For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
3
views
21
references
 Top references
cited by
11
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      161
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Deployment, suicide, and overdose among comorbidity phenotypes following mild traumatic brain injury: A retrospective cohort study from the Chronic Effects of Neurotrauma Consortium

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Mild traumatic brain injury in the Veteran population is frequently comorbid with pain, post-traumatic stress disorder, and/or depression. However, not everyone exposed to mild traumatic brain injury experiences these comorbidities and it is unclear what factors contribute to this variability. The objective of this study was to identify comorbidity phenotypes among Post-9/11 deployed Veterans with no or mild traumatic brain injury and examine the association of comorbidity phenotypes with adverse outcomes. We found that Veterans with mild traumatic brain injury (n = 93,003) and no brain injury (n = 434,378) were mean age of 32.0 (SD 9.21) on entering Department of Veterans Health Administration care, were predominantly Caucasian non-Hispanic (64.69%), and served in the Army (61.31%). Latent class analysis revealed five phenotypes in each subcohort; Moderately Healthy and Mental Health phenotypes were common to both. The Healthy phenotype was found only in no brain injury. Unique phenotypes in mild traumatic brain injury included Moderately Healthy+Decline, Polytrauma, and Polytrauma+Improvement. There was substantial variation in adverse outcomes. The Polytrauma+Improvement phenotype had the lowest likelihood of adverse outcomes. There were no differences between Moderately Healthy+Decline and Polytrauma phenotypes. Phenotypes of comorbidity vary significantly by traumatic brain injury status including divergence in phenotypes (and outcomes) over time in the mild traumatic brain injury subcohort. Understanding risk factors for the divergence between Polytrauma vs. Polytrauma+Improvement and Moderately Healthy vs. Moderately Healthy+Decline, will improve our ability to proactively mitigate risk, better understand the early patterns of comorbidity that are associated with neurodegenerative sequelae following mild traumatic brain injury, and plan more patient-centered care.

          Related collections

          Most cited references21

          • Record: found
          • Abstract: found
          • Article: not found

          Trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans using Department of Veterans Affairs health care, 2002-2008.

          Charles Marmar, Shira Maguen, Daniel Bertenthal … (2009)
          We sought to investigate longitudinal trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans. We determined the prevalence and predictors of mental health diagnoses among 289,328 Iraq and Afghanistan veterans entering Veterans Affairs (VA) health care from 2002 to 2008 using national VA data. Of 289,328 Iraq and Afghanistan veterans, 106,726 (36.9%) received mental health diagnoses; 62,929 (21.8%) were diagnosed with posttraumatic stress disorder (PTSD) and 50 432 (17.4%) with depression. Adjusted 2-year prevalence rates of PTSD increased 4 to 7 times after the invasion of Iraq. Active duty veterans younger than 25 years had higher rates of PTSD and alcohol and drug use disorder diagnoses compared with active duty veterans older than 40 years (adjusted relative risk = 2.0 and 4.9, respectively). Women were at higher risk for depression than were men, but men had over twice the risk for drug use disorders. Greater combat exposure was associated with higher risk for PTSD. Mental health diagnoses increased substantially after the start of the Iraq War among specific subgroups of returned veterans entering VA health care. Early targeted interventions may prevent chronic mental illness.
          Article 0 comments Cited 122 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Modifying resilience mechanisms in at-risk individuals: a controlled study of mindfulness training in Marines preparing for deployment.

            N. Thom, Erik Thompson, Eric Potterat … (2014)
            Military deployment can have profound effects on physical and mental health. Few studies have examined whether interventions prior to deployment can improve mechanisms underlying resilience. Mindfulness-based techniques have been shown to aid recovery from stress and may affect brain-behavior relationships prior to deployment. The authors examined the effect of mindfulness training on resilience mechanisms in active-duty Marines preparing for deployment. Eight Marine infantry platoons (N=281) were randomly selected. Four platoons were assigned to receive mindfulness training (N=147) and four were assigned to a training-as-usual control condition (N=134). Platoons were assessed at baseline, 8 weeks after baseline, and during and after a stressful combat training session approximately 9 weeks after baseline. The mindfulness training condition was delivered in the form of 8 weeks of Mindfulness-Based Mind Fitness Training (MMFT), a program comprising 20 hours of classroom instruction plus daily homework exercises. MMFT emphasizes interoceptive awareness, attentional control, and tolerance of present-moment experiences. The main outcome measures were heart rate, breathing rate, plasma neuropeptide Y concentration, score on the Response to Stressful Experiences Scale, and brain activation as measured by functional MRI. Marines who received MMFT showed greater reactivity (heart rate [d=0.43]) and enhanced recovery (heart rate [d=0.67], breathing rate [d=0.93]) after stressful training; lower plasma neuropeptide Y concentration after stressful training (d=0.38); and attenuated blood-oxygen-level-dependent signal in the right insula and anterior cingulate. The results show that mechanisms related to stress recovery can be modified in healthy individuals prior to stress exposure, with important implications for evidence-based mental health research and treatment.
            Article 0 comments Cited 65 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Prevalence of chronic pain, posttraumatic stress disorder, and persistent postconcussive symptoms in OIF/OEF veterans: polytrauma clinical triad.

              Henry L Lew, John Otis, Carlos Tun … (2009)
              This study examines the prevalence and coprevalence with which returning Operation Iraqi Freedom (OIF)/Operation Enduring Freedom (OEF) veterans were reporting symptoms consistent with chronic pain, posttraumatic stress disorder (PTSD), and persistent postconcussive symptoms (PPCS). The medical records of 340 OIF/OEF veterans seen at a Department of Veterans Affairs Polytrauma Network Site were comprehensively reviewed. Analyses indicated a high prevalence of all three conditions in this population, with chronic pain, PTSD, and PPCS present in 81.5%, 68.2%, and 66.8%, respectively. Only 12 of the veterans (3.5%) had no chronic pain, PTSD, or PPCS. The frequency at which these three conditions were present in isolation (10.3%, 2.9%, and 5.3%, respectively) was significantly lower than the frequency at which they were present in combination with one another, with 42.1% of the sample being diagnosed with all three conditions simultaneously. The most common chronic pain locations were the back (58%) and head (55%). These results underscore the complexity of the presenting complaints in OIF/OEF veterans and support the importance of a multidisciplinary team approach to assessment and treatment.
              Article 0 comments Cited 53 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Mary Jo Pugh:
                ORCID: http://orcid.org/0000-0003-4196-7763
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Alicia A. Swan: Role: InvestigationRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Megan E. Amuan: Role: Data curationRole: Formal analysisRole: InvestigationRole: SoftwareRole: Writing – original draftRole: Writing – review & editing
                Blessen C. Eapen: Role: ConceptualizationRole: InvestigationRole: Writing – review & editing
                Carlos A. Jaramillo: Role: ConceptualizationRole: InvestigationRole: Writing – review & editing
                Roxana Delgado: Role: InvestigationRole: Writing – original draftRole: Writing – review & editing
                David F. Tate: Role: ConceptualizationRole: InvestigationRole: Writing – review & editing
                Kristine Yaffe: Role: Funding acquisitionRole: InvestigationRole: Writing – review & editing
                Chen-Pin Wang: Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Suresh Agarwal: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 20 September 2019
                Publication date Collection: 2019
                Volume: 14
                Issue: 9
                Electronic Location Identifier: e0222674
                Affiliations
                [1 ] VA Salt Lake City Health Care System, Informatics, Decision-Enhancement and Analytic Sciences Center, Salt Lake City, Utah, United States of America
                [2 ] Department of Internal Medicine, University of Utah, School of Medicine, Salt Lake City, Utah, United States of America
                [3 ] Department of Psychology, University of Texas at San Antonio, San Antonio, Texas, United States of America
                [4 ] Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Health Care System, Los Angeles, California, United States of America
                [5 ] Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
                [6 ] Polytrauma Rehabilitation Center, South Texas Veterans Health Care System, San Antonio, Texas, United States of America
                [7 ] Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, Missouri, United States of America
                [8 ] Department of Psychiatry, Neurology & Epidemiology, University of California, San Francisco, San Francisco, California, United States of America
                [9 ] Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
                Duke University School of Medicine, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0003-4196-7763
                Article
                Publisher ID: PONE-D-19-11940
                DOI: 10.1371/journal.pone.0222674
                PMC ID: 6754132
                PubMed ID: 31539410
                SO-VID: 362da744-907a-4aaa-9827-8882de6531b0
                License:

                This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

                History
                Date received : 26 April 2019
                Date accepted : 3 September 2019
                Page count
                Figures: 5, Tables: 1, Pages: 14
                Funding
                Funded by: Congressionally Directed Medical Research Program
                Award ID: W81XWH-13-2-0095-04
                Award Recipient :
                Funded by: Department of Veterans Affairs
                Award ID: I01CX001246
                Award Recipient :
                ORCID: http://orcid.org/0000-0003-4196-7763
                This study was supported by U.S. Department of Veterans Affairs funds, I01CX001246, https://www.research.va.gov, to MJP; and U.S. Department of Defense W81XWH-13-2-0095-04, http://cdmrp.army.mil, to KY. The sponsors played no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.
                Categories
                Subject: Research Article
                Subject: Medicine and Health Sciences
                Subject: Critical Care and Emergency Medicine
                Subject: Trauma Medicine
                Subject: Traumatic Injury
                Subject: Neurotrauma
                Subject: Traumatic Brain Injury
                Subject: Medicine and Health Sciences
                Subject: Mental Health and Psychiatry
                Subject: Medicine and Health Sciences
                Subject: Health Care
                Subject: Veteran Care
                Subject: Biology and Life Sciences
                Subject: Genetics
                Subject: Phenotypes
                Subject: Medicine and Health Sciences
                Subject: Mental Health and Psychiatry
                Subject: Suicide
                Subject: Medicine and Health Sciences
                Subject: Mental Health and Psychiatry
                Subject: Neuropsychiatric Disorders
                Subject: Anxiety Disorders
                Subject: Post-Traumatic Stress Disorder
                Subject: Medicine and Health Sciences
                Subject: Mental Health and Psychiatry
                Subject: Neuroses
                Subject: Anxiety Disorders
                Subject: Post-Traumatic Stress Disorder
                Subject: Medicine and Health Sciences
                Subject: Mental Health and Psychiatry
                Subject: Mood Disorders
                Subject: Depression
                Subject: Social Sciences
                Subject: Political Science
                Subject: Governments
                Subject: Armed Forces
                Subject: Military Personnel
                Subject: Veterans
                Custom metadata
                Data Availability The dataset underlying our study is a third-party dataset from VA, which is not owned or collected by the authors. The dataset was provided to our team after approval by the South Texas Veterans Health Care System Research and Development committee in accordance with VA data security regulations. For others to access these data, the same process is required based on VA Data Security and privacy regulations. The authors did not have any special access privileges that others would not have. To inquire about and initiate the process of accessing the data, a request should be sent to the following point of contact: VA Information Resource Center (VIReC), Email: virec@ 123456va.gov , Building 18 Hines VA Hospital (151V), 5000 S. 5th Avenue, Hines, IL 60141-3030, 708-202-2413, 708-202-2415 (fax).

                ScienceOpen disciplines: Uncategorized
                Data availability:
                ScienceOpen disciplines: Uncategorized

                Comments

                Comment on this article

                scite_

                Similar content161

                See all similar

                Cited by11

                See all cited by

                Most referenced authors264

                See all reference authors