Traumatic Brain Injury, PTSD, and Current Suicidal Ideation Among Iraq and Afghanistan U.S. Veterans

Abstract

Suicide is a prevalent problem among veterans deployed to Iraq and Afghanistan. Traumatic brain injury (TBI) and psychiatric conditions, such as posttraumatic stress disorder (PTSD), are potentially important risk factors for suicide in this population, but the literature is limited by a dearth of research on female veterans and imprecise assessment of TBI and suicidal behavior. This study examined 824 male and 825 female U.S. veterans who were enrolled in the baseline assessment of the Veterans After-Discharge Longitudinal Registry (Project VALOR), an observational registry of veterans with and without PTSD who deployed in support of the wars in Iraq and Afghanistan and were enrolled in the Veterans Affairs healthcare system. Results indicated that current depressive symptoms, PTSD, and history of prior TBI were all significantly associated with current suicidal ideation (Cohen's d = 0.91, Cramers' Vs = .19 and .08, respectively). After adding a number of variables to the model, including psychiatric comorbidity, TBI history was associated with increased risk of current suicidal ideation among male veterans only (RR = 1.55). TBI is an important variable to consider in future research on suicide among veterans of the wars in Iraq and Afghanistan, particularly among male veterans.

Prospective Longitudinal Evaluation of the Effect of Deployment-Acquired Traumatic Brain Injury on Posttraumatic Stress and Related Disorders: Results From the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

“…A study of 161 U.S. military personnel referred to a TBI clinic in Iraq for suspected head injury found that multiple episodes of TBI, which were common among U.S. military personnel, were associated with increased risk for lifetime suicidal thoughts and behaviors, as well as for current suicidal ideation (11). Baseline assessment of the Veterans After-Discharge Longitudinal Registry (Project VALOR), an observational registry of over 1,600 veterans with and without PTSD who deployed in support of the wars in Iraq and Afghanistan and were enrolled in the Veterans Affairs health care system, found that a history of TBI was associated with increased risk for current suicidal ideation, though only in men (9). The present longitudinal cohort study failed to clearly demonstrate an increase in risk for suicidality in individuals who sustained TBI during deployment.…”

Activities and interim outcomes of a multi-site development project to promote cognitive support technology use and employment success among postsecondary students with traumatic brain injuries

“…The Center also reported that, since 2000, a total of 320,344 U.S. military personnel worldwide have had a medical diagnosis of TBI. Wisco et al (2014) found that U.S. veterans who had experienced multiple TBI incidents and those who had experienced a loss of consciousness due to TBI were significantly more likely to report suicidal ideation than those who had a single TBI and those who had no loss of consciousness. They also found that male veterans had a significantly higher risk of suicidal ideation following TBI, but female veterans did not.…”

Randomized Placebo-Controlled Trial of Methylphenidate or Galantamine for Persistent Emotional and Cognitive Symptoms Associated with PTSD and/or Traumatic Brain Injury

“…Moreover, there is a high level of co-occurrence of TBI and PTSD in this population. Many observational studies from both military and civilian settings (Hoge et al, 2008;Schneiderman et al, 2008) have firmly established an association between mTBI and PTSD (Hoge et al, 2008;Schneiderman et al, 2008;Carlson et al, 2011;Hart et al, 2014;Stein and McAllister, 2009;Tanev et al, 2014;Wilk et al, 2012;Wisco et al, 2014;Yurgil et al, 2014). These observations signal not only a need for effective interventions for PTSD and mTBI occurring individually, but for interventions that have the potential to address both conditions at the same time.…”