Traumatic brain injury and posttraumatic stress disorder examined with the Behavioral Dyscontrol Scale-II in post-9/11 veterans

Post 9/11-era veterans and service members are at high risk for posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) exposures. However, symptom overlap between these conditions presents challenges in differential diagnosis and discriminating the relative contributions of each when co-occurring. Neurological soft signs (NSS) represent a potential diagnostic tool given demonstrated associations with PTSD, but to date there is limited research assessing a possible association with mTBI history. The current study sought to identify whether NSS can discriminate between PTSD, mTBI, and their co-occurrence via a neuropsychological test of complex motor functioning, the Behavioral Dyscontrol Scale-II (BDS-II). The study sample included 241 post-9/11 veterans. After adjusting for symptom and performance validity, study results indicated that NSS as measured by the BDS-II did not discriminate between the mTBI, PTSD, and co-occurring mTBI+PTSD groups. Additionally, in contrast to previous research, no association was observed between NSS and PTSD symptoms. Findings do not support NSS insofar as their utility in discrimination between mTBI and PTSD.