All ETDs from UAB

Advisory Committee Chair

Thomas Novack

Advisory Committee Members

Paul Blanton

Lori Davis

Katherine Fabrizio

David Vance

Document Type

Dissertation

Date of Award

2012

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

Traumatic Brain Injury (TBI) and Posttraumatic Stress Disorder (PTSD) have been referred to as "signature injuries" among veterans of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). The aims of the current study were to identify demographic and injury related variables associated with the co-occurrence of mild Traumatic Brain Injury (mTBI) and PTSD and to identify neuropsychological assessment measures that differentiate individuals with mTBI from those with co-occurring mTBI and PTSD. A total of 81 OIF/OEF veterans participated in this study comprising the mTBI (n=21) and combined (n=60) groups. The results of logistic regression analyses indicated that Caucasians were 21% more likely to have a PTSD diagnosis (Wald X2 (1) = 4.576, p=.032, O.R. = .210). Individuals who reported loss of consciousness were over 3 times more likely to have a PTSD diagnosis (Wald X2 (1) = 4.421, p=.035, O.R. = 3.287). In terms of classification of individual participants into outcome groups, this model correctly classified 72.4% of participants (91.1% combined group, 20.0% mTBI). With regard to cognitive variables, a significant discriminant function was found in which each of three predictor variables was significantly correlated with the discriminant function with loadings of .877 (CVLT-II recognition hits), .775 (CVLT-II short delay free recall), and .728 (CVLT-II short delay cued recall). 74% of cases were correctly classified based on this model (98% combined group, 10% mTBI group). A second, significant discriminant function analysis was conducted using a theoretical model in which each of four predictor variables were significantly correlated with the discriminant function with loadings of .814 (CVLT-II recognition hits), .685 (CVLT-II short delay free recall), .590 (Trail Making Test Part B), and .565 (CVLT-II long delay free recall). 74% of cases were correctly classified (94% combined group and 20% accuracy for the mTBI group. Overall, the current results indicate reported loss of conscious to be predictive of developing PTSD in the context of mTBI. While some aspects of verbal memory and executive functioning differed between groups, their predictive utility in differentiating individuals with mTBI versus those with combined mTBI and PTSD was limited.

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