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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)
Open accessAbstract
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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“Additionally, there is a high prevalence of MDE and GAD among service members (Kessler et al. 2014; Rosellini et al. 2015; Stein et al. 2015) which have been associated with substantial morbidity and severe role impairment (Rosellini et al. 2015).”
From Childhood adversity, adult stress, and the risk of major depression or generalized anxiety disorder in US soldiers: a test of the stress sensitization hypothesis (2017) · cites this paper as Stein et al. 2015
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Metadata
- 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
- Venue
- American Journal of Psychiatry
- Published
- 2015-11-01
- Volume
- 172
- Issue
- 11
- Pages
- 1101-1111
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- 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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