Examining the Role of Behavioral Health Factors on Inpatient Traumatic Brain Injury Rehabilitation Outcomes Among Service Members and Veterans

IF 2 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation Pub Date : 2026-09-01 Epub Date: 2026-06-07 DOI:10.1016/j.arrct.2026.100664

Justin T. McDaniel PhD, Jolie N. Haun PhD, Julie McMahon-Grenz MS, OTR/L, Tali Schneider PhD, Karen Skop PT, DPT, MS, Sharon Barton MS, CRC, CVE, CBIS, CPD, Roberto Sandoval PT, DPT, Kimberly Samson PT, DPT, MS, Risa Nakase-Richardson PhD, Kevin Wells MPH, Mary Jo Pugh PhD

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Abstract

Objective

To examine the association between behavioral health factors, specifically pretreatment alcohol and tobacco use, and traumatic brain injury (TBI)-related outcomes in the Intensive Evaluation and Treatment Program (IETP).

Design

Retrospective longitudinal cohort design.

Setting

The intervention and data collection were conducted at 5 Veterans Health Administration (VHA) sites (Florida, Texas, California, Minnesota, and Virginia).

Participants

Behavioral health and TBI-related outcome data were collected from N=205 veteran and active-duty service member participants with mild-to-moderate TBI.

Interventions

The VHA IETP delivered interdisciplinary rehabilitation to veterans and service members with a history of mild-to-moderate TBI and related conditions, including posttraumatic stress disorder (PTSD), pain, impaired function, and adverse neurobehavioral symptoms.

Main Outcome Measures

The exploratory outcome measures included the Neurobehavioral Symptom Inventory, the PTSD Checklist for DSM-5, the Patient Reported Outcomes Measurement Information System Pain Interference scale, and the Mayo-Portland Adaptability Inventory. Pretreatment tobacco and alcohol use behaviors were extracted from patient medical records. Multiple linear regression models were fitted to the data to test our hypotheses.

Results

Alcohol use was not shown to be associated with changes in any of the outcomes; however, tobacco use was associated with attenuated improvement in PTSD symptoms (p=.03).

Conclusions

This study suggests that pretreatment tobacco use may lessen the effects of long-term PTSD rehabilitation among patients with TBI.

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行为健康因素对现役军人和退伍军人创伤性脑损伤住院康复效果的影响

目的探讨行为健康因素，特别是预处理酒精和烟草使用与强化评估和治疗计划（IETP）中创伤性脑损伤（TBI）相关结局的关系。设计：回顾性纵向队列设计。干预和数据收集在5个退伍军人健康管理局（VHA）站点（佛罗里达州、德克萨斯州、加利福尼亚州、明尼苏达州和弗吉尼亚州）进行。研究对象：行为健康和创伤性脑损伤相关结果数据来自205名轻中度创伤性脑损伤的退伍军人和现役军人。干预措施VHA IETP为有轻度至中度创伤性脑损伤病史和相关疾病的退伍军人和服务人员提供跨学科康复，包括创伤后应激障碍（PTSD）、疼痛、功能受损和不良神经行为症状。探索性结果测量包括神经行为症状量表、DSM-5 PTSD检查表、患者报告结果测量信息系统疼痛干扰量表和Mayo-Portland适应性量表。从患者病历中提取预处理后的烟草和酒精使用行为。对数据进行多元线性回归模型拟合以检验我们的假设。结果：酒精使用未显示与任何结果的变化有关；然而，吸烟与PTSD症状改善的减弱相关（p=.03）。结论烟草预处理可降低创伤性脑损伤患者PTSD长期康复的效果。

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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