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Aggression in Military Members With Mild Traumatic Brain Injury and Post-Traumatic Stress Disorder Is Associated With Intimate Partner Health-Related Quality of Life

  • Tracey A. Brickell
    Correspondence
    Correspondence to: Tracey A. Brickell, DPsych, Scientific Director, DVBIC-TBICoE 15-Year Longitudinal TBI Study, Contractor, General Dynamics Information Technology, Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Building 51, Room 1502B, 4954 N Palmer Rd, Bethesda, MD 20889. Phone: (301) 400-1872.
    Affiliations
    Department of Research, Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland

    Department of Research, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland

    F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland

    Department of Research, General Dynamics Information Technology, Silver Spring, Maryland
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  • Louis M. French
    Affiliations
    Department of Research, Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland

    Department of Research, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland

    F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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  • Megan M. Wright
    Affiliations
    Department of Research, Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland

    Department of Research, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland

    Department of Research, General Dynamics Information Technology, Silver Spring, Maryland
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  • Rael T. Lange
    Affiliations
    Department of Research, Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland

    Department of Research, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland

    Department of Research, General Dynamics Information Technology, Silver Spring, Maryland

    Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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      Abstract

      Objective

      We aimed to examine the relationship between service member/veteran (SMV) aggression and health-related quality of life (HRQOL) in their intimate partners.

      Methods

      This prospective cohort study included 201 female intimate partner caregivers of post-9/11 male SMVs with a diagnosis of uncomplicated mild traumatic brain injury and post-traumatic stress disorder from a military treatment facility. Caregivers completed 17 HRQOL measures and rated the level the SMV experiences problems with verbal or physical expressions of irritability, anger, or aggression on the Mayo–Portland Adaptability Inventory, 4th edition. Caregivers were classified into three SMV Aggression groups: i) none or very mild (n = 53); ii) mild (n = 47); and iii) moderate or severe (n = 101). HRQOL scores were classified as clinically elevated using a cutoff of 60T or higher.

      Results

      Using χ2 analysis, the moderate or severe group had a significantly higher proportion of clinically elevated scores on 15 HRQOL measures compared with the none or very mild group, and six measures compared with the mild group. The mild group had higher scores on two measures compared with the none or very mild group. Using analysis of covariance (and controlling for caregiver strain), the moderate or severe group had significantly higher scores on 11 HRQOL measures compared with the none or very mild group, and two measures compared with the mild group. The mild group had higher scores on five measures compared with the none or very mild group.

      Conclusions

      Many caregivers who report moderate to severe SMV aggression after a traumatic brain injury report poor HRQOL beyond the strain of care provision. Traumatic brain injury and post-traumatic stress disorder programs should screen for and treat SMV aggression and attend to the health needs of SMVs’ caregivers.
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      Biography

      Tracey A. Brickell, DPsych, is the Scientific Director of the Caregiver and Family Member Study, part of the Defense and Veterans Brain Injury Center (DVBIC)-Traumatic Brain Injury Center of Excellence (TBICoE) 15-Year Longitudinal TBI Study (Sec721 NDAA FY07) at Walter Reed National Military Medical Center (WRNMMC), Maryland, USA.

      Biography

      Louis M. French, PsyD, is the Deputy Director for Operations at the National Intrepid Center of Excellence at WRNMMC and Site Director for the TBICoE at WRNMMC, Maryland, USA.

      Biography

      Megan M. Wright, MA, is the Research Management Coordinator for the DVBIC-TBICoE 15-Year Longitudinal TBI Study (Sec721 NDAA FY07) at WRNMMC, Maryland, USA.

      Biography

      Rael T. Lange, PhD, is the Scientific Director of the Natural History of TBI Study, part of the DVBIC-TBICoE 15-Year Longitudinal TBI Study (Sec721 NDAA FY07) at WRNMMC, Maryland, USA.