Traumatic brain injury and PTSD screening efforts evaluated using latent class analysis

Area of Science:

• Military health
• Neuroscience
• Psychiatry

Background:

• Service members returning from deployment are screened for health issues.
• Persistent postconcussive symptoms and mental health conditions like PTSD are common concerns.
• Current screening methods may not fully capture the prevalence of these conditions.

Purpose of the Study:

• To identify distinct patterns of persistent postconcussive symptoms in service members.
• To compare these symptom patterns with screening results for PTSD and mild traumatic brain injury (TBI).
• To inform policy and improve treatment decisions for postdeployment health.

Main Methods:

• Latent class analysis of self-report data from 12,581 male service members.
• Utilized persistent postconcussive symptoms from Post-Deployment Health Assessments (PDHA) and Reassessments (PDHRA).
• Identified four classes: systemic, cognitive/behavioral, comorbid, and nonpresenting.

Main Results:

• Four distinct symptom classes were identified, varying in neurological and mental health symptom endorsement.
• The comorbid class reported a wide range of symptoms across both domains.
• Estimated probable neurological injury at 17.9%, higher than the 13.1% positive mild TBI screening rate.

Conclusions:

• Current PDHA and PDHRA may underestimate the prevalence of postdeployment health problems.
• Additional screening items or alternative algorithms focusing on postconcussive symptoms are needed.
• Improved identification can lead to more service members receiving necessary treatment.