Risk-Taking Behaviors and Impulsivity Among Veterans With and Without PTSD and Mild TBI

Abstract

Military personnel commonly experience post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI), both of which are associated with premature mortality. The present study examined two factors that may play a role in premature mortality--impulsivity and risk-taking behaviors--in a sample of 234 veterans screening positive for PTSD, mTBI, PTSD + mTBI, and controls. Analyses of variance demonstrated that veterans with PTSD, regardless of mTBI status, reported engaging in more frequent risky behaviors and reported a greater tendency to engage in impulsive behaviors when in a negative affective state. They also reported more premilitary delinquent behaviors and more suicide-related behaviors than controls. The present study highlights associations between impulsivity, risk-taking behaviors, and PTSD, and suggests continuity across the lifespan in terms of a predisposition to engage in impulsive and/or risky behaviors. Thorough evaluation of impulsivity and potentially risky behaviors is important in clinical settings to guide interventions and reduce the mortality and public health impact of high-risk behaviors in veterans.

Repeated stressor exposure enhances contextual fear memory in a beta-adrenergic receptor-dependent process and increases impulsivity in a non-beta receptor-dependent fashion

“…It is well-known that stress can increase impulsive behaviors such as drug abuse [31]–[34], risk taking behavior [35]–[38], and food intake [39]. In fact, enhanced formation of fearful memories and increased impulsivity (including risk taking behaviors, drug abuse, and emotional outburst) are both commonly observed in veterans repeatedly exposed to stressful environments [37]. …”

PTSD's risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology

“…Examples include substance use (James et al, 2014), risky sexual behaviors (Weiss et al, 2014), and deliberate self-harm (Weiss et al, 2015a). Indeed, a study on Veterans receiving treatment for PTSD indicated that a significant number of deaths were related to substance use, suicide, and homicide (Drescher et al, 2003).…”

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

“…Depue and colleagues report that veterans with co-occurring mTBI and PTSD have reduced anterior amygdala volume relative to controls and that this volume reduction was associated with poor inhibitory control and increased self-reported impulsivity [29]. However, one study demonstrated among veterans with PTSD, mTBI, or cooccurring mTBI and PTSD, those with PTSD self-reported engaging in risky and impulsive behaviors regardless of mTBI diagnosis [30]. Interestingly, no studies to date have examined the cognitive domain of impulsivity using delayed or probability discounting procedures.…”