Cited by 162Traumatic Brain Injury ResearchPosttraumatic Stress Disorder ResearchOccupational Health and Performance

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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)

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Stein, Murray B., Kessler, Ronald C., Heeringa, Steven G., Jain, Sonia, Campbell-Sills, Laura, Colpe, Lisa J., Fullerton, Carol S., Nock, Matthew K., Sampson, Nancy A., Schoenbaum, Michael, Sun, Xiaoying, Thomas, Michael L., Ursano, Robert J., On behalf of the Army STARRS collaborators·2015·American Journal of Psychiatry

DOI 10.1176/appi.ajp.2015.14121572PMC PMC5125442

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Abstract

OBJECTIVE: Traumatic brain injury (TBI) is increasingly recognized as a risk factor for deleterious mental health and functional outcomes. The purpose of this study was to examine the strength and specificity of the association between deployment-acquired TBI and subsequent posttraumatic stress and related disorders among U.S. Army personnel. METHOD: A prospective, longitudinal survey of soldiers in three Brigade Combat Teams was conducted 1-2 months prior to an average 10-month deployment to Afghanistan (T0), upon redeployment to the United States (T1), approximately 3 months later (T2), and approximately 9 months later (T3). Outcomes of interest were 30-day prevalence postdeployment of posttraumatic stress disorder (PTSD), major depressive episode, generalized anxiety disorder, and suicidality, as well as presence and severity of postdeployment PTSD symptoms. RESULTS: Complete information was available for 4,645 soldiers. Approximately one in five soldiers reported exposure to mild (18.0%) or more-than-mild (1.2%) TBI(s) during the index deployment. Even after adjusting for other risk factors (e.g., predeployment mental health status, severity of deployment stress, prior TBI history), deployment-acquired TBI was associated with elevated adjusted odds of PTSD and generalized anxiety disorder at T2 and T3 and of major depressive episode at T2. Suicidality risk at T2 appeared similarly elevated, but this association did not reach statistical significance. CONCLUSIONS: The findings highlight the importance of surveillance efforts to identify soldiers who have sustained TBIs and are therefore at risk for an array of postdeployment adverse mental health outcomes, including but not limited to PTSD. The mechanism(s) accounting for these associations need to be elucidated to inform development of effective preventive and early intervention programs.

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Authors: Stein, M. B., Kessler, R. C., Heeringa, S. G., Jain, S., Campbell-Sills, L., Colpe, L. J., Fullerton, C. S., Nock, M. K., Sampson, N. A., Schoenbaum, M., Sun, X., Thomas, M. L., Ursano, R. J., & collaborators, O. B. O. T. A. S.
Affiliations: University of Michigan (US)
From the Department of Psychiatry, University of California San Diego, La Jolla, Calif.; the Department of Family Medicine and Public Health, University of California San Diego, La Jolla, Calif.; the VA San Diego Healthcare System, San Diego; the Department of Health Care Policy, Harvard Medical School, Boston; the University of Michigan, Institute for Social Research, Ann Arbor, Mich.; the National Institute of Mental Health, Bethesda, Md.; the Center for the Study of Traumatic Stress, Department of...
ORCID: Stein, Murray B.
Kessler, Ronald C.
Heeringa, Steven G.
Jain, Sonia
Colpe, Lisa J.
Nock, Matthew K.
Sampson, Nancy A.
Schoenbaum, Michael
Thomas, Michael L.
Ursano, Robert J.
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 2015-11-01
Volume: 172
Issue: 11
Pages: 1101-1111
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/appi.ajp.2015.14121572
PMC: PMC5125442
OpenAlex: W2098752569
Cited by: 161
References: 40
Citations by year: 2026: 10 · 2025: 15 · 2024: 6 · 2023: 13 · 2022: 16 · 2021: 16 · 2020: 11 · 2019: 21 · 2018: 23 · 2017: 15 · 2016: 9 · 2015: 2
FWCI: 12.82
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: American Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders: U.S. Department of Defense
U.S. Department of Health and Human Services
Pfizer
F. Hoffmann-La Roche
School of Medicine, Boston University
University of Pittsburgh
King's College London
Uniformed Services University of the Health Sciences
University of California, San Diego
National Institute of Mental Health (U01MH087981)
Topics: Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Performance
Keywords: post-traumatic stress disorder, major depressive episode, generalized anxiety disorder, suicidality, military personnel, Army STARRS, redeployment, Afghanistan deployment, mental health risk factors
MeSH terms: Adult, Anxiety Disorders, Brain Concussion, Brain Injuries, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Longitudinal Studies, Male, Military Personnel, Prospective Studies, Sex Factors, Stress Disorders, Post-Traumatic, Suicide, Attempted, United States, Cohort Studies, Trauma Severity Indices, Prevalence, Logistic Models, Young Adult, Afghan Campaign 2001-, Suicidal Ideation, Occupational Injuries

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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)

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