Open AccessPostconcussive, posttraumatic stress and depressive symptoms in recently deployed U.S. Army soldiers with traumatic brain injury.
Author(s) -
Stephanie Agtarap,
Laura CampbellSills,
Thomas Michael,
Ronald C. Kessler,
Robert J. Ursano,
Murray B. Stein
Publication year - 2019
Publication title -
psychological assessment
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.96
H-Index - 140
eISSN - 1939-134X
pISSN - 1040-3590
DOI - 10.1037/pas0000756
Subject(s) - anhedonia , psychology , poison control , clinical psychology , mood , psychiatry , depression (economics) , cognition , somatization , anxiety , medicine , schizophrenia (object oriented programming) , environmental health , economics , macroeconomics
Prior studies raise questions about whether persistent postconcussive symptoms (PCS) are differentiable from mental health sequelae of traumatic brain injury (TBI). To investigate whether PCS represented a distinct symptom domain, we evaluated the structure of post-concussive and psychological symptoms using data from The Army STARRS Pre/Post Deployment Study, a panel survey of three U.S. Army Brigade Combat Teams that deployed to Afghanistan. Data from 1229 participants who sustained probable TBI during deployment completed ratings of past-30-day post-concussive, posttraumatic stress, and depressive symptoms three months after their return. Exploratory factor analysis (EFA; n = 300) and confirmatory factor analysis (CFA; n = 929) of symptom ratings were performed in independent subsamples. EFA suggested a model with 3 correlated factors resembling PCS, posttraumatic stress, and depression. CFA confirmed adequate fit of the 3-factor model (CFI = .964, RMSEA = .073 [.070, .075]), contingent upon allowing theoretically defensible cross-loadings. Bifactor CFA indicated that variance in all symptoms was explained by a general factor (λ = .36-.93), but also provided evidence of domain factors defined by (a) reexperiencing/hyperarousal, (b) cognitive/somatic symptoms, and (c) depressed mood/anhedonia. Soldiers with more severe TBI had higher cognitive/somatic scores, whereas soldiers with more deployment stress had higher general and reexperiencing/hyperarousal scores. Thus, variance in PCS is attributable to both a specific cognitive/somatic symptom factor and a general factor that also explains variance in posttraumatic stress and depression. Measurement of specific domains representing cognitive/somatic symptoms, reexperiencing/hyperarousal, and depressed mood/anhedonia may help clarify the relative severity of PCS, posttraumatic stress, and depression among individuals with recent TBI. (PsycINFO Database Record (c) 2019 APA, all rights reserved).