Examining the Influence of Mild Traumatic Brain Injury and Posttraumatic Stress Disorder on Alcohol Use Disorder in OEF/OIF Veterans

Abstract

Findings from this study can inform treatment providers by alerting them to the possibility of subthreshold PTSD in Veterans with mTBI. Providers may begin PTSD treatments or consider targeting hyperarousal symptoms early in treatment to reduce distress. PTSD is also uniquely associated with alcohol use disorder in male Veterans, while more research on predictors of alcohol use disorder is needed for female Veterans.

Dual Diagnosis of Traumatic Brain Injury and Alcohol Use Disorder: Characterizing Clinical and Neurobiological Underpinnings

“…It should be taken into consideration that some recent studies have not found that TBI increases risk for AUD [2,15]. Most recently, Miles and colleagues (2015) found that mTBI did not predict AUD diagnoses for men or women veterans [15]. This study improved on the Miller and Johnson studies by using a mental health evaluation instead of ICD-9 codes for diagnoses, but the sample size was smaller (N=1278).…”

“…This increased risk is independent of TBI severity, and those incurring a TBI outside of deployment may be at greater risk. It should be taken into consideration that some recent studies have not found that TBI increases risk for AUD [2,15]. Most recently, Miles and colleagues (2015) found that mTBI did not predict AUD diagnoses for men or women veterans [15].…”

“…This study improved on the Miller and Johnson studies by using a mental health evaluation instead of ICD-9 codes for diagnoses, but the sample size was smaller (N=1278). Because separate analyses were conducted for men and women in the Miles study [15], it is unknown whether or not mTBI would predict AUD in a pooled sample of men and women. Furthermore, it is not clear whether pre-injury history of AUD, mTBI, PTSD, or other mental health disorders had an impact on findings as these were not accounted for in the study criteria or analyses [15].…”

“…Table 1 summarizes how these clinical characteristics define TBI severity into mild, moderate, and severe categories. Mild TBI (mTBI) is defined by a period of LOC lasting less than 30 min or AOC lasting less than 24 h, PTA lasting less than 24 h, a GCS score of [13][14][15], and an absence of brain lesion findings using standard clinical neuroimaging [6,9].…”

How Service Dogs Enhance Veterans’ Occupational Performance in the Home: A Qualitative Perspective

“…TBI is caused by a blow, bump, or jolt to the head and is diagnosed by severity ranging from mild to severe (Centers for Disease Control and Prevention, 2017). Symptoms of TBI vary and may include physical symptoms (e.g., headache, trouble sleeping, vision problems, noise and light sensitivity, and feeling dizzy), cognitive symptoms (e.g., memory problems, difficulty staying focused, poor judgment, trouble putting thoughts together), and/or emotional symptoms (e.g., depression, anger, outbursts, anxiety, and personality changes) (Miles, Graham, & Teng, 2015; U.S. Department of Veterans Affairs, 2015; U.S. Department of Veterans Affairs, 2017). PTSD frequently accompanies TBI (Gironda et al, 2009;Hoge et al, 2008;Ruff, Riechers, Wang, Piero, & Ruff, 2012).…”