Blast Concussion and Posttraumatic Stress As Predictors of Postcombat Neuropsychological Functioning in OEF/OIF/OND Veterans

Overview

Journal Neuropsychology

Publisher American Psychological Association

Specialty Neurology

Date 2019 Sep 24

PMID 31545626

Citations 9

Authors

Nathaniel W Nelson

Seth G Disner

Carolyn R Anderson

Bridget M Doane

Kathryn McGuire

Gregory J Lamberty

James Hoelzle

Scott R Sponheim

Affiliations

Soon will be listed here.

Abstract

Objectives: Many combat veterans exhibit cognitive limitations of uncertain origin. In this study, we examined factors that predict cognitive functioning by considering effects of blast-related concussion (BRC), non-blast-related concussion (NBRC), and posttraumatic stress disorder (PTSD) symptoms. Analyses specifically tested whether (a) BRC and NBRC were distinct in their prediction of cognitive performance; (b) a dose-response relationship existed between recurrent concussion (BRC and NBRC) and cognitive impairment; and (c) PTSD symptoms mediated the relationship between BRC and cognitive performance.

Method: Two hundred eighty veterans with combat zone deployment histories completed semistructured clinical interviews to define BRC and NBRC histories, current and past mental health disorders, and dimensional ratings of PTSD symptomatology. Participants were also administered a number of neuropsychological measures to appraise cognitive functioning.

Results: A structural equation model (SEM) suggested that BRC and NBRC were not distinct in their prediction of cognitive performance, and there was no evidence that recurrent concussion (blast or nonblast) was directly associated with cognitive performance. BRC was significantly associated with PTSD symptoms ( = .24), PTSD symptoms were significantly associated with cognitive performance in the SEM ( = -.27), and PTSD symptoms significantly mediated the link between BRC and cognitive performance ( = .03).

Conclusions: These results suggest that concussion history fails to directly contribute to cognitive performance, regardless of mechanism (blast or nonblast) and recurrence. BRC is nonetheless unique in its contribution to PTSD and PTSD-related cognitive deficits. Results support interventions specific to PTSD management in the interest of promoting neuropsychological functioning among war veterans. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Citing Articles

Inefficient Attentional Control Explains Verbal-Memory Deficits Among Military Veterans With Posttraumatic Reexperiencing Symptoms.

Marquardt C, Pokorny V, Disner S, Nelson N, McGuire K, Sponheim S Clin Psychol Sci. 2023; 10(3):499-513.

PMID: 38020495 PMC: 10663645. DOI: 10.1177/21677026211025018.

Neuro-psychiatric symptoms in directly and indirectly blast exposed civilian survivors of urban missile attacks.

Saar-Ashkenazy R, Naparstek S, Dizitzer Y, Zimhoni N, Friedman A, Shelef I BMC Psychiatry. 2023; 23(1):423.

PMID: 37312064 PMC: 10262527. DOI: 10.1186/s12888-023-04943-1.

The 8 January 2020 theatre ballistic missile attack on US soldiers stationed at Al Asad Air Base, Iraq: case series using a concussion subtypes framework to approach a real-world, chaotic blast-related TBI mass casualty event.

Hainsworth J, Johnson A, Godfred-Cato S, Smolinski G, Jorgensen-Wagers K BMJ Neurol Open. 2023; 5(1):e000343.

PMID: 37265548 PMC: 10230862. DOI: 10.1136/bmjno-2022-000343.

Long-Term Effects of Repeated Blast Exposure in United States Special Operations Forces Personnel: A Pilot Study Protocol.

Edlow B, Bodien Y, Baxter T, Belanger H, Cali R, Deary K J Neurotrauma. 2022; 39(19-20):1391-1407.

PMID: 35620901 PMC: 9529318. DOI: 10.1089/neu.2022.0030.

Alterations in the Topology of Functional Connectomes Are Associated with Post-Traumatic Stress Disorder and Blast-Related Mild Traumatic Brain Injury in Combat Veterans.

Rowland J, Stapleton-Kotloski J, Martindale S, Rogers E, Ord A, Godwin D J Neurotrauma. 2021; 38(22):3086-3096.

PMID: 34435885 PMC: 8917881. DOI: 10.1089/neu.2020.7450.

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