Postconcussive symptoms in OEF-OIF veterans: factor structure and impact of posttraumatic stress. 2009

Jared F Benge, and Nicholas J Pastorek, and G Matthew Thornton
Medical Health Care Line, Michael E. DeBakey Veteran Affairs Medical Center, Houston, TX 77030, USA. Jared.Benge@va.gov

OBJECTIVE 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 NSI's factor structure and assessed the impact of posttraumatic stress (PTS) on the scale at the item and factor levels. METHODS 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. CONCLUSIONS 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.

UI MeSH Term Description Entries
D008297 Male Males
D009483 Neuropsychological Tests Tests designed to assess neurological function associated with certain behaviors. They are used in diagnosing brain dysfunction or damage and central nervous system disorders or injury. Aphasia Tests,Cognitive Test,Cognitive Testing,Cognitive Tests,Memory for Designs Test,Neuropsychological Testing,AX-CPT,Behavioral Assessment of Dysexecutive Syndrome,CANTAB,Cambridge Neuropsychological Test Automated Battery,Clock Test,Cognitive Function Scanner,Continuous Performance Task,Controlled Oral Word Association Test,Delis-Kaplan Executive Function System,Developmental Neuropsychological Assessment,Hooper Visual Organization Test,NEPSY,Neuropsychologic Tests,Neuropsychological Test,Paced Auditory Serial Addition Test,Repeatable Battery for the Assessment of Neuropsychological Status,Rey-Osterrieth Complex Figure,Symbol Digit Modalities Test,Test of Everyday Attention,Test, Neuropsychological,Tests, Neuropsychological,Tower of London Test,Neuropsychologic Test,Test, Cognitive,Testing, Cognitive,Testing, Neuropsychological,Tests, Cognitive
D001924 Brain Concussion A nonspecific term used to describe transient alterations or loss of consciousness following closed head injuries. The duration of UNCONSCIOUSNESS generally lasts a few seconds, but may persist for several hours. Concussions may be classified as mild, intermediate, and severe. Prolonged periods of unconsciousness (often defined as greater than 6 hours in duration) may be referred to as post-traumatic coma (COMA, POST-HEAD INJURY). (From Rowland, Merritt's Textbook of Neurology, 9th ed, p418) Cerebral Concussion,Commotio Cerebri,Concussion, Intermediate,Concussion, Mild,Concussion, Severe,Mild Traumatic Brain Injury,Brain Concussions,Cerebral Concussions,Concussion, Brain,Concussion, Cerebral,Intermediate Concussion,Intermediate Concussions,Mild Concussion,Mild Concussions,Severe Concussion,Severe Concussions
D005163 Factor Analysis, Statistical A set of statistical methods for analyzing the correlations among several variables in order to estimate the number of fundamental dimensions that underlie the observed data and to describe and measure those dimensions. It is used frequently in the development of scoring systems for rating scales and questionnaires. Analysis, Factor,Analysis, Statistical Factor,Factor Analysis,Statistical Factor Analysis,Analyses, Factor,Analyses, Statistical Factor,Factor Analyses,Factor Analyses, Statistical,Statistical Factor Analyses
D005260 Female Females
D006787 Hospitals, Veterans Hospitals providing medical care to veterans of wars. Veterans Hospitals,Hospital, Veterans,Veterans Hospital
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012650 Self Disclosure A willingness to reveal information about oneself to others. Disclosure, Self,Disclosures, Self,Self Disclosures
D013313 Stress Disorders, Post-Traumatic A class of traumatic stress disorders with symptoms that last more than one month. Moral Injury,Neuroses, Post-Traumatic,PTSD,Post Traumatic Stress Disorder,Post-Traumatic Stress Disorders,Acute Post-Traumatic Stress Disorder,Chronic Post-Traumatic Stress Disorder,Delayed Onset Post-Traumatic Stress Disorder,Neuroses, Posttraumatic,Posttraumatic Stress Disorders,Stress Disorder, Post Traumatic,Stress Disorders, Posttraumatic,Acute Post Traumatic Stress Disorder,Chronic Post Traumatic Stress Disorder,Delayed Onset Post Traumatic Stress Disorder,Injury, Moral,Moral Injuries,Neuroses, Post Traumatic,Post Traumatic Stress Disorders,Post-Traumatic Neuroses,Post-Traumatic Stress Disorder,Posttraumatic Neuroses,Posttraumatic Stress Disorder,Stress Disorder, Post-Traumatic,Stress Disorder, Posttraumatic

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