Psychological Predictors of Neurobehavioral Symptoms in a Polytrauma Veteran Sample

ABSTRACT

Given the high prevalence of comorbid conditions found in polytrauma settings, effective screening measures are needed. Several screening tools are commonly used in polytrauma clinics within the Department of Veterans Affairs (VA). This study examined the use of three screening measures—the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and PTSD Checklist–Civilian Version (PCL-C)—to predict scores on the Neurobehavioral Symptom Inventory (NSI). Research suggests that the presence of mental health conditions, such as PTSD, shares a significant amount of variance with postconcussive symptoms. The investigators hypothesized that the PCL-C would be the best predictor of scores on the NSI. All subjects were administered the screening measures as part of an evaluation in an outpatient Level III polytrauma clinic. Regression analysis was used to determine which instrument might serve as the best predictor of NSI total scores. Regression analysis revealed that BAI, BDI-II, and PCL-C total scores were good predictors of NSI total scores, with the BAI accounting for the majority of the variance. Mental health conditions can account for higher scores on the NSI, and screening of other mental health conditions should be taken into account when reviewing the NSI for individuals in polytrauma settings.

KEYWORDS:

• Neurobehavioral symptom inventory
• polytrauma
• PTSD
• traumatic brain injury
• veterans

Acknowledgment

This manuscript is the result of work supported with resources and the use of facilities at the St. Cloud VA Health Care System. The contents of this manuscript do not represent the views of the Department of Veterans Affairs or the United States Government. Preliminary data was presented at the 32nd Annual National Academy of Neuropsychology Conference in Nashville, Tennessee.

Additional information

Notes on contributors

Glen A. Palmer

Glen A. Palmer is a Clinical Neuropsychologist and Research Program Coordinator at the St. Cloud VA Health Care System, St. Cloud, MN. His research interests include PTSD, polytrauma, and neuropsychological assessment.

Maggie C. Happe

Maggie C. Happe is a Clinical Psychologist working in Extended Care and Rehabilitation at the St. Cloud VA Health Care System, St. Cloud, MN. Her research interests include geriatric psychology, health psychology, and neuropsychology.

Janine M. Paxson

Janine M. Paxson is the Chief Psychologist and Mental Health Programs Manager at the St. Cloud VA Health Care System, St. Cloud, MN. Her research interests include PTSD, anxiety disorders, cognitive therapy, assessment, and treatment outcomes.

Benjamin K. W. Jurek

Benjamin K. W. Jurek is a Clinical Psychologist at the St. Cloud VA Health Care System, St. Cloud, MN. His research interests include dual diagnoses and program evaluation.

Joseph J. Graca

Joseph J. Graca is a clinical psychologist in private practice in Bisbee, AZ. He recently retired after working 33 years in the VA Health Care system. His research interests include therapy and assessment for PTSD.

Stephen A. Olson

Stephen A. Olson works in the capacity of research investigator and data entry person at St. Cloud VA Health Care System, St. Cloud, MN. His interest is nutrition, with a growing interest in how the mind deals with stress and depression.