Mental, Physical, and Social Mediators of the Relationship Between Mild Traumatic Brain Injury and Functional Impairment in U.S. Military Veterans.

IF 2.4 4区医学 Q2 PSYCHIATRY

Psychiatry-Interpersonal and Biological Processes Pub Date : 2025-08-06 DOI:10.1080/00332747.2025.2528524

Sarah Meshberg-Cohen, Polly Ingram, Joan M Cook, Ian C Fischer, Robert H Pietrzak

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引用次数: 0

Abstract

Objective: This study examined mental, physical, and social variables that may mediate the relationship between mild traumatic brain injury (mTBI) and functional impairment in a nationally representative sample of U.S. military veterans.

Method: Data were analyzed from 3,985 U.S. military veterans who participated in the National Health and Resilience in Veterans Study.

Results: Study results revealed that 10.0% (95% confidence interval = 8.7-11.4%) of veterans screened positive for mTBI on the Veterans Affairs' Mild TBI Injury Screening and Evaluation tool. Veterans with a positive mTBI screen scored lower on measures of mental, physical, and cognitive functioning, and higher on a measure of psychosocial difficulties compared to those with a negative mTBI screen. Symptoms of major depression, generalized anxiety, and posttraumatic stress disorder, insomnia, somatic symptoms, and loneliness significantly mediated the relationship between mTBI screening status and various functional outcomes. Specifically, these mediators accounted for 87.1% of the association with physical functioning, 84.2% of the association with mental functioning, and 73.0% of the association with cognitive functioning, with mTBI screening status remaining significantly associated with each measure. For psychosocial functioning, these mediators accounted for 89.2% of the association, and mTBI screening status was no longer associated with this outcome.

Conclusions: Collectively, these findings underscore the importance of early, targeted, and multi-modal interventions that address psychiatric symptoms, somatic symptoms, insomnia, and loneliness to enhance overall functioning and well-being among veterans with mTBI.

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美国退伍军人轻度创伤性脑损伤和功能障碍之间关系的心理、生理和社会中介。

目的：本研究考察了可能介导轻度创伤性脑损伤（mTBI）和功能障碍之间关系的心理、生理和社会变量，研究对象为具有全国代表性的美国退伍军人。方法：对美国3985例临床资料进行分析参加退伍军人国家健康和恢复力研究的退伍军人。结果：研究结果显示，在退伍军人事务部轻度TBI损伤筛查与评估工具中，10.0%（95%置信区间= 8.7-11.4%）的退伍军人mTBI筛查呈阳性。与mTBI筛查阴性的退伍军人相比，mTBI筛查阳性的退伍军人在精神、身体和认知功能方面得分较低，在心理社会困难方面得分较高。重度抑郁、广泛性焦虑、创伤后应激障碍、失眠、躯体症状和孤独感显著介导mTBI筛查状态与各种功能结局的关系。具体而言，这些介质占与身体功能相关的87.1%，与精神功能相关的84.2%，与认知功能相关的73.0%，mTBI筛查状态与每项测量均显着相关。对于心理社会功能，这些介质占关联的89.2%，mTBI筛查状态不再与此结果相关。结论：总的来说，这些发现强调了早期、有针对性和多模式干预的重要性，这些干预可以解决精神症状、躯体症状、失眠和孤独感，以增强mTBI退伍军人的整体功能和幸福感。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychiatry-Interpersonal and Biological Processes 医学-精神病学

CiteScore

2.70

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Internationally recognized, Psychiatry has responded to rapid research advances in psychiatry, psychology, neuroscience, trauma, and psychopathology. Increasingly, studies in these areas are being placed in the context of human development across the lifespan, and the multiple systems that influence individual functioning. This journal provides broadly applicable and effective strategies for dealing with the major unsolved problems in the field.