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
收藏
页数:10
相关论文
共 59 条
[31]   Intimate Partner Violence Among Female OEF/OIF/OND Veterans Who Were Evaluated for Traumatic Brain Injury in the Veterans Health Administration: A Preliminary Investigation [J].
Iverson, Katherine M. ;
Sayer, Nina A. ;
Meterko, Mark ;
Stolzmann, Kelly ;
Suri, Pradeep ;
Gormley, Katelyn ;
Seibert, Marjorie Nealon ;
Yan, Kun ;
Pogoda, Terri K. .
JOURNAL OF INTERPERSONAL VIOLENCE, 2020, 35 (13-14) :2422-2445
[32]   Associations between traumatic brain injury from intimate partner violence and future psychosocial health risks in women [J].
Iverson, Katherine M. ;
Dardis, Christina M. ;
Grillo, Alessandra R. ;
Galovski, Tara E. ;
Pogoda, Terri K. .
COMPREHENSIVE PSYCHIATRY, 2019, 92 :13-21
[33]   Deployment-Related Traumatic Brain Injury Among Operation Enduring Freedom/Operation Iraqi Freedom Veterans: Associations with Mental and Physical Health by Gender [J].
Iverson, Katherine M. ;
Pogoda, Terri K. ;
Gradus, Jaimie L. ;
Street, Amy E. .
JOURNAL OF WOMENS HEALTH, 2013, 22 (03) :267-275
[34]   Psychiatric Diagnoses and Neurobehavioral Symptom Severity among OEF/OIF VA Patients with Deployment-Related Traumatic Brain Injury: A Gender Comparison [J].
Iverson, Katherine M. ;
Hendricks, Ann M. ;
Kimerling, Rachel ;
Krengel, Maxine ;
Meterko, Mark ;
Stolzmann, Kelly L. ;
Baker, Errol ;
Pogoda, Terri K. ;
Vasterling, Jennifer J. ;
Lew, Henry L. .
WOMENS HEALTH ISSUES, 2011, 21 (04) :S210-S217
[35]  
Kay THD., 1993, J Head Trauma Rehabil, V8, P86, DOI [DOI 10.1097/00001199-199309000-00010, 10.1097/00001199-199309000-00010, DOI 10.1097/00001199-199309000-00009]
[36]   Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care [J].
Kimerling, Rachel ;
Iverson, Katherine M. ;
Dichter, Melissa E. ;
Rodriguez, Allison L. ;
Wong, Ava ;
Pavao, Joanne .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2016, 31 (08) :888-894
[37]   Access to Mental Health Care Among Women Veterans Is VA Meeting Women's Needs? [J].
Kimerling, Rachel ;
Pavao, Joanne ;
Greene, Liberty ;
Karpenko, Julie ;
Rodriguez, Allison ;
Saweikis, Meghan ;
Washington, Donna L. .
MEDICAL CARE, 2015, 53 (04) :S97-S104
[38]   Factors Associated With Completing Comprehensive Traumatic Brain Injury Evaluation [J].
Maguen, Shira ;
Lau, Karen M. ;
Madden, Erin ;
Seal, Karen .
MILITARY MEDICINE, 2012, 177 (07) :797-803
[39]   The Focus They Deserve: Improving Women Veterans' Health Care Access [J].
Marshall, Vanessa ;
Stryczek, Krysttel C. ;
Haverhals, Leah ;
Young, Jessica ;
Au, David H. ;
Ho, P. Michael ;
Kaboli, Peter J. ;
Kirsh, Susan ;
Sayre, George .
WOMENS HEALTH ISSUES, 2021, 31 (04) :399-407
[40]   A methodology for assessing deployment trauma and its consequences in OEF/OIF/OND veterans: The TRACTS longitudinal prospective cohort study [J].
McGlinchey, Regina E. ;
Milberg, William P. ;
Fonda, Jennifer R. ;
Fortier, Catherine Brawn .
INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, 2017, 26 (03)