 |
|
Neuropsychological Outcomes of Army Personnel Following Deployment to the Iraq War
Jennifer J. Vasterling, PhD;
Susan P. Proctor, DSc;
Paul Amoroso, MD, MPH;
Robert Kane, PhD;
Timothy Heeren, PhD;
Roberta F. White, PhD
JAMA. 2006;296:519-529.
Context The effects of war-zone deployment on neuropsychological health remain poorly understood. Neuropsychological performance deficits serve as sensitive measures of neural dysfunction and are often associated with psychosocial and occupational problems. Previous studies have not conducted objective neuropsychological assessments both before and after a major war-zone deployment.
Objective To examine objective neuropsychological outcomes of Iraq War deployment in a large military cohort.
Design, Setting, and Participants The Neurocognition Deployment Health Study, a prospective, cohort-controlled study conducted at military installations. This report centers on 961 male and female active-duty Army soldiers drawn from the larger cohort. Deploying Army soldiers (n = 654) were examined prior to deployment to Iraq (April-December 2003) and shortly after return (within a mean of 73 days [median, 75 days]; January-May 2005) from Iraq deployment. A comparison group of soldiers (n = 307) similar in military characteristics but not deploying overseas during the study was assessed in sessions timed to be as close as possible to the assessment of deployers. Military unit sampling procedures facilitated representation of combat, combat support, and combat service support functions among both deployers and nondeployers.
Main Outcome Measures Individually administered, performance-based neuropsychological tasks. Estimates ( ; the unstandardized parameter estimate) for the absolute differences in adjusted mean outcome scores between deployed and nondeployed groups were determined using generalized estimating equations.
Results Multiple linear regression analyses adjusted for battalion membership revealed that Iraq deployment, compared with nondeployment, was associated with neuropsychological compromise on tasks of sustained attention ( = 0.11; P<.001), verbal learning ( = –1.51; P = .003), and visual-spatial memory ( = –3.82; P<.001). Iraq deployment was also associated with increased negative state affect on measures of confusion ( = 1.40; P<.001) and tension ( = 1.24; P<.001). In contrast, deployment was associated with improved simple reaction time ( = 4.30; P = .003). Deployment effects remained statistically significant after taking into account deployment-related head injury and stress and depression symptoms.
Conclusions Deployment to Iraq is associated with increased risk of neuropsychological compromise. Findings point to the need to investigate further the impact of deployment on neural functioning. Public health implications include consideration of neuropsychological compromise in health prevention and postdeployment clinical and occupational management.
Author Affiliations: Southeast Louisiana Veterans Health Care System and Tulane University School of Medicine, New Orleans (Dr Vasterling); VA Boston Healthcare System and Boston University School of Public Health, Boston, Mass (Drs Proctor, Heeren, and White); US Army Research Institute of Environmental Medicine, Natick, Mass (Dr Proctor); Madigan Army Medical Center, Fort Lewis, Wash (Dr Amoroso); and VA Maryland Health Care System and University of Maryland School of Medicine, Baltimore (Dr Kane).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Association of Time Since Deployment, Combat Intensity, and Posttraumatic Stress Symptoms With Neuropsychological Outcomes Following Iraq War Deployment
Marx et al.
Arch Gen Psychiatry 2009;66:996-1004.
ABSTRACT
| FULL TEXT
Exploring the Convergence of Posttraumatic Stress Disorder and Mild Traumatic Brain Injury
Stein and McAllister
Am. J. Psychiatry 2009;166:768-776.
ABSTRACT
| FULL TEXT
A Preliminary Investigation of Mental Health Needs and Barriers to Mental Health Care for Female Veterans of Iraq and Afghanistan
Owens et al.
Traumatology 2009;15:31-37.
ABSTRACT
Suicide Among Incarcerated Veterans
Wortzel et al.
J Am Acad Psychiatry Law 2009;37:82-91.
ABSTRACT
| FULL TEXT
Spouses' Ability to Cope with Deployment and Adjust to Air Force Family Demands: Identification of Risk and Protective Factors
Spera
Armed Forces & Society 2009;35:286-306.
ABSTRACT
Validation of Scales From the Deployment Risk and Resilience Inventory in a Sample of Operation Iraqi Freedom Veterans
Vogt et al.
Assessment 2008;15:391-403.
ABSTRACT
Effect of Parents' Wartime Deployment on the Behavior of Young Children in Military Families
Chartrand et al.
Arch Pediatr Adolesc Med 2008;162:1009-1014.
ABSTRACT
| FULL TEXT
New onset and persistent symptoms of post-traumatic stress disorder self reported after deployment and combat exposures: prospective population based US military cohort study
Smith et al.
BMJ 2008;336:366-371.
ABSTRACT
| FULL TEXT
Mild Traumatic Brain Injury in U.S. Soldiers Returning from Iraq
Hoge et al.
NEJM 2008;358:453-463.
ABSTRACT
| FULL TEXT
2008 Theme Issue on Violence and Human Rights: Call for Papers
Cole and Flanagin
JAMA 2007;298:2792-2793.
FULL TEXT
Deployment-related stress and trauma in Dutch soldiers returning from Iraq: Prospective study
ENGELHARD et al.
Br. J. Psychiatry 2007;191:140-145.
ABSTRACT
| FULL TEXT
Combat and Peacekeeping Operations in Relation to Prevalence of Mental Disorders and Perceived Need for Mental Health Care: Findings From a Large Representative Sample of Military Personnel
Sareen et al.
Arch Gen Psychiatry 2007;64:843-852.
ABSTRACT
| FULL TEXT
Deployment to the Iraq War and Neuropsychological Sequelae
Boiko
JAMA 2006;296:2678-2678.
FULL TEXT
Deployment to the Iraq War and Neuropsychological Sequelae
Hoge
JAMA 2006;296:2678-2679.
FULL TEXT
Neuropsychological changes following military service in Iraq: case proven, but what is the significance?
Hotopf and Wessely
JAMA 2006;296:574-575.
FULL TEXT
|
