Abstract
<h3>Research Objectives</h3> To investigate the relative contributions of demographic factors, behavioral health and mood symptoms, and history of mild Traumatic Brain Injury (mTBI) on neuropsychological test performance. <h3>Design</h3> Cross-sectional Study. <h3>Setting</h3> Three VA Polytrauma Network Sites. <h3>Participants</h3> Veterans aged 18 years and older who deployed to Iraq and/or Afghanistan conflicts, and had not received treatment for concussion in the preceding 30 days were eligible for enrollment. Across sites, 454 Veterans were enrolled between August 1, 2010 and September 30, 2011. After excluding Veterans with missing outcome data or with scores below study cutoffs on measures of symptom/performance validity, 250 Veterans remained. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> Cognitive functioning assessed using neuropsychological measures of processing speed, executive functioning, attention, and memory. <h3>Results</h3> Using separate multiple regression models (i.e., one for each neuropsychological measure), examining specified predictor variables (estimated pre-injury IQ scores, demographics, behavioral health ratings, insomnia, alcohol use, pain, positive mTBI history, anxiety, depression, presence of Posttraumatic Stress Disorder), indicate that current mood symptoms and other behavioral health concerns (e.g., pain/sleep) predict objective cognitive performance over and above mTBI history. <h3>Conclusions</h3> Some Veterans presenting to neuropsychology clinics with subjective cognitive complaints attribute these to their prior mTBI. However, many also have commonly co-occurring mood, sleep, and pain concerns which are also known to impact cognition. Our findings suggest that these modifiable factors, rather than mTBI history, likely play a greater role in objective cognitive abilities (i.e., performance on neuropsychological tests). These findings inform ongoing efforts to improve patient education regarding the expected recovery course from mTBI and the relationship between mood and health on daily cognitive efficiency. <h3>Author(s) Disclosures</h3> N/A.
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