Lifetime and childhood traumatic experiences as risk factors for persistent post-concussive symptoms among US service members.

OBJECTIVES

The objectives of this study were to investigate how the number of lifetime and childhood traumatic experiences relates to persistent post-concussive symptoms (PPCS) and mental health symptoms among US service members (SMs).

METHODS

This study included 65 SMs who belonged to one of three groups: (1) 18 with mild traumatic brain injury (mTBI) and no PPCS; (2) 18 with mTBI and PPCS; and (3) 29 with an extra-cranial injury but no mTBI. Lifetime traumatic experiences were measured using the Trauma History Screen (THS) and childhood traumatic experiences were measured using the Adverse Childhood Experiences (ACEs) survey. The outcomes included severity of post-traumatic stress disorder (PTSD) measured by Clinician Administered PTSD Scale-5, the level of post-traumatic stress symptoms measured by the PTSD Checklist, DSM-5, and the level of mental health symptoms measured by the Brief Symptom Inventory.

RESULTS

A greater number of lifetime (but not childhood) traumatic experiences were found among those with mTBI and PPCS compared to those with mTBI but no PPCS or no mTBI; however a greater number of childhood traumatic experiences were associated with poor mental health symptoms in areas of somatization and interpersonal sensitivity, but only among those with mTBI and PPCS.

CONCLUSIONS

The findings of this exploratory study show that the number of lifetime traumatic experiences may be related to persistent post-concussive symptoms; however, only the number of childhood trauma was associated with mental health symptoms among those with persistent symptoms. These findings support screening for childhood and lifetime traumatic experiences during evaluations at clinic intake to improve risk assessment, treatment planning, and recovery expectations and outcomes. While the results may highlight the need for early identification of at-risk individuals for persistent symptoms to enhance readiness and return-to-duty rates, further studies are needed to elucidate the mechanisms of these associations.