Objective: Mild traumatic brain injury (TBI) that occurs in a deployment environment is characteristically different from mild TBI that occurs outside of deployment. This study evaluated differential and interaction effects of deployment and nondeployment mild TBI on cognitive and behavioral health outcomes. Research Method: Combat veterans (N = 293) who passed performance-validity measures completed the Mid-Atlantic MIRECC Assessment of TBI (MMA-TBI), Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale (CAPS-5), a neuropsychological assessment battery, and self-report questionnaires. A 2 × 2 × 2 analysis of variance (ANOVA) was conducted to evaluate the main and interaction effects across mild TBI groups and PTSD diagnosis. Results: Deployment TBI was associated with poorer outcomes on several cognitive tests: Wechsler Adult Intelligence Scale, 4th edition (WAIS-IV); Working Memory Index (WMI; p = .018); Trail Making Test A (TMT-A; p < .001); and Trail Making Test B (TMT-B; p = .002). Deployment TBI and PTSD were also associated with increased PTSD, depressive, and neurobehavioral symptoms; pain interference; and poorer sleep quality. Nondeployment TBI had no effect on cognitive performance and was associated only with poorer sleep quality. PTSD had the strongest associations with symptom measures and deployment TBI with cognitive outcomes. There were no significant interaction effects after adjusting for multiple comparisons. Conclusions: Remote outcomes associated with mild deployment TBI are different from those associated with nondeployment mild TBI and are robust beyond PTSD. This suggests that the environment surrounding a TBI event influences cognitive and symptom sequelae. Veterans who experience mild TBI during deployment may report changes in cognition, but most will continue to function within the expected range. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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部署和非部署轻度 TBI 对神经心理学结果的不同影响。

目的：部署环境中发生的轻度创伤性脑损伤 (TBI) 与部署之外发生的轻度 TBI 有着明显的不同。本研究评估了部署和非部署轻度 TBI 对认知和行为健康结果的差异和相互作用影响。研究方法：通过绩效有效性测量的退伍军人 (N = 293) 完成了中大西洋 MIRECC TBI 评估 (MMA-TBI)、临床医生管理的创伤后应激障碍 (PTSD) 量表 (CAPS-5)、神经心理学评估电池和自我报告问卷。进行 2 × 2 × 2 方差分析 (ANOVA)，以评估轻度 TBI 组和 PTSD 诊断的主要效应和交互效应。结果：部署 TBI 与多项认知测试的较差结果相关：韦克斯勒成人智力量表，第四版 (WAIS-IV)；工作记忆指数（WMI；p = .018）；试验 A（TMT-A；p < .001）；和越野测试 B (TMT-B；p = .002)。部署性 TBI 和 PTSD 也与 PTSD、抑郁和神经行为症状的增加有关；疼痛干扰；以及睡眠质量较差。非展开性 TBI 对认知能力没有影响，仅与较差的睡眠质量相关。PTSD 与症状测量和部署 TBI 与认知结果的关联最强。调整多重比较后没有显着的交互作用。结论：与轻度部署 TBI 相关的远程结果不同于与非部署轻度 TBI 相关的远程结果，并且在 PTSD 之外具有稳健性。这表明 TBI 事件周围的环境会影响认知和症状后遗症。在服役期间经历轻度创伤性脑损伤的退伍军人可能会报告认知发生变化，但大多数人将继续在预期范围内发挥作用。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。