@article{ref1,
title="The effects of mild TBI, PTSD, and combined mild TBI/PTSD on returning veterans",
journal="Journal of neurotrauma",
year="2014",
author="Combs, Hannah Lane and Berry, David T. R. and Pape, Theresa L-B and Babcock-Parziale, Judith and Smith, Bridget and Schleenbaker, Randal and Shandera-Ochsner, Anne and High, Walter M.",
volume="32",
number="13",
pages="956-966",
abstract="United States Veterans of the Iraqi (Operation Iraqi Freedom (OIF)) and Afghanistan (Operation Enduring Freedom (OEF)) conflicts have frequently returned from deployment after sustaining mild traumatic brain injury (mTBI) and enduring stressful events resulting in posttraumatic stress disorder (PTSD). A large number of returning servicemembers have been diagnosed with both a history of mTBI and current PTSD. Substantial literature exists on the neuropsychological factors associated with mTBI and PTSD occurring separately; far less research has explored the combined effects of PTSD and mTBI. The current study employed neuropsychological and psychological measures in a sample of 251 OIF/OEF Veterans to determine whether participants with a history of mTBI and concurrent PTSD (mTBI+PTSD) have poorer cognitive and psychological outcomes than participants with mTBI only (mTBI-o), PTSD only (PTSD-o), or Veteran controls (VC), when groups are comparable on IQ, education, and age. The mTBI+PTSD group performed more poorly than VC, mTBI-o, and PTSD-o groups on several neuropsychological measures. Effect size comparisons suggest small deleterious effects for mTBI-o on measures of processing speed and visual attention and small effects for PTSD-o on measures of verbal memory, with moderate effects for mTBI+PTSD on the same variables. Additionally, the mTBI+PTSD group was significantly more psychologically distressed than the PTSD-o group, and PTSD-o group was more distressed than VC and mTBI-o groups. These findings suggest Veterans with mTBI+PTSD perform significantly lower on neuropsychological and psychiatric measures than Veterans with mTBI-o or PTSD-o. The results also raise the possibility of persisting cognitive changes following mTBI sustained during deployment.<p /> <p>Language: en</p>",
language="en",
issn="0897-7151",
doi="10.1089/neu.2014.3585",
url="http://dx.doi.org/10.1089/neu.2014.3585"
}