Miles SR, Brenner LA, Neumann D, Hammond FM, Ropacki S, Tang X, Eapen BC, Smith A, Nakase-Richardson R. Arch. Phys. Med. Rehabil. 2019; ePub(ePub): ePub.
Affiliation
Mental Health and Behavioral Sciences and Defense and Veterans Brain Injury Center, James A. Haley Veterans' Hospital, Morsani College of Medicine Pulmonary and Sleep Medicine Division, University of South Florida. Electronic address: Risa.Richardson@va.gov.
OBJECTIVE: Examine the relationship between staff perceived irritability, anger, and aggression (IAA) and posttraumatic stress disorder (PTSD) in veterans with traumatic brain injury (TBI) of all severity levels.
DESIGN: Longitudinal cohort design. SETTING: Veterans Affairs Polytrauma Transitional Rehabilitation Programs. PARTICIPANTS: Veterans and service members with TBI of all severity levels enrolled in the Veterans Affairs Polytrauma Rehabilitation Centers' Traumatic Brain Injury Model System national database (N = 240). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Univariable and multivariable logistic regression modeling was used to examine the association between IAA and potential risk factors, including PTSD symptoms. IAA was measured as a single construct using an item from the Mayo-Portland Adaptability Inventory-4 that was rated by a program staff member at admission and discharge from the inpatient rehabilitation program. PTSD symptoms were assessed using the PTSD Checklist-Civilian Version.
RESULTS: PTSD symptoms uniquely predicted program staff rated IAA at discharge even after controlling for severity of TBI, age, male gender, education, and annual earning. The model explained 19% of the variance in IAA.
CONCLUSIONS: When TBI severity and PTSD symptoms were considered simultaneously in a sample of veterans, only PTSD symptoms predicted staff-rated IAA. Given the negative outcomes linked with IAA, Veterans may benefit from assessment and treatment of PTSD symptoms within rehabilitation settings.