Factors Associated With Recovery From Posttraumatic Stress Disorder in Combat Veterans: The Role of Deployment Mild Traumatic Brain Injury (mTBI)

Impact and Implications Veterans who have recovered from posttraumatic stress disorder (PTSD) show less severe neurobehavioral and depressive symptoms, better sleep quality, less functional pain interference, and higher quality of life. No significant differences were generally found in cognitive functioning between those who have recovered from PTSD and those who have not. Findings highlight the importance of PTSD treatment in combat veterans, as reduction in PTSD symptoms may correspond with better sleep quality, less severe psychiatric symptoms, and improved functional outcomes. Among veterans with history of deployment mild traumatic brain injury (mTBI), those who have recovered from PTSD displayed better cognitive functioning on tests of processing speed than those who have not (although effect sizes were small to medium). This finding underscores the importance of targeting PTSD symptoms when addressing behavioral health concerns in veterans with history of deployment mTBI, as resolution of PTSD symptoms may correlate with improved cognitive functioning in some domains. Objective: Examine factors associated with recovery from posttraumatic stress disorder (PTSD) and evaluate the role of deployment mild traumatic brain injury (mTBI) in the relationship between PTSD recovery and functional outcomes. Method: Post 9/11 combat veterans with lifetime history of PTSD (N = 124, 84.7% male) completed the Mid-Atlantic MIRECC Assessment of Traumatic Brain Injury (MMA-TBI), Salisbury Blast Interview (SBI), Clinician Administered PTSD scale (CAPS-5), cognitive assessment battery, and measures of depression, PTSD symptoms, neurobehavioral symptoms, sleep quality, pain interference, and quality of life. Results: Analyses of variance (ANOVA) results revealed significant differences in most behavioral health outcomes based on PTSD recovery, with participants who have recovered from PTSD showing less severe neurobehavioral and depressive symptoms, better sleep quality, less functional pain interference, and higher quality of life. No differences were found in cognitive functioning between those who have recovered from PTSD and those who have not. History of deployment mTBI did not significantly moderate the relationship between PTSD recovery and most functional and cognitive outcomes with the exception of 2 measures of processing speed. Specifically, among participants with history of deployment mTBI, those who have recovered from PTSD displayed better cognitive functioning than those who have not. Additionally, participants who have not recovered from PTSD had higher levels of blast exposure during military service. Conclusions: PTSD recovery was associated with better psychological functioning and higher quality of life, but not with objective cognitive functioning. Deployment mTBI history moderated only the relationship between PTSD recovery status and tests of processing speed.