Female Service Members and Symptom Reporting after Combat and Non-Combat-Related Mild Traumatic Brain Injury
Abstract
Females are often excluded from military-related mild traumatic brain injury (mTBI) research because of its relatively low prevalence in this population. The purpose of this study was to focus on outcome from mTBI in female service members, compared with males. Participants were 172 United States military service members selected from a larger sample that had sustained an mTBI, and were evaluated within 24 months of injury (Age: mean = 28.9, SD = 8.1) at one of six military medical centers. Eighty-six women were matched to 86 men on nine key variables: TBI severity, mechanism of injury, bodily injury severity, days post-injury, age, number of deployments, theater where wounded, branch of service, and rank. Participants completed the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist (PCL-C). There were no meaningful gender differences across all demographic and injury-related variables ( p > 0.05). There were significant group differences and medium effect sizes for the NSI total score and all four NSI cluster scores. Symptoms most affected related to nausea, sensitivity to light, change in taste/smell, change in appetite, fatigue, and poor sleep. There were significant group differences and small-medium effect sizes for the PCL-C total score and two of the three PCL-C cluster scores. Symptoms most affected related to poor concentration, trouble remembering a stressful event, and disturbing memories/thoughts/images. Females consistently experienced more symptoms than males. As females become more active in combat-related deployments, it is critical that future studies place more emphasis on this important military population.
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With regards to sleep after TBI, women often report having worse sleep outcomes after injury than men, and the female sex is considered to be a risk factor when measuring sleep disorders after injury.
“With regards to sleep after TBI, women often report having worse sleep outcomes after injury than men, and the female sex is considered to be a risk factor when measuring sleep disorders after injury.103–107”
From Effects of Traumatic Brain Injury on the Orexin/Hypocretin System (2025) · cites this paper as [103]
Cites
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Sex Differences in Traumatic Brain Injury: What We Know and What We Should Know
Gupte, R. P., Brooks, W. M., Vukas, R. R., Pierce, J. D., & Harris, J. L. (2019) · Journal of Neurotrauma · doi:10.1089/neu.2018.6171 · Cited by 533 · see citing works
Effects of Traumatic Brain Injury on the Orexin/Hypocretin System
Somach, R. T., Lim, M. M., & Cohen, A. S. (2025) · Neurotrauma Reports · doi:10.1089/neur.2024.0111 · Cited by 2 · see citing works
- Authors
- Brickell, T. A., Lippa, S. M., French, L. M., Kennedy, J. E., Bailie, J. M., & Lange, R. T.
- Affiliations
- Uniformed Services University of the Health Sciences (US)
- Walter Reed National Military Medical Center (US)
- Brooke Army Medical Center (US)
- United States Navy (US)
- University of British Columbia (CA)
- Venue
- Journal of Neurotrauma
- Publisher
- SAGE Publications
- Published
- 2017-01
- Volume
- 34
- Issue
- 2
- Pages
- 300-312
- ISSN
- 0897-7151 (ISSN-L)
- 1557-9042
- OpenAlex
- W2497186913
- Cited by
- 69
- References
- 3
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 13 · 2023: 5 · 2022: 3 · 2021: 6 · 2020: 14 · 2019: 9 · 2018: 4 · 2017: 5
- FWCI
- 5.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Neurotrauma (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Defense
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
- Keywords
- mild traumatic brain injury, war injuries, gender differences, symptom reporting, post-traumatic stress disorder, Neurobehavioral Symptom Inventory, fatigue, sleep disorders, nausea, combat deployment
- MeSH terms
- Adult, Amnesia, Brain Concussion, Combat Disorders, Female, Humans, Male, Military Personnel, Nausea, Neuropsychological Tests, Sex Characteristics, United States, Post-Concussion Syndrome, Iraq War, 2003-2011, Young Adult, Afghan Campaign 2001-, Self Report
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