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Health outcomes associated with military deployment: mild traumatic brain injury, blast, trauma, and combat associations in the Florida National Guard.
Arch Phys Med Rehabil. 2012 Nov; 93(11):1887-95.AP

Abstract

OBJECTIVES

To determine the association between specific military deployment experiences and immediate and longer-term physical and mental health effects, as well as examine the effects of multiple deployment-related traumatic brain injuries (TBIs) on health outcomes.

DESIGN

Online survey of cross-sectional cohort. Odds ratios were calculated to assess the association between deployment-related factors (ie, physical injuries, exposure to potentially traumatic deployment experiences, combat, blast exposure, and mild TBI) and current health status, controlling for potential confounders, demographics, and predeployment experiences.

SETTING

Nonclinical.

PARTICIPANTS

Members (N=3098) of the Florida National Guard (1443 deployed, 1655 not deployed).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Presence of current psychiatric diagnoses and health outcomes, including postconcussive and non-postconcussive symptoms.

RESULTS

Surveys were completed an average of 31.8 months (SD=24.4, range=0-95) after deployment. Strong, statistically significant associations were found between self-reported military deployment-related factors and current adverse health status. Deployment-related mild TBI was associated with depression, anxiety, posttraumatic stress disorder (PTSD), and postconcussive symptoms collectively and individually. Statistically significant increases in the frequency of depression, anxiety, PTSD, and a postconcussive symptom complex were seen comparing single to multiple TBIs. However, a predeployment TBI did not increase the likelihood of sustaining another TBI in a blast exposure. Associations between blast exposure and abdominal pain, pain on deep breathing, shortness of breath, hearing loss, and tinnitus suggested residual barotrauma. Combat exposures with and without physical injury were each associated not only with PTSD but also with numerous postconcussive and non-postconcussive symptoms. The experience of seeing others wounded or killed or experiencing the death of a buddy or leader was associated with indigestion and headaches but not with depression, anxiety, or PTSD.

CONCLUSIONS

Complex relationships exist between multiple deployment-related factors and numerous overlapping and co-occurring current adverse physical and psychological health outcomes. Various deployment-related experiences increased the risk for postdeployment adverse mental and physical health outcomes, individually and in combination. These findings suggest that an integrated physical and mental health care approach would be beneficial to postdeployment care.

Authors+Show Affiliations

Mental Health and Behavioral Sciences - Psychology Service, James A. Haley Veterans' Hospital, Tampa, FL 33612, USA. Rodney.Vanderploeg@va.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

22705240

Citation

Vanderploeg, Rodney D., et al. "Health Outcomes Associated With Military Deployment: Mild Traumatic Brain Injury, Blast, Trauma, and Combat Associations in the Florida National Guard." Archives of Physical Medicine and Rehabilitation, vol. 93, no. 11, 2012, pp. 1887-95.
Vanderploeg RD, Belanger HG, Horner RD, et al. Health outcomes associated with military deployment: mild traumatic brain injury, blast, trauma, and combat associations in the Florida National Guard. Arch Phys Med Rehabil. 2012;93(11):1887-95.
Vanderploeg, R. D., Belanger, H. G., Horner, R. D., Spehar, A. M., Powell-Cope, G., Luther, S. L., & Scott, S. G. (2012). Health outcomes associated with military deployment: mild traumatic brain injury, blast, trauma, and combat associations in the Florida National Guard. Archives of Physical Medicine and Rehabilitation, 93(11), 1887-95. https://doi.org/10.1016/j.apmr.2012.05.024
Vanderploeg RD, et al. Health Outcomes Associated With Military Deployment: Mild Traumatic Brain Injury, Blast, Trauma, and Combat Associations in the Florida National Guard. Arch Phys Med Rehabil. 2012;93(11):1887-95. PubMed PMID: 22705240.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Health outcomes associated with military deployment: mild traumatic brain injury, blast, trauma, and combat associations in the Florida National Guard. AU - Vanderploeg,Rodney D, AU - Belanger,Heather G, AU - Horner,Ronnie D, AU - Spehar,Andrea M, AU - Powell-Cope,Gail, AU - Luther,Stephen L, AU - Scott,Steven G, Y1 - 2012/06/13/ PY - 2012/01/09/received PY - 2012/05/07/revised PY - 2012/05/15/accepted PY - 2012/6/19/entrez PY - 2012/6/19/pubmed PY - 2013/1/15/medline SP - 1887 EP - 95 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 93 IS - 11 N2 - OBJECTIVES: To determine the association between specific military deployment experiences and immediate and longer-term physical and mental health effects, as well as examine the effects of multiple deployment-related traumatic brain injuries (TBIs) on health outcomes. DESIGN: Online survey of cross-sectional cohort. Odds ratios were calculated to assess the association between deployment-related factors (ie, physical injuries, exposure to potentially traumatic deployment experiences, combat, blast exposure, and mild TBI) and current health status, controlling for potential confounders, demographics, and predeployment experiences. SETTING: Nonclinical. PARTICIPANTS: Members (N=3098) of the Florida National Guard (1443 deployed, 1655 not deployed). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Presence of current psychiatric diagnoses and health outcomes, including postconcussive and non-postconcussive symptoms. RESULTS: Surveys were completed an average of 31.8 months (SD=24.4, range=0-95) after deployment. Strong, statistically significant associations were found between self-reported military deployment-related factors and current adverse health status. Deployment-related mild TBI was associated with depression, anxiety, posttraumatic stress disorder (PTSD), and postconcussive symptoms collectively and individually. Statistically significant increases in the frequency of depression, anxiety, PTSD, and a postconcussive symptom complex were seen comparing single to multiple TBIs. However, a predeployment TBI did not increase the likelihood of sustaining another TBI in a blast exposure. Associations between blast exposure and abdominal pain, pain on deep breathing, shortness of breath, hearing loss, and tinnitus suggested residual barotrauma. Combat exposures with and without physical injury were each associated not only with PTSD but also with numerous postconcussive and non-postconcussive symptoms. The experience of seeing others wounded or killed or experiencing the death of a buddy or leader was associated with indigestion and headaches but not with depression, anxiety, or PTSD. CONCLUSIONS: Complex relationships exist between multiple deployment-related factors and numerous overlapping and co-occurring current adverse physical and psychological health outcomes. Various deployment-related experiences increased the risk for postdeployment adverse mental and physical health outcomes, individually and in combination. These findings suggest that an integrated physical and mental health care approach would be beneficial to postdeployment care. SN - 1532-821X UR - https://www.unboundmedicine.com/medline/citation/22705240/Health_outcomes_associated_with_military_deployment:_mild_traumatic_brain_injury_blast_trauma_and_combat_associations_in_the_Florida_National_Guard_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(12)00403-0 DB - PRIME DP - Unbound Medicine ER -