USA — Study Ties Problems to Post-traumatic Stress

WASHINGTON — Ser­vice mem­bers who suf­fer mild trau­mat­ic brain injuries in com­bat and then strug­gle with depres­sion, irri­tabil­i­ty, alco­hol abuse and sim­i­lar prob­lems after they return home most like­ly are expe­ri­enc­ing post-trau­mat­ic stress, rather than brain injury symp­toms, accord­ing to a new study.

The study, spon­sored by the Defense and Vet­er­ans Affairs depart­ments and pub­lished in this month’s Archives of Gen­er­al Psy­chi­a­try, a Jour­nal of the Amer­i­can Med­ical Asso­ci­a­tion pub­li­ca­tion, tracked Min­neso­ta Nation­al Guard sol­diers dur­ing the last month of their 16-month deploy­ment to Iraq, then again a year after they returned home. 

The find­ings, based on the self-report­ing of 953 sol­diers with fol­low-ups from the clin­i­cians, showed “very lit­tle evi­dence for a long-term neg­a­tive impact” from con­cus­sions or mild TBI on “psy­cho-social out­comes” –- anx­i­ety, depres­sion, drug and alco­hol abuse and the like — after account­ing for post-trau­mat­ic stress, said Melis­sa A. Polus­ny, a clin­i­cal psy­chol­o­gist at the Min­neapo­lis Vet­er­ans Affairs Health Care Sys­tem and a pro­fes­sor at Uni­ver­si­ty of Min­neso­ta Med­ical School. 

Polus­ny wrote the study along with five oth­er clin­i­cal psy­chol­o­gists, and in col­lab­o­ra­tion with Army Col. (Dr.) Michael Rath, a sur­geon with the 34th Infantry Divi­sion brigade that par­tic­i­pat­ed in the study. 

“After we sta­tis­ti­cal­ly con­trolled for PTSD symp­toms, there were vir­tu­al­ly no long-term symp­toms from con­cus­sive and mild TBI,” she said. 

Polus­ny empha­sized that the study only inves­ti­gat­ed mild TBI, which may cause a per­son to be momen­tar­i­ly dazed or con­fused or lose con­scious­ness for few­er than 20 min­utes, but caus­es no actu­al injury to the brain or skull. Also, the study did not con­sid­er repeat­ed head trau­ma -– the sub­ject of oth­er stud­ies that have sug­gest­ed long-term effects -– in the sol­diers, 95 per­cent of whom were on their first deploy­ment to Iraq in 2005, she said. 

The study’s focus on mild TBI is sig­nif­i­cant for today’s warfight­ers, Polus­ny said, because “the vast major­i­ty of reports of TBI are mild.” 

The study’s find­ings, she added, are “very inter­est­ing and not exact­ly what we expected.” 

The find­ings show that ser­vice mem­bers are much more like­ly to report con­cus­sions and mild trau­mat­ic brain injuries after they return home than they are in the com­bat the­ater. Of those sur­veyed, only 9 per­cent report­ed con­cus­sions or TBI in the­ater, but 22 per­cent report­ed inci­dents after redeployment. 

Sim­i­lar­ly, 9 per­cent report­ed symp­toms of post-trau­mat­ic stress dis­or­der in the­ater, com­pared to 14 per­cent at home; and 9 per­cent report­ed symp­toms of depres­sion, com­pared to 18 per­cent at home. 

Many of the sol­diers who answered that they did not have mild TBI or post-trau­mat­ic stress dis­or­der symp­toms actu­al­ly did, the VA’s pub­li­ca­tion brief of the study says. Of those, 64 per­cent report­ed hav­ing prob­lems with dis­tractibil­i­ty and irri­tabil­i­ty, 60 per­cent report­ed mem­o­ry prob­lems, 57 per­cent report­ed ring­ing in the ears, and 23 per­cent had bal­ance problems. 

Anoth­er notable find­ing, Polus­ny said, is that after their return home, more than 40 per­cent of the Iraq war vet­er­ans report­ed some lev­els of alco­hol abuse. 

“There’s been a lot of atten­tion paid to PTSD and mild TBI and even sui­cide risk, but the preva­lence of prob­lem drink­ing appears to be much high­er among return­ing ser­vice mem­bers than any of these oth­er prob­lems,” she said. 

Researchers were sur­prised at the wide dif­fer­ence in report­ing from the war the­ater to home, Polus­ny said. They believe the dis­par­i­ty may be due to ser­vice mem­bers’ reluc­tance to report prob­lems while deployed, or that they have a dif­fer­ent impres­sion of events when they return home, she said. The dif­fer­ences may reflect a need for bet­ter post-deploy­ment ques­tion­ing of vet­er­ans, she added. 

“One of the real­ly impor­tant impli­ca­tions of the find­ings is that we need to be care­ful­ly screen­ing for PTSD, and make sure vet­er­ans receive treat­ment,” Polus­ny said. 

Polus­ny added that the find­ings caused con­cern that com­bat vet­er­ans may mis­at­tribute the rea­son for their prob­lems, which could ham­per treat­ment or cause a ser­vice mem­ber to not seek treatment. 

“If a vet­er­an is hav­ing irri­tabil­i­ty and mem­o­ry prob­lems, and assumes he had a con­cus­sion when maybe he is suf­fer­ing from PTSD symp­toms, … we need to make sure we are treat­ing vet­er­ans for the right prob­lems,” she said. The study did not inves­ti­gate the cause of the PTSD or whether the TBI trig­gered it. 

“The events that sur­round a con­cus­sion or mild TBI in the­ater — being exposed to a blast or being in a fire­fight — those kinds of events already place some­one at risk of PTSD,” Polus­ny said. “Is that due to injury to the brain, or the sit­u­a­tion they are in? We can’t piece that apart yet.” 

U.S. Depart­ment of Defense
Office of the Assis­tant Sec­re­tary of Defense (Pub­lic Affairs) 

Face­book and/or on Twit­ter

Team GlobDef

Seit 2001 ist im Internet unterwegs, um mit eigenen Analysen, interessanten Kooperationen und umfassenden Informationen für einen spannenden Überblick der Weltlage zu sorgen. war dabei die erste deutschsprachige Internetseite, die mit dem Schwerpunkt Sicherheitspolitik außerhalb von Hochschulen oder Instituten aufgetreten ist.

Alle Beiträge ansehen von Team GlobDef →