TY - JOUR
T1 - Predictors of Postdeployment Functioning in Combat-Exposed U.S. Military Veterans
AU - Disner, Seth G.
AU - Kramer, Mark D.
AU - Nelson, Nathaniel W.
AU - Lipinski, Alexandra J.
AU - Christensen, Julia M.
AU - Polusny, Melissa A.
AU - Sponheim, Scott R.
N1 - Publisher Copyright:
© 2017, © The Author(s) 2017.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Posttraumatic stress disorder (PTSD) and sequelae of mild traumatic brain injury (mTBI) are presumed to contribute to reintegration difficulties in combat-exposed veterans. Yet their relative impacts on postdeployment functioning are not well understood. The current study used structural equation modeling (SEM) to clarify the extent to which symptoms of internalizing disorders (e.g., depression, anxiety), mTBI symptoms, and cognitive performance are associated with functional impairment in 295 combat-exposed veterans. SEM results showed that internalizing symptoms most significantly predicted functional impairment (r = 0.72). Blast mTBI and cognitive performance were associated with internalizing (r = 0.24 and −0.25, respectively), but functional impairment was only modestly related to cognition (r = −0.17) and unrelated to mTBI. These results indicate that internalizing symptoms are the strongest predictor of functioning in trauma-exposed veterans, exceeding the effects of mTBI and cognitive performance. This evidence supports prioritizing interventions that target internalizing psychopathology to improve functioning in cases of co-occurring PTSD and mTBI.
AB - Posttraumatic stress disorder (PTSD) and sequelae of mild traumatic brain injury (mTBI) are presumed to contribute to reintegration difficulties in combat-exposed veterans. Yet their relative impacts on postdeployment functioning are not well understood. The current study used structural equation modeling (SEM) to clarify the extent to which symptoms of internalizing disorders (e.g., depression, anxiety), mTBI symptoms, and cognitive performance are associated with functional impairment in 295 combat-exposed veterans. SEM results showed that internalizing symptoms most significantly predicted functional impairment (r = 0.72). Blast mTBI and cognitive performance were associated with internalizing (r = 0.24 and −0.25, respectively), but functional impairment was only modestly related to cognition (r = −0.17) and unrelated to mTBI. These results indicate that internalizing symptoms are the strongest predictor of functioning in trauma-exposed veterans, exceeding the effects of mTBI and cognitive performance. This evidence supports prioritizing interventions that target internalizing psychopathology to improve functioning in cases of co-occurring PTSD and mTBI.
KW - neuropsychology
KW - posttraumatic stress disorder
KW - trauma
KW - war
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U2 - 10.1177/2167702617703436
DO - 10.1177/2167702617703436
M3 - Article
AN - SCOPUS:85024123635
SN - 2167-7026
VL - 5
SP - 650
EP - 663
JO - Clinical Psychological Science
JF - Clinical Psychological Science
IS - 4
ER -