A new cohort study found that veterans with mild traumatic brain injuries sustained in psychologically traumatic contexts may exhibit significantly higher posttraumatic stress disorder severity, postconcussive symptoms, and levels of disability compared to those with nonperitraumatic mild traumatic brain injuries or no traumas at all.
In the study, published in JAMA Network Open, lead study author Emily J. Van Etten, PhD, and her colleagues analyzed the data from 567 post-9/11 veterans in the TRACTS study at the Veterans Affairs Boston Healthcare System, collected between 2009 and 2024. The participants were categorized into three groups: peritraumatic mild traumatic brain injury (mTBI) (n = 195), nonperitraumatic mTBI (n = 189), and no TBI (n = 183).
The veterans with peritraumatic mTBI reported greater PTSD severity (F2,552 = 8.45, P < .001), postconcussive symptoms (F2,533 = 11.09, P < .001), and disability levels (F2,527 = 11.13, P < .001) compared with the other groups. No statistically significant differences were observed between the nonperitraumatic mTBI and no TBI groups.
Validated assessment tools included the Clinician-Administered PTSD Scale–4th Edition (CAPS-4) for PTSD, the Neurobehavioral Symptom Inventory (NSI) for postconcussive symptoms, and the World Health Organization Disability Assessment Schedule II (WHODAS-II) for disability.
The investigators suggested that peritraumatic mTBI may "scaffold" the formation of PTSD symptoms by creating acute biological and physiological conditions conducive to their development, potentially enhancing long-term postconcussive symptoms and functional impairments.
Meanwhile, the findings may influence screening and treatment protocols in veterans and other populations at risk for both TBI and PTSD.
No conflicts of interest were reported by the authors.
