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Updated: Oct 14, 2026
A Novel In Vitro Model of Blast Traumatic Brain Injury
Published on: December 21, 2018
Emerging Patterns of Mental Health Comorbidities Among Those With Blast or Blunt Mechanism TBI: Leveraging Total
Molly J Sullan1, Kate Clauss, Maya O'Neil
1Author Affiliations: Department of Veterans Affairs, Brain Health Coordinating Center, Aurora, Colorado (Sullan, Holliday, and Brenner); Department of Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, Colorado (Sullan, and Kinney); Center to Improve Veteran Involvement in Care (CIVIC) VA Portland Healthcare System, Portland, Oregon (Clauss, O'Neil, Vlajic, and Baker-Robinson); Department of Psychiatry Oregon Health & Science University, Portland, Oregon (Clauss); Department of Psychiatry Oregon Health & Science University, VISN 20 Mental Illness Research, Education, and Clinical Center (MIRECC) VA Portland Healthcare System, Portland, Oregon (O'Neil); VA Pacific Islands Health Care System, Honolulu, Hawaii (Holliday); Departments of Psychiatry & Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, Colorado (Holliday); Department of Veteran Affairs (VA) Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC) for Suicide Prevention, Aurora, Colorado (Kinney); VA Brain Health Coordinating Center, Aurora, Colorado (Kinney); Translational Research Center for TBI and Stress Disorders National Network Center, VA Boston Healthcare System, Boston, Massachusetts & Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas (Fortier and Milberg); Geriatric Research, Education, and Clinical Centers (GRECC), VA Boston Healthcare System, Boston, Massachusetts (Milberg); National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts (Fortier and Milberg); Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (Fortier and Milberg); Department of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts (Fortier and Milberg); Department of Veterans Affairs (VA), Long-term Impact for Military-relevant Brain Injury Consortium (LIMBIC), Richmond, Virginia (Cifu); VA Brain Health Coordinating Center, Richmond, Virginia (Cifu); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia (Cifu); Departments of Physical Medicine and Rehabilitation, Psychiatry, and Neurology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado (Brenner).
Objective:
Traumatic brain injury (TBI) is associated with postinjury mental health (MH) sequelae, yet associations between injury-related risk factors (eg, injury mechanism, multiple injuries) and outcomes remain poorly understood. We leveraged a newly harmonized national dataset to evaluate relationships between TBI characteristics and MH outcomes.
Data Sources:
We analyzed data from the Total Brain Diagnostics (TBD) dataset, a harmonized data source including 2 large, multisite, longitudinal prospective cohort studies: the Long-term Impact of Military-relevant Brain Injury Consortium's (LIMBIC) and the Translational Research Center for TBI and Stress Disorders (TRACTS).
Participants:
Veterans and Service Members (n = 3771).
Design:
Pooled cross-sectional analyses of harmonized data.
Main Measures:
TBI Characteristics (Predictors): Number of TBIs, whether the participant had experienced a blast-related TBI, and whether the participant had experienced loss of consciousness secondary to a TBI. Mental Health Conditions/Symptoms (Outcomes): Probable post-traumatic stress disorder (PTSD), probable depression, probable anxiety, suicidal ideation, suicide attempts, and probable unhealthy alcohol use.
Results:
Blast TBI was associated with greater odds of probable PTSD (OR 1.85, P < .001, 95% CI: 1.57-2.17), probable depression (OR 1.66, P < .001, 95% CI: 1.42-1.95), and probable anxiety (OR 1.73, P < .001, 95% CI: 1.45-2.05) compared with blunt TBI. Post-hoc analyses suggested differences in the frequency of co-occurring MH outcomes among those with blast versus blunt TBIs.
Conclusions:
Findings suggest unique MH outcomes driven by blast injury mechanism, highlighting potential differences in underlying etiology.
