Executive Dysfunction and Self-Harm Behavior: An Examination of Veterans With TBI, PTSD, or Both
Condition: Traumatic Brain Injury; Post Traumatic Stress Disorder; Suicide; Self-Injurious Behavior
MeSH terms: Brain Injuries; Brain Injuries, Traumatic; Stress Disorders, Traumatic; Suicide; Stress Disorders, Post-Traumatic; Self-Injurious Behavior
Study type: Observational

Summary: 
      1. To determine whether tasks taken from the field of cognitive neuroscience can detect and
           distinguish impairments in executive function above and beyond standard
           neuropsychological measures in individuals with: a.) Mild Traumatic Brain Injury (TBI),
           b.) Post Traumatic Stress Disorder (PTSD), c.)Mild TBI+PTSD

        2. To determine whether performance on these tasks is linked to pertinent psychiatric
           outcomes (e.g. history of suicidality), which is associated with compromised executive
           function and impulsivity.

        3. To determine whether information regarding brain anatomy can provide additional
           information above and beyond behavior performance in distinguishing between these two
           groups.
    

Detailed description: 
      Individuals who served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF)
      are reporting histories of traumatic brain injury (TBI) and symptoms associated with post
      traumatic stress disorder (PTSD). Standard neuropsychological measures are ineffective at
      distinguishing between TBI and PTSD. This pilot project will examine whether methods from
      cognitive neuroscience can determine the effects of TBI and/or PTSD on executive function.
      Executive function includes many aspects of goal-oriented behavior, including the ability to
      inhibit inappropriate behaviors and thoughts. In the proposed study, the investigators are
      focusing on inhibitory processing, as it is a core component of executive function. Although
      both TBI and PTSD compromise executive function and TBI often occurs in the context of a
      traumatic event, very little research has attempted to disentangle the effects that each of
      these conditions has on inhibitory control. In addition, the investigators are interested in
      how disinhibition may be linked to impulsive real-world behaviors, such as suicidal
      tendencies, which are observed at elevated rates in individuals with TBI as well as those
      with PTSD. Knowing the ways in which inhibitory functions are compromised in these
      individuals should aid in the development of appropriate treatments aimed at functional
      improvement for those with mild TBI, PTSD, or mild TBI+PTSD.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The participants in this observational study will be recruited from the following
        populations of OEF/OIF Veterans: 1.) those seeking mental health, rehabilitative,
        psychological or other services within the Veterans Health Administration (VHA) Eastern
        Colorado Healthcare System , 2.) those in existing clinical and research databases, and 3.)
        Veterans in the community not seeking care within the VHA.