Brain Trauma Increases PTSD Risk for Active-Duty Marines

A recent study looks at the association between traumatic brain injury and the risk of post-traumatic stress disorder for active duty marines.

According to researchers from the Veterans San Diego Healthcare System and University of California, San Diego School of medicines, they found that TBI's suffered during active-duty deployment to Iraq and Afghanistan were a high predictor of PTSD problems.

A team of researchers headed by principal investigator Dewleen G. Baker, MD, research director at the VA Center of Excellence for Stress and Mental Health, professor in the Department of Psychiatry at UC San Diego and a practicing psychiatrist in the VA San Diego Healthcare system worked to analyze 1,648 active-duty Marines and Navy servicemen from four infantry battalions of the First Marine Division that were based at Camp Pendleton in north San Diego County. All participants were evaluated approximately one month before a scheduled 7-month deployment to Iraq or Afghanistan, or one week after deployment had ended, and then again six months later.

All participants were evaluated based on the Clinician-Administered PTSD Scale or CAPS, which is widely used to diagnose PTSD and severity, asking about previous head injuries before they joined the service.

The study notes that in the United States alone, 1.7 million Americans annually sustain a TBI with an estimated 5 million Americans living with TBI-related disabilities.

The authors discovered the following, courtesy of a press release: 

"The severity of post-deployment PTSD symptoms depends, in part, on the severity of pre-existing symptoms from prior trauma and combat intensity," said Baker. "An individual with no pre-existing PTSD symptoms and low combat intensity is at minimal risk for developing PTSD - less than a 1 percent probability. Increases in pre-existing symptom scores and combat intensity modestly increase post-deployment symptom scores by 1 to 2 percent.

"By contrast, deployment-related mild TBI increases post-deployment symptom scores by 23 percent, and moderate to severe injuries increase scores by 71 percent. This percent increase is equivalent to a 14-point increase in combat intensity scores for mild TBI, and a 37-point increase for moderate or severe TBI."

Baker noted many factors, both environmental and individual, may contribute to development of PTSD. Two of the most important are pre-existing psychiatric symptoms and the nature of the "trauma event."

"However, TBI was the strongest predictor of PTSD, even when controlling for pre-existing symptoms and combat intensity," she said. "These findings may be used to identify individuals who may be at risk for developing PTSD and provide them with more immediate health care."

More information regarding the study can be found via JAMA Psychiatry.