Citation

Agtarap S, Hungerford LD, Ettenhofer ML. J. Head Trauma Rehabil. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000854

PMID

36951920

Abstract

OBJECTIVE: To identify both shared and unique groups of posttraumatic stress and postconcussive symptoms using bifactor analysis. SETTING: Two large military outpatient traumatic brain injury (TBI) rehabilitation clinics in the Southwestern United States. PARTICIPANTS: A sample of 1476 Active Duty Service Members seeking treatment for a mild TBI sustained more than 30 days previously, without history of moderate or severe TBI, who completed measures of postconcussive and posttraumatic stress symptoms assessed at clinic intake.

DESIGN: Observational, correlational study with data taken from an institutional review board-approved clinical registry study. MAIN MEASURES: Neurobehavioral Symptom Inventory (NSI) and Posttraumatic Stress Disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-V) (PCL-5). Concurrent measures were Patient Health Questionnaire (PHQ-8), Pittsburgh Sleep Quality Index (PSQI), and Headache Impact Test (HIT-6).

RESULTS: Results identified a bifactor model demonstrating unique posttraumatic stress, depressive, cognitive, and neurological/somatic symptom groups that were still evident after accounting for a universal factor representing general distress. These symptom groups were differentially related to concurrently measured clinical outcomes.

CONCLUSION: Use of a bifactor structure may help derive clinically useful signals from self-reported symptoms among Active Duty Service Members seeking outpatient treatment for mild TBI.

Language: en