Veterans Health Administration, South Texas Veterans Health Care System, San Antonio, TX; Departments of Epidemiology and Biostatistics; Division of General and Hospital Medicine; Department of Psychiatry, University of Texas Health San Antonio, San Antonio, TX; Department of Rehabilitation Medicine, University of Texas Health San Antonio, San Antonio, TX.
OBJECTIVE: Examine the association between traumatic brain injury (TBI) severity and social, family, community reintegration outcomes as well as return to work status among Post-9/11 veterans in Department of Veterans Affairs (VA) care.
DESIGN: Retrospective observational cohort study. SETTING: Mail/online survey fielded to a national sample of veterans. PARTICIPANTS: Among a sample of Post-9/11 veterans with at least 3 years of VA care stratified according to TBI severity and comorbidities, 2023 completed and returned surveys. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Deployment Risk and Resilience Inventory-2 family functioning and social support subscales; Military to Civilian Questionnaire; employment status.
RESULTS: Bivariate analyses revealed that veterans with every classification of TBI severity reported significantly more difficulty on social, family, community reintegration outcomes than those with no TBI. In the fully adjusted model, veterans with unclassified and moderate/severe TBI reported significantly more difficulty with community reintegration and were less likely to be employed relative to those with no TBI; those with unclassified TBI also reported significantly more difficulty with family functioning. Veterans with mild TBI also reported significantly more difficulty with community reintegration.
CONCLUSIONS: This study provides insight into long-term outcomes associated with TBI in Post-9/11 veterans and suggests that exposure to TBI has a negative impact on social and family functioning, community reintegration, and return to work even after controlling for comorbidity, deployment experiences, and sociodemographic characteristics. Additional research is required to explicate what appear to be complex interactions among TBI severity, psychosocial well-being, combat exposures, and socioeconomic resources in this population.