Civilian Samples Research Articles

Learning & motivational talk in smoking cessation interventions: An examination of session language in two randomized trials

ObjectivesMotivational Interviewing (MI), a client-centered approach that seeks to evoke and resolve ambivalence, and health education (HE), which provides health information and advice, may both provide some benefit to unmotivated smokers. In HE, it is possible that client language reflective of new learning, or “learning talk” (LT), and rejection of health advice, or “rejection talk,” (RT), may uniquely reflect intent of subsequent behavior change. MethodsThis project utilized MI and HE sessions from two randomized clinical trials (RCTs), one in a low-income, diverse community civilian sample of 255 unmotivated smokers, and the other in a sample of Veterans with mental illness who were unmotivated smokers (n = 55).Mixed methods approaches were utilized to reliably code sessions using the Motivational Interviewing Skill Code 2.5 (MISC 2.5)1 and a refined Learning Talk coding system2. ResultsReliability of LT and RT codes ranged from fair to excellent (ICCs from 0.43–0.93). ConclusionLT appears to be a unique construct and its impact on post-session changes in smoking is warranted. Practice implicationsThis system can be used in a study to code existing interventions for smokers using both MI and HE techniques and relate in-session client LT to subsequent smoking behaviors.

Intolerance of uncertainty on distress and impairment: The mediating role of repetitive negative thinking.

Repetitive negative thinking and intolerance of uncertainty are risk and maintenance factors for emotional disorders. Although emerging evidence suggests that intolerance of uncertainty predicts increases in distress through repetitive negative thinking, these relationships have yet to be investigated among veterans. The present study examines if repetitive negative thinking mediates the relationships of intolerance of uncertainty with stress, disordered symptoms and impairment among a mixed clinical sample of veterans. Two hundred and forty-four treatment-seeking veterans with diagnoses of major depressive disorder, panic disorder, or posttraumatic stress disorder completed measures of intolerance of uncertainty, repetitive negative thinking, stress, impairment, depression, panic, and posttraumatic stress prior to receiving treatment. Mediation models revealed indirect effects of intolerance of uncertainty through repetitive negative thinking on stress and impairment in the full sample, and on disordered symptoms in subsamples with major depressive disorder and posttraumatic stress disorder. Conversely, intolerance of uncertainty did not have direct or indirect effects on disordered symptoms in a panic disorder subsample. Findings suggest that repetitive negative thinking and intolerance of uncertainty uniquely contribute to stress, impairment, and disordered symptoms, but repetitive negative thinking, may, in part, drive intolerance of uncertainty's contribution to emotional disorders. Interventions for repetitive negative thinking might improve the efficacy of existing transdiagnostic treatment protocols. Cross-sectional data is a limitation of the present study. Prospective designs in civilian samples can better establish the temporality of these relationships and if they are generalizable to the larger population.

Effects of mindfulness meditation training offered in-person and via a virtual world on self-compassion: A study with U.S. military active duty and veterans.

Mindfulness-based, in-person programs are effective at reducing stress and enhancing resilience in military and civilian samples, yet few studies have examined or compared training offered via real-time, interactive social media. Such a program would have a wider-reach and could include those unable to attend in-person. There is also interest in resolving ambiguity about the effects of mindfulness training on individual difference variables, such as self-compassion. The purpose of this research was to compare pre/post self-compassion for three interventions; Mindfulness-based Stress Reduction delivered in-person (IP), mindfulness meditation training delivered via a Virtual World (VW), and a wait-list Control Group (CG) among active duty and veteran U.S. military. A 2 (pre/post)×3 (group) factorial design was conducted with 250 active duty and veteran U.S. Military service members, with self-compassion measures as dependent variables. Self Compassion improved 10% for the IP group and 14% for the VW group, while the CG group did not improve. Combined treatment groups yielded a 10.3% improvement in self-compassion compared with no change in the CG and with a group×time interaction effect (p < 0.01). Participants with lower initial self-compassion experienced greater benefits than those with higher baseline self-compassion (p < 0.01). IP and VW Mindfulness Meditation training were equally effective in increasing self-compassion. Adding effective on-line mindfulness delivery will promote self-compassion among a more extensive audience, likely yielding improved coping, confidence, connectedness, cheerfulness, steadiness, and self-satisfaction, while lessening anxiety, fear-of-failure, and stress among participants.

Racial, Ethnic, and Sex Differences in Eating Disorder Onset Among U.S. Military Service Members.

Bulimia nervosa (BN) and binge eating disorder (BED) are the most prevalent eating disorders (EDs) among military personnel. Although sex differences are noted in ED prevalence in military and civilian samples, mixed findings have emerged when evaluating racial and ethnic differences. The present study examined independent associations and interactions between sex, race, ethnicity, and probable BED and BN onset. The sample included 91,413 and 96,245 service members from the Millennium Cohort Study for BED and BN analyses, respectively. Up to four datapoints (from 2001-2013) were used to conduct longitudinal complementary log-log regression analyses, as participants were followed until the outcome occurred or until study completion. BN was more likely among women than men, and no sex difference emerged for BED onset. BN was more likely among Hispanic/Latinx, Multiracial, Black, and Asian/Pacific Islander (API) while BED was less likely among Black and API versus non-Hispanic/Latinx White (NHW) service members. Interactions revealed greater likelihood of BN in Hispanic/Latinx service members was driven by men. Additional efforts are needed amongst racially and ethnically diverse groups in preventing and detecting EDs in military personnel. Future intersectionality research could elucidate systemic inequities and other contributing factors to ED onset to inform prevention and treatment efforts.

Development of the complex trauma screener: A brief measure of ICD-11 PTSD and complex PTSD

The purpose of this study was to develop the Complex Trauma Screener (CTS), a brief screener (seven items) of the ICD-11 trauma disorders that can be used in “quick-paced” facilities. We examined the factor structure of the CTS in two separate samples: civilian college students (N = 823) and military veterans (N = 130) who reported exposure to at least one traumatic event. Confirmatory factor analyses (CFAs) supported two highly-correlated factors (post-traumatic stress disorder [PTSD] and Disturbances in Self-Organization [DSO]) that loaded on the ICD-11-consistent items. The model fit indices indicated good to excellent model fit in both samples, and the internal consistencies for the scales were borderline to good (α = 0.68–0.86). Supplementary analyses supported the gender invariance of the CFA model in the civilian student sample, as well as convergent (with another trauma inventory) and discriminant validity (with borderline disorder features, depression, and mania) of the CTS in both samples. The CTS is, to our knowledge, the shortest instrument designed to measure the ICD-11 trauma disorders and is ideal for “fast-paced” facilities that have significant assessment time restraints. The CTS is, therefore, is a psychometrically-validated instrument that can help mental health professionals efficiently screen adults for ICD-11 trauma disorders.

Measuring civilian moral injury: Adaptation and validation of the Moral Injury Events Scale (Civilian) and Expressions of Moral Injury Scale (Civilian).

Moral injury (MI) research has been expanded to populations beyond the military in recent years. A key barrier to further research into MI in civilian populations is the lack of valid, reliable measures of the construct appropriate for general civilian use. This article addresses this barrier by adapting two existing military measures and exploring their psychometrics in a general civilian sample: the Moral Injury Events Scale-Civilian (MIES-C) and Expressions of Moral Injury Scale-Military (EMIS-C). A sample of civilian women (n = 192) and men (n = 88) completed the above measures, and additional scales designed to capture theoretically supported primary and secondary markers of MI (guilt, shame, anger; depression, posttraumatic stress symptoms, anxiety). Confirmatory factor analyses found that the factor structure of the MIES-C and EMIS-C replicated well within our civilian sample. Discriminant validity was indicated through a significant negative correlation with well-being. Both measures correlated as predicted with each other and measures of MI markers at the total score level. Correlations of individual subscales with each of these measures were more varied. Results shed light on differential relationships between the type of MI event and clinical outcomes, suggesting some conceptual differences in how MI is experienced in general civilian populations. Results suggest that civilian populations are also susceptible to MI, but that existing measures may have problems capturing this effectively. While the MIES-C and EMIS-C are supported for civilian use, further scale construction efforts for this population are warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Attitudes towards women in the military and their relation to both quantity and quality contact with female leaders.

Contact experiences with women in senior leadership roles are important for creating acceptance of women in organizations dominated by men, such as the military, as leadership roles are considered demanding, requiring numerous agentic qualities that are often ascribed to men. The military lacks women in leadership levels within its organization. We wished to determine whether quality and quantity contact with women in leadership positions reduces intergroup anxiety, increases empathy and perspective-taking, and subsequently creates more favorable attitudes toward women in the military. This was examined in three studies, one with a military sample consisting of men (n = 95), another with a civilian sample of men (n = 367), and a third study with a civilian sample of women (n = 374). Our findings revealed that quality contact was related to attitudes toward women in the military for all three samples. Results from the indirect effects tests conducted for the civilian male and female samples revealed that for civilian men, intergroup anxiety demonstrated a significant indirect effect between quantity contact and attitudes toward women in the military, while both intergroup anxiety and perspective-taking demonstrated significant indirect effects between quality contact and attitudes toward women in the military. Furthermore, both quantity and quality contact demonstrated significant direct effects. On the other hand, results revealed that for civilian women the only significant relation was the direct effect between quality contact and attitudes toward women in the military. Intergroup anxiety, perspective-taking, and empathy did not demonstrate any indirect effects for the civilian women sample. Thus, given that interactions with women in leadership positions are related to views of women in the military, research should further explore the role of contact for women in non-traditional work roles.

Trauma, psychopathic traits, and mental health outcomes: A propensity score matching approach between service member and civilian samples.

Trauma, psychopathic traits, and mental health outcomes: A propensity score matching approach between service member and civilian samples.

The Intersection between Alcohol use and Sexual Activity among Young Adult Male U.S. Service Members.

The current study explores drinking habits, preferences for alcohol use before sexual activity, and alcohol-related sexual behavior among young adult male active duty service members in the United States. Hazardous alcohol use is a significant problem among United States military service members. Whereas the association between alcohol use and sexual assault is well documented in civilian samples, less is known regarding the intersection of alcohol use and sexual activity among soldiers. Descriptive statistics were utilized to summarize drinking habits, preferences for alcohol use before sexual activity, and alcohol-related sexual behavior. A sample of 338 active-duty male service members between the ages of 18 and 24 were recruited from a large military post in the Southeastern United States. Constructs were assessed using self-report surveys. Participants reported consuming alcohol, on average, 5.6 times over the prior month. Average alcohol consumption was reported to be 7.8 beverages per drinking occasion. Participants reported engaging in heavy drinking an average of 2.9 times over the past 30 days. On average, service members reported a preference for 1.3 drinks before sexual activity. Furthermore, 75.2% of participants preferred to be sober during sex, and 82.1% preferred to engage in sexual activity with a sober partner. Approximately 14% of the sample reported using alcohol to improve their chances of having sex. These findings highlight high rates of alcohol use among soldiers. Nonetheless, young adult male soldiers report a preference for sexual activity while sober. Understanding the co-occurrence of alcohol use and sexual activity has the potential to inform the development of integrated alcohol and sexual assault prevention programs for service members.

Investigating Relations Between the Symptoms of Panic, Agoraphobia, and Suicidal Ideation: The Significance of Comorbid Depressive Symptoms in Veterans with Panic Disorder.

Although panic disorder has been frequently associated with increased suicidal ideation and behaviors, there are multiple explanations for this association in the literature. For example, some research has demonstrated panic disorder symptoms to mediate agoraphobia and suicidal ideation, while other researchers have hypothesized that comorbid depression symptoms contribute to suicidal ideation across anxiety disorders. Of note, none of these studies were completed in veterans, a population at higher risk for suicide relative to civilian samples. The present study investigated relations between the symptoms of panic, agoraphobia, depression, and suicidal ideation in 58 veterans diagnosed with panic disorder via correlations, hierarchical regression, and exploratory path analyses. Multiple models were investigated based on prior research. The final path model demonstrated that symptoms of panic disorder predicted agoraphobia symptoms, with agoraphobia predicting symptoms of depression. Symptoms of depression, then, predicted suicidal ideation. Discussion of the findings related to comorbid depressive symptoms highlight considerations for the assessment and treatment practices for panic disorder, with a particular focus on veterans receiving care within Veterans Affairs Healthcare System.

Scoping review of return-to-work interventions for persons with traumatic brain injury

Purpose The study approach sought to understand which vocational rehabilitation (VR) strategies are available for individuals seeking return to work (RTW) following traumatic brain injury (TBI). Secondly, the review aimed to identify how these RTW interventions and outcomes are evaluated. Materials and Methods Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, the scoping review began by identifying relevant English language articles via PubMed, CINAHL, PsycINFO, and Embase databases for peer-reviewed journal articles published from January 2013 to September 2021. The review focused on identifying studies with a sample population of people with moderate to severe TBI. Results A total of 23 studies met the search criteria. For each included study, the following data were extracted: (a) country of origin, (b) sample size, (c) civilian or military sample population, (d) age, (e) participant gender, (f) RTW definition, (g) intervention approach, and (h) RTW outcome. The results were synthesized by placement into one of four categories as a function of the study’s underlying methodological approach Conclusions The development of effective RTW approaches has largely been neglected in the rehabilitation literature for persons with TBI in civilian and military populations. Effective strategies do exist to help guide efforts to return this population to productive activity, including work. Implications for Rehabilitation Lack of productive engagement in work and school among persons with traumatic brain injury (TBI) presents a chronic challenge in rehabilitation systems internationally. Rehabilitation professionals should utilize multidisciplinary and integrated return-to-work (RTW) interventions given the varied areas of function that can result from TBI. Rehabilitation professionals should apply RTW interventions that promote on-site training and workplace integration. Given the idiosyncratic nature of TBI, RTW interventions should be tailored to meet the specific needs of the person seeking support.

Symptoms and Engagement in Anti-social Behavior 10 Years After Mild Traumatic Brain Injury Within a Community Civilian Sample: A Prospective Cohort Study With Age-Sex Matched Control Group

ObjectiveTo determine if there are longer-term effects on symptoms, health status, mood, and behavior 10 years after a mild traumatic brain injury (mTBI). DesignProspective cohort study. SettingCommunity-based, civilian sample. ParticipantsAdults aged ≥16 years at follow-up who experienced an mTBI 10 years ago, and an age and sex-matched non-injured control group. InterventionsNot applicable. Main Outcome MeasuresmTBI cases and controls were asked to complete self-report assessments of functioning (WHO Disability Assessment Schedule Version 2), symptoms (Rivermead Post-Concussion Symptom Questionnaire), health status (100-point scale), alcohol (Alcohol Use Disorders Identification Test) and substance use (Alcohol, Smoking and Substance Involvement Screening Test), and whether they had engaged in any anti-social behaviors over the past 12 months. ResultsData were analyzed for 368 participants (184 mTBI cases and 184 age-sex matched controls). Just over a third of mTBI cases (64, 34.8%) reported that they were still affected by their index mTBI 10 years later. After adjusting for education and ethnicity, the mTBI group had statistically higher overall symptom burden (F=22.32, P<.001, ηp2=0.07) compared with controls. This difference remained after excluding those who experienced a recurrent TBI. The mTBI group were more than 3 times as likely to have engaged in anti-social behavior during the previous 12 months (F=5.89, P=.02). There were no group differences in health status, functioning, or problematic alcohol or substance use 10 years post-injury. ConclusionsThis study provides evidence of potential longer-term associations between mTBI, post-concussion symptoms, and anti-social behavior which warrants further evaluation. Future research should also examine if longer-term effects may be preventable with access to early rehabilitation post-injury.

War trauma impacts in Ukrainian combat and civilian populations: Moral injury and associated mental health symptoms

ABSTRACT This is the first study to compare active-duty soldiers and student civilian samples during the first three months of the Ukrainian-Russian war in relation to moral injury and its association with PTSD, anxiety and depression. A total of 350 participants, including 191 active-duty soldiers of the Ukrainian Armed Force (UAF), who were on the frontline during the full-scale invasion of Russian troops in February 2022, and 159 students from different HEIs in Volyn oblast, were recruited into the study through their attendance at the Ukrainian Psychotrauma Center. Prior to the in-person group-intervention program of psychosocial support for military and civil populations at the Ukrainian Psychotrauma Center, moral injury, PTSD, depression, and anxiety were assessed. Results showed significantly higher moral injury, PTSD, depression, and anxiety scores in civilian students, with a two-way ANOVA indicating a significant impact of female gender in civilians only. A hierarchical regression indicated that moral injury is a predictor of PTSD symptoms in both active-duty and civilian student groups. However, previous family trauma of genocide is associated with PTSD symptoms in active soldiers only. The findings of the current study could contribute insights for clinical practice for combatants and civilians during the current war.

Investigating the latent structure of the International Trauma Questionnaire to assess ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD in an adult civilian sample during the Ukraine war.

The symptom structure of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) and the validity of the International Trauma Questionnaire (ITQ) are yet to be tested among civilians in an active war zone. The present investigation examined the factor structure of the ITQ, the internal consistency of observed scores, and their associations with demographic characteristics and war-related experiences using a nationwide sample of 2,004 adults from the general population of Ukraine approximately 6 months after the full-scale Russian invasion in 2022. Overall, rates of endorsement across all symptom clusters were high. The mean total number of war-related stressors reported was 9.07 (SD = 4.35, range: 1-26). Internal reliability was good for all six ITQ subscales, Cronbach's αs = .73-.88, and the correlated six-factor model was found to provide the best representation of the latent structure of the ITQ in the present sample based on fit indices. There was evidence of a dose-response relationship, with increasing scores on all symptom clusters associated with higher total reported war-related stressors.

Overlap of relationship distress and intimate partner violence in community samples.

Mixed-gender couples presenting for couple therapy are at 2-3 times higher risk for physical intimate partner violence (IPV) than community couples. However, it is unclear if this elevation of relative risk is the same in the general population because relationship distress and treatment-seeking are often confounded. We used archival data from three representative U.S. civilian samples and one representative U.S. Air Force sample to test the hypothesis that clinically significant relationship distress is associated with increased risk of various forms of IPV. In these community samples, those in mixed-gender distressed relationships were at 2-3 times higher risk than those in nondistressed relationships for any physical IPV during the past year and at 3-6 times higher risk for clinically significant psychological and physical IPV during the past year. Given that the increase in IPV risk is similar for individuals in distressed community relationships and therapy-seeking relationships, the prior findings of the elevated rates of IPV in clinical samples are unlikely to be due to therapy-seeking. Although epidemiological risk involves statistical, not causal, associations, the increased co-occurrence of IPV in distressed mixed-gender couples fits with numerous theories of IPV and has implications for both screening and future research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Family Cohesion and Relationship Quality in Defence Force Families: Rapid Review

Objective: Retention of serving members in the military may be increased through targeted psycho-social support of their families and dependents. This Defence funded study aimed to provide updated evidence on associations between current military service and the well-being of the member’s couple and relationships, to inform policy and practice. We conducted a rapid review of family and couple relationship qualities, comparing current serving samples with civilian, never-serving families. Method: We followed the Cochrane Rapid Review Method, searching publications from 2000. Outcomes were limited to modifiable factors of importance for policy related decision-making. Results: Four search strategies were constructed in Medline, PsycINFO, CINAHL and Cochrane CENTRAL. The review, in two parts, identified over 15,000 articles, of which only seven met the review criteria. The dearth of research identified reflected predominant focus on veteran rather than currently serving samples, and absence of comparison to a civilian group. We therefore also examined individual studies that closely approximated the inclusion criteria. Conclusions: The collated evidence offered four main findings: 1) A significant decrease in marital satisfaction for men and women with progressing stages of deployment; 2) Consistently higher prevalence of intimate partner violence for military versus civilian samples, growing with length of deployment, and mediated by histories childhood abuse or neglect; 3) Increased risk of psychological distress and problematic alcohol use by spouses of serving members, and 4) Barriers to engagement in therapeutic programs for military couples. Practice implications for screening and policy implications for targeted prevention efforts are discussed.

Gender differences in nightmare characteristics following trauma

Gender is one of the well-recognized risk factors for idiopathic nightmares, but rarely connected to posttraumatic nightmare characteristics. Thus, this study aims to test gender differences in (posttraumatic) nightmare characteristics after controlling for trauma-related psychopathology in a large sample of people who experienced trauma. Research participants were 707 soldiers (mean age 31.3 years, 19.5% women) admitted to a hospital-based treatment program for veterans who completed extensive assessments consisting of clinical interviews and self-rating measures with respect to socio-demographic characteristics and psychopathology, as well as dream-related variables. Results indicate no gender differences with respect to nightmare frequency, psychophysical and emotional involvement, reorientation, and dream recall after awakening. Differences between men and women in the amount of replicative content are fully, and in case of nightmare related impairment, explained mainly by the presence of PTSD diagnosis, nightmare frequency, and age. This study questions the significance of gender as a risk factor or predictor of specific (posttraumatic) nightmare characteristics in traumatized and military samples. Further research needs to test if our findings are restricted to military contexts or can be generalized to civilian samples.

Prevalence and correlates of alcohol-induced blackout in a diverse sample of veterans.

Alcohol-induced blackouts have been associated concurrently and prospectively with alcohol-related harm. Although rates of heavy drinking among military samples tend to be comparable or higher than rates among civilian samples, the prevalence and correlates of blackout in the military population are understudied. Veterans (N=241, 29% female, 39% Black) reported on their alcohol consumption and mental health as part of a larger health-related study among veterans. In this secondary analysis, we tested theoretically and empirically informed predictors (gender, drinking quantity, and other drug use) and consequences [depression, posttraumatic stress disorder (PTSD)] of alcohol-induced blackout. Given the diversity of the sample, potential roles of racial/ethnic discrimination and drinking to cope in alcohol-induced blackout were also tested. Past-year prevalence of alcohol-induced blackout was 53% among veterans who drank alcohol and 68% among those who screened positive for hazardous drinking. Everyday experience of racial discrimination was the strongest concurrent predictor of alcohol-induced blackout. Drinking quantity and use of other drugs were significant correlates only in bivariate models. Controlling for gender, race, drinking quantity, other drug use, and discrimination, blackout frequency was significantly associated with symptoms of depression, but not symptoms of PTSD. Both blackout and racial discrimination were associated with drinking to cope. The prevalence and correlates of alcohol-induced blackout among veterans are largely consistent with those documented in civilian and young adult populations. Among racially diverse groups, racial discrimination may be more strongly associated with mental health symptoms than alcohol consumption or acute alcohol consequences such as blackout.

Shooter biases and stereotypes among police and civilians

The present research assesses potential correlates of discriminatory police behavior, comparing police and civilian participants in a first person shooter task (FPST) as well as on various self-report measures of intergroup contact, intergroup attitudes, and ideological beliefs in three preregistered studies. Study 1 (N = 330), using a FPST with a short response window (630 ms), did not observe shooter biases in reaction times, error rates and signal detection parameters in neither police nor civilian participants. Study 2a (N = 290), using a longer response window (850 ms), observed a shooter bias in reaction times, error rates, and response criterion in both civilian and police participants. These shooter biases were largely driven by faster reactions, fewer errors, and more liberal shoot decisions for armed Arab (vs. White) targets. Study 2b (N = 191; 850 ms response window) closely replicated shooter biases in reaction times, error rates, and response criterion in a sample of civilian online participants. Across studies, we observed similar results in the shooter task for police and civilian samples. Furthermore, both police and civilian participants expressed anti-Muslim and anti-Arab attitudes across a variety of self-report measures. However, compared to civilians, police participants reported higher levels of anti-Muslim attitudes on some measures as well as higher levels of social dominance orientation, which might pose additional risk factors for discriminatory behavior. Lastly, while we observed reliable individual differences in self-reported intergroup attitudes, ideologies, and intergroup contact, none of these characteristics correlated with shooter biases.

Comparison of veterans affairs and NIDILRR traumatic brain injury model systems participants with disorders of consciousness

ABSTRACT Objective To characterize demographic, pre-injury, and outcome data within the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) and Veterans Affairs (VA) Traumatic Brain Injury Model Systems (TBIMS) cohorts with severe traumatic brain injury (TBI) with no command-following ability at time of admission to acute rehabilitation. Design Retrospective cohort. Setting NIDILRR and VA TBI Model Systems (TBIMS) centers. Participants 396 NIDILRR and 72 VA participants without command-following ability who experienced TBI with subsequent Disorder of Consciousness (DoC). Main Outcome Measure Pre-injury and injury characteristics, rehabilitation outcomes, and 1-year self-reported outcomes. Results VA TBIMS cohort included individuals who were active duty or had military service before their injury. The VA cohort were more likely to be re-hospitalized at 1-year follow-up or residing in a long-term care or rehab setting. The NIDILRR TBIMS cohort had higher FIM and DRS scores at rehabilitation discharge, while the VA participants saw longer lengths of stay and higher numbers of “violent” injury types. Conclusions This study allows for a better understanding of the comparability between VA and NIDILRR DoC cohorts providing guidance on how veteran and civilian samples might be merged in future TBIMS studies to explore predictors of recovery from a DoC.