Senior Scientist HJF, supporting Uniformed Services University
Abstract Text: Service members who have sustained combat head injuries face higher risks of PTSD, anxiety, depression, and adjustment disorders. Despite these known associations, prospective and longitudinal data are needed to better understand the relationship between head injury and mental health outcomes. Reported associations between concussion risk factors and psychological health measures suggest that these factors (i.e., sport history, concussion history) may also be predictive of depression, anxiety, and somatization symptoms. The military has long been concerned with psychological factors impacting military performance, including concerns that military cadets may be at risk for developing depression and anxiety due to military training demands. While the role of risk factors such as prior concussion and female sex are relatively clear, associations with anxiety and depression are less clear and consistent, particularly in trying to elucidate the role of pre-morbid conditions and post-injury symptoms. This project uses Concussion Assessment, Research and Education (CARE) Consortium longitudinal data, concussion recovery patterns, and associations with baseline mental health surveys to identify risk factors for depression, somatization, anxiety, and suicidal ideation as measured by the baseline Brief Symptom Inventory-18 (BSI-18) in service academy cadets and midshipmen. We hypothesized that cadets and midshipmen entering the military service academies with more prior concussions, younger age at first exposure to contact/collision sport activity, and/or more years of exposure to contact/collision sports, will have higher scores on their BSI-18 at baseline and post-injury follow-up assessments. We will conduct correlational analyses to compare overall BSI baseline scores with age, age of first exposure, and years of exposure to contact/collision sports, and we will conduct one-way analysis of variance (ANOVA) to compare BSI scores with concussion history (absent vs. present). Next, a multiple regression analysis will be conducted to compare effects across the hypothesized risk factors. Finally, association patterns across specific mental health domains of depression, somatization, anxiety, and suicidal ideations and the hypothesized risk factors will be compared. The results will also be considered in light of whether the expected patterns hold across subgroups (e.g., men vs. women). These findings are expected to highlight the importance of considering whether and to what degree predictors of baseline mental health also influence concussion recovery patterns and track with concussion history over time.
Disclosures: The views expressed herein are those of the authors and do not reflect the official policy of The Henry M. Jackson Foundation, or of the Department of Army/Navy/Air Force, Department of Defense, or U.S. Government. The opinions and assertions expressed herein are those of the authors and do not necessarily reflect the official policy or position of the Uniformed Services University or the Department of Defense.
Keywords: depression, anxiety, mental health, risk factors, military service academies
