B – 28 Neuropsychological, Psychological, and Physical Functioning in Comorbid Traumatic Brain Injury and Post-traumatic Stress Disorder

Objective The present study compared the neuropsychological, psychological, and physical functioning of civilians with Traumatic Brain Injury (TBI) vs. TBI + Post-traumatic Stress Disorder (PTSD) at different levels of TBI severity (i.e., mild, moderate, severe). Method Data were derived from a pre-existing database (TBI Model Systems National Database). Participants were grouped into the mild TBI-only (n=90), moderate TBI-only (n=27), severe TBI-only (n=79), mild TBI+PTSD (n=99), moderate TBI+PTSD (n=22), and severe TBI+PTSD (n=91). Multiple independent samples t-tests and Mann-Whitney U tests were conducted to compare the mild TBI-only vs. mild TBI+PTSD, moderate TBI-only vs. moderate TBI+PTSD, and severe TBI-only vs. severe TBI+PTSD on the Brief Test of Adult Cognition by Telephone (episodic memory, executive functioning, global cognition), Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire (PHQ-9), and physical health. Alpha levels for all analyses were set to .01 to correct for family-wise error. Results There were no significant differences in episodic memory, executive functioning, or global cognition scores between the comorbid and TBI-only groups at all levels of TBI severity. Participants in the mild, moderate, and severe comorbid groups reported significantly higher anxiety and depression than their counterparts in the TBI-only groups. Participants in the severe comorbid group reported significantly poorer health than those in the severe TBI-only group. Conclusion The present findings negate the hypothesis of the cumulative effect of comorbid TBI+PTSD on neuropsychological performance. The effect of this comorbidity on physical health seems to depend on TBI severity. Comorbid TBI+PTSD seems to be associated with greater psychological dysfunction at all levels of TBI severity.