Examining the Utility of Veterans Health Administration (VHA) Traumatic Brain Injury Screening among Women Veterans: Recommendations for Expansion to Include Interpersonal Violence

被引:1
作者
Pebole, Michelle M. [1 ,2 ]
Iverson, Katherine M. [3 ,4 ]
Bolduc, Caitlin M. [1 ]
Joyce, Julie M. [1 ]
Sablone, Caroline A. [1 ]
Fortier, Catherine B. [1 ,2 ]
机构
[1] VA Boston Healthcare Syst, Translat Res Ctr TBI & Stress Disorders TRACTS, Boston, MA 02130 USA
[2] Harvard Med Sch, Dept Psychiat, Boston, MA 02215 USA
[3] VA Boston Healthcare Syst, Natl Ctr PTSD, Womens Hlth Sci Div, Boston, MA 02130 USA
[4] Boston Univ, Chobanian & Avedisian Sch Med, Dept Psychiat, Boston, MA 02118 USA
关键词
women veterans; brain injury; screening; interpersonal violence; partner violence; INTIMATE PARTNER VIOLENCE; BOSTON ASSESSMENT; MILITARY SERVICE; COMORBIDITY; INTERVIEW; SEVERITY; PAIN; PTSD; CARE; TBI;
D O I
10.3390/brainsci14080814
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Women veterans (WVs) are more likely than men veterans to experience traumatic brain injury (TBI) from causes unrelated to deployment. Yet, current Veterans Health Administration (VHA) TBI screening focuses on deployment. This study examines the utility of the VHA TBI screening tool for WVs. Using the Boston Assessment for TBI-Lifetime (BAT-L) as the gold standard, sensitivity and specificity of the VHA screen were identified for deployment and non-deployment injuries. Injuries missed by the screen were thematically described. Sensitivity and specificity were compared by context (research, clinical). Ninety WVs were included; fifty-three (60.9%) met TBI criteria per the BAT-L. For TBIs occurring during deployment, sensitivity was higher in research (89.1%) compared to clinics (61.7%); specificity was lower in research (60.7%) compared to clinics (93.0%). The BAT-L identified 27 non-deployment TBIs not captured by the VHA screen, most frequently from physical assault or sports. The VHA screen does not include non-deployment events; thus, non-deployment sensitivity and specificity could not be calculated. For lifetime TBIs (deployment + non-deployment etiologies), sensitivity was higher in research (73.5%) compared to clinics (48.9%). Specificity was lower in research (60.0%) compared to clinics (100.0%). Findings can inform improvements to TBI screening among WVs, including expansion for interpersonal violence.
引用
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页数:10
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