Chronicity of Posttraumatic Stress Disorder Symptoms Following Traumatic Brain Injury: A Comparison of Special Operators and Conventional Forces.

Abstract

Background: Special Operations Forces (SOF) have become the solution to many of the United States military challenges due to their ability to conduct time sensitive, clandestine, and high-risk missions. Historically, SOF were assumed to be resilient to the psychological sequelae of war, including posttraumatic stress disorder (PTSD). However, the objective burden of PTSD in SOF, particularly after traumatic brain injury (TBI), remains unknown. This study compared average PTSD symptoms over time between SOF and Conventional Forces (CF) who had sustained a TBI.

Methods: This prospective cohort study examined Servicemembers and Veterans admitted to one of five Veterans Affairs Polytrauma Rehabilitation Centers for TBI. Propensity score matching created matched samples of 205 SOF and 205 CF. The PTSD Checklist-Civilian version (PCL-C) measured PTSD symptoms at admission and 1, 2, 5, and 10 years post TBI.

Results: In a longitudinal mixed-effects model of PTSD symptoms over time grouped by TBI severity, SOF and CF had similar severity and patterns of PTSD symptoms. SOF and CF with mild TBI had more PTSD symptoms across all time points compared to those with moderate and severe TBI.

Conclusion: The evolution and severity of PTSD symptoms after TBI in SOF and CF were similar. While SOFs had higher resilience compared to CFs in previous work, SOFs are not impervious to trauma exposure and PTSD. Increasing awareness of PTSD prevalence and consequences is needed to serve SOF. Identifying those needing care and providing evidence-based PTSD treatments can have the downstream effects of reducing attrition from the service and maintaining military readiness.