Postconcussive Symptoms in OEF-OIF Veterans: Factor Structure and Impact of Posttraumatic Stress
VETERANS AFFAIRS MEDICAL CENTER WASHINGTON DC
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PURPOSE Veterans with a history of mild traumatic brain injury mTBI are reporting postconcussive symptoms PCSx in addition to experiencing postdeployment physical and emotional comorbidities. The Veterans Health Administration has mandated specialized evaluation and treatment for veterans with a history of mTBI and has suggested widespread use of the Neurobehavioral Symptom Inventory NSI as a measure of PCSx. This study evaluated the NSIs factor structure and assessed the impact of posttraumatic stress PTS on the scale at the item and factor levels. RESEARCH METHOD Five hundred twenty-nine charts of returning veterans who screened positive for traumatic brain injury were reviewed, and 345 who met criteria for mTBI were included in the study. RESULTS Results of factor analysis on the NSI revealed a difficult-to-interpret factor structure that was inconsistent with the results of civilian studies. PTS explained 5-38 of the variance in individual PCSx, and after controlling for this variance, the factor structure more closely paralleled findings from the civilian literature. CONCLUSION PTS is an important variable to account for when evaluating PCSx in veterans. Research and clinical implications for the measurement and interpretation of self-reported PCSx are discussed.
- Medicine and Medical Research