requirements for a doctoral degree in clinical psychology at the University of Kentucky. David T. R. Berry holds the copyright to the Letter Memory Test. All proceeds from the Letter Memory Test are donated to the Harris Psychological Services Center at the University of Kentucky Address correspondence to: Walter M. High, Jr, Cardinal Hill Rehabilitation Hospital, 2050 Versailles Rd., Lexington, KY 40504, USA. Email: [email protected] Accepted for publication 17 September 2012. First published online 7 June 2013

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AB - Current combat veterans are exposed to many incidents that may result in mild traumatic brain injury (mTBI) and/or posttraumatic stress disorder (PTSD). While there is literature on the neuropsychological consequences of PTSD only (PTSD-o) and mTBI alone (mTBI-o), less has been done to explore their combined (mTBI+PTSD) effect. The goal of this study was to determine whether Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans with mTBI+PTSD have poorer cognitive and psychological outcomes than veterans with PTSD-o, mTBI-o, or combat exposure-only. The final sample included 20 OIF/OEF veterans with histories of self-reported deployment mTBI (mTBI-o), 19 with current PTSD (PTSD-o), 21 with PTSD and self-reported mTBI (mTBI+PTSD), and 21 combat controls (CC) (no PTSD and no reported mTBI). Groups were formed using structured interviews for mTBI and PTSD. All participants underwent comprehensive neuropsychological testing, including neurocognitive and psychiatric feigning tests. Results of cognitive tests revealed significant differences in performance in the mTBI+PTSD and PTSD-o groups relative to mTBI-o and CC. Consistent with previous PTSD literature, significant differences were found on executive (switching) tasks, verbal fluency, and verbal memory. Effect sizes tended to be large in both groups with PTSD. Thus, PTSD seems to be an important variable affecting neuropsychological profiles in the post-deployment time period. Consistent with literature on civilian mTBI, the current study did not find evidence that combat-related mTBI in and of itself contributes to objective cognitive impairment in the late stage of injury.

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Neuropsychological effects of self-reported deployment-related mild TBI and current PTSD in OIF/OEF veterans

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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