TY - JOUR
T1 - Traumatic Brain Injury Severity, Comorbidity, Social Support, Family Functioning, and Community Reintegration Among Veterans of the Afghanistan and Iraq Wars
AU - Trajectories of Resilience and Complex Comorbidity Study Team
AU - Pugh, Mary Jo
AU - Swan, Alicia A.
AU - Carlson, Kathleen F.
AU - Jaramillo, Carlos A.
AU - Eapen, Blessen C.
AU - Dillahunt-Aspillaga, Christina
AU - Amuan, Megan E.
AU - Delgado, Roxana E.
AU - McConnell, Kimberly
AU - Finley, Erin P.
AU - Grafman, Jordan H.
N1 - Publisher Copyright:
© 2017
PY - 2018/2
Y1 - 2018/2
N2 - Objective: To examine the association between traumatic brain injury (TBI) severity; social, family, and community reintegration outcomes; and 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: Sample of post-9/11 veterans with at least 3 years of VA care stratified according to TBI severity and comorbidities who completed and returned surveys (N=2023). Interventions: Not applicable. Main Outcome Measures: Deployment Risk and Resilience Inventory-2 family functioning and social support subscales; Military to Civilian Questionnaire; and employment status. Results: Bivariate analyses revealed that veterans with every classification of TBI severity reported significantly more difficulty on social, family, and 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 effect 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 appears to be complex interactions among TBI severity, psychosocial well-being, combat exposures, and socioeconomic resources in this population.
AB - Objective: To examine the association between traumatic brain injury (TBI) severity; social, family, and community reintegration outcomes; and 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: Sample of post-9/11 veterans with at least 3 years of VA care stratified according to TBI severity and comorbidities who completed and returned surveys (N=2023). Interventions: Not applicable. Main Outcome Measures: Deployment Risk and Resilience Inventory-2 family functioning and social support subscales; Military to Civilian Questionnaire; and employment status. Results: Bivariate analyses revealed that veterans with every classification of TBI severity reported significantly more difficulty on social, family, and 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 effect 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 appears to be complex interactions among TBI severity, psychosocial well-being, combat exposures, and socioeconomic resources in this population.
KW - Brain injuries
KW - Mental health
KW - Rehabilitation
KW - Stress disorders, post-traumatic
KW - Veterans
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U2 - 10.1016/j.apmr.2017.05.021
DO - 10.1016/j.apmr.2017.05.021
M3 - Article
C2 - 28648681
AN - SCOPUS:85028049484
SN - 0003-9993
VL - 99
SP - S40-S49
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 2
ER -