Deployment Risk Factors and Postdeployment Health Profiles Associated With Traumatic Brain Injury in Heavy Drinking Veterans

Abstract

Along with post-traumatic stress disorder (PTSD), mild traumatic brain injury (mTBI) is considered one of the “signature wounds” of combat operations in Iraq (Operation Iraqi Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]), but the role of mTBI in the clinical profiles of Veterans with other comorbid forms of postdeployment psychopathology is poorly understood. The current study explored the deployment risk and postdeployment health profiles of heavy drinking OIF and OEF Veterans as a function of mTBI. Sixty-nine heavy-drinking OIF/OEF Veterans were recruited through a Veterans’ Affairs Medical Center and completed questionnaires and structured interviews assessing war-zone experiences, postdeployment drinking patterns, and PTSD symptoms. Veterans with positive mTBI screens and confirmed mTBI diagnoses endorsed higher rates of combat experiences, including direct and indirect killing, and met criteria for PTSD at a higher rate than Veterans without a history of mTBI. Both PTSD and combat experiences independently predicted screening positive for mTBI, whereas only combat experiences predicted receiving a confirmed mTBI diagnosis. mTBI was not associated with any dimension of alcohol use. These results support a growing body of literature linking mTBI with PTSD.

Sleep, Sleep Disorders, and Circadian Health following Mild Traumatic Brain Injury in Adults: Review and Research Agenda

“…147 The increased prevalence of PTSD is important because PTSD can worsen outcomes in people with mTBI. For example, comorbid PTSD and TBI result in higher prevalence of cognitive and functional impairments 148 including reduced attentional performance, 149 more frequent and severe headaches, 150 other painrelated complaints, mood disorders, other anxiety disorders, and substance use disorders, 13,151,152 than either condition alone. [153][154][155] Sleep disturbances are common in both PTSD and mTBI and are more common among those with comorbid PTSD and mTBI than among those with either condition alone.…”

Combat-Acquired Traumatic Brain Injury, Posttraumatic Stress Disorder, and Their Relative Associations With Postdeployment Binge Drinking

“…The etiology that contributes to a TBI may be the same that contributes to the development of PTSD. 3,26-30 Hence, it is logical that TBI and PTSD are correlated among those returning from OEF/OIF. 8,31-34 Studies have found that mild TBI, defined as an alteration or loss of consciousness of up to 30 minutes after an injury event, 35,36 may increase the likelihood of developing PTSD, 31,37 or complicate recovery from PTSD.…”

The strategy of coping with stress and selected health related behavioural patterns of demobilized battle participants

“…Using alcohol (or other stimulants) with the aim of easing the effects of experiences of a traumatic nature constitutes a problem for a multitude of people who are involved in actions that endanger their safety, to a large extent soldiers and non-professional veterans of combat action [4]. Searching for relief and improvement of self-esteem by means of alcohol is treated as a non-constructive strategy in easing the psycho-physiological effects of stress, which improves self-esteem only for a brief period, after which it deepens the existing health, financial and social problems [5].…”

“…Research illustrates that in terms of people who want to reduce the unpleasant experiences, there is a risk of developing an addiction [4,6]. The relation between health and coping with long-term stress and pain is widely analysed and widely documented in psychoneuroimmunology [8,9].…”