Characterization of Lifetime TBIs in a Cohort of Recently Deployed Soldiers: The Warrior Strong Study

Objective: To describe and characterize the lifetime history of traumatic brain injury (TBI) among active duty soldiers returning from deployment to Afghanistan or Iraq. Method: Data were extracted from a larger parent study that was conducted at two large United States Army bases between 2009 and 2014 during Post-Deployment Health Assessment. The sample included 1,060 soldiers who sustained at least one TBI during their lifetime. Results: The Ohio State University TBI-Identification Method interview was administered to characterize individuals' total lifetime history of TBI. Soldiers reported sustaining a median of 2 lifetime TBIs. Slightly more than half of the sample without a most recent deployment-related TBI still reported a history of a lifetime TBI (some of which occurred during previous deployments). Most lifetime injuries reported were of mild severity; however, 6% of individuals reported a history of moderate/severe TBI. Blast was the most frequent mechanism associated with recent deployment-related mild TBIs. Conclusion: Findings suggest that soldiers who screened positive, as well as those who screened negative, for a history of TBI during their recent deployment still endorsed a lifetime history of TBI. Future research is needed to explore the functional impact of multiple TBIs over one's lifetime to help inform screening, assessment, and treatment among military personnel. Impact and Implications Although soldiers in this sample mostly reported mild traumatic brain injuries (TBIs), 6% of individuals reported lifetime moderate to severe TBIs. Moreover, a number of soldiers reported a history of nondeployment TBIs. A history of such injuries may contribute to persistent post-TBI symptoms, as well as postmilitary functional challenges. Additional research to investigate the timing, severity, and history of multiple TBIs on short- and long-term outcomes is indicated.