History of loss of consciousness with mild traumatic brain injury affects PTSD symptom presentation in treatment-seeking Iraq/Afghanistan veterans

Objective: This study was conducted (1) to examine differences in post-traumatic stress disorder (PTSD) symptoms, perceived quality-of-life (QoL) and post-concussive symptoms (PCS) among veterans who experienced deployment-related mild traumatic brain injuries (mTBIs) with or without loss of consciousness (LOC) and (2) to test the additive role of PCS on QOL. Design: Two hundred and twelve Iraq/Afghanistan veterans who were admitted to a residential programme for PTSD were assessed shortly following intake. A MANCOVA was conducted to examine QoL, PTSD symptom domains and PCS across the No LOC and LOC groups. Multivariate regression models were conducted to examine whether prevalence of PCS might be uniquely linked with veterans' QoL (physical, psychological and social). Results: When controlling for combat exposure (CE), LOC status was uniquely linked with avoidance symptomatology, Psychological QoL and PCS; LOC status was not significantly linked with other domains of PTSD or QoL. When controlling for CE and PTSD, PCS was similarly linked with QoL in the psychological domain, but not Physical or Social QoL. Conclusion/Implications: LOC associated with a mTBI may contribute to behavioural avoidance and poorer psychological well-being among veterans seeking treatment for PTSD. In addition, PCS associated with mTBI may diminish Psychological QoL for veterans seeking treatment for PTSD.