Neurobehavioral Symptoms in Veterans with Deployment-Related TBI: Examining the Additional Impact of Pre- and Post-Deployment Tbis

We utilized a large sample of Veterans who had sustained a traumatic brain injury (TBI) during deployment to evaluate the additional impact of pre- and post-deployment TBI's on neurobehavioral symptoms.Participants included 9934 Veterans (90.9% male; age: M = 34.5) diagnosed with TBI during the Veterans Health Administration's Comprehensive Traumatic Brain Injury Evaluation (CTBIE), a clinician-administered interview that includes an assessment of pre-, during-, and post-deployment TBI. The Neurobehavioral Symptom Inventory (NSI) is administered as part of the CTBIE, from which five subscale scores were evaluated: vestibular, somatic/sensory, cognitive, affective symptoms, and symptom interference. Chi-square tests evaluated the relationship between TBI group ("TBI during deployment only" [n = 6886]; "pre-deployment TBI" [n = 1835]; "post-deployment TBI" [n = 775]; "both pre/post-deployment TBI" [n = 438]) and NSI subscale scores (dichotomized into high vs. low symptoms).There was a significant association between TBI status and all five symptom scores (p's ≤ 0.001; V = 0.04-0.06). The "post-deployment TBI" group endorsed the highest rates of symptoms across all NSI scores except vestibular. Pairwise comparisons showed that the "post-deployment TBI" and "both pre/post-deployment TBI" groups endorsed comparable rates of symptoms, while both groups generally endorsed higher rates of symptoms compared to the "pre-deployment TBI" and "TBI during deployment only" groups. Finally, rates of symptoms among these latter groups (pre-deployment and during deployment) did not differ from each other.Results suggest that post-deployment TBI's have a greater impact on symptom endorsement than pre-deployment TBI's. Findings highlight the importance of evaluating both number and timing of TBI's and the value of providing psychoeducation around brain health to this population.