Traumatic brain injury, stress, and mental health of American servicewomen and women veterans
Creators: name: Corry, Daniel T
Publisher: name: University of Iowa
Year: 2025
Subjects: subject: COVID-19
subject: Deployment
subject: Military
subject: Women
subject: public abstract
subject: Mental Health
subject: Traumatic Brain Injury
subject: Psychology
subject: FOS: Psychology

description: Traumatic brain injury (TBI) is a common injury among military personnel and can lead to long-term symptoms of mental health problems. Women in the military are a growing population who are at increased risk of mental health problems after a TBI compared to both non-military women and men in the military. With a recent policy change allowing women to assume combat roles that had been previously restricted to men, the risk of TBI in military servicewomen has increased.
description: With their evolving roles, women in the military are likely to encounter deployment-related stress from combat-related events and military sexual trauma (MST). Examining stress and its relationship with mental health is crucial among those who have sustained a TBI, as those with TBI often have abnormal responses to stress that could predispose them to mental health problems. Further, examining factors that may modify or mediate these relationships will help to provide a clearer idea of the complex relationship between TBI, stress, and mental health.
description: This research sought to elucidate how TBI and stress in conjunction affect mental health among military servicewomen. In Aim 1, I assessed how the association between deployment- related stress and symptoms of depression and posttraumatic stress disorder (PTSD) could be modified by social determinants of health and military characteristics among a population of military servicewomen with TBI. In Aim 2, I examined how TBI might affect posttraumatic growth (PTG), and how this association might be modified by a positive screen for PTSD, among a population of rural women Veterans of the Reserve Armed Forces and National Guard (RNG). Finally, in Aim 3, I explored how stress from the COVID-19 pandemic mediated the associations between TBI and mental health problems among rural women RNG Veterans.
description: Among women in the military with TBI, nine different deployment-related stressors were independently associated with both depression and PTSD. Education level modified these associations, where those with a high school education or less had more severe symptoms of both depression and PTSD compared to those with some college or more education who were exposed to the same stressor. Military rank specifically modified the relationships between two deployment-related stressors and depression, where enlisted servicewomen had more severe symptoms than officers exposed to the same stressor. Household income did not significantly modify any association.
description: Among rural women RNG Veterans, TBI was not associated with PTG and PTSD did not modify the association. It is possible that other factors not included in this analysis, such as social support, have a greater effect on PTG. Additionally, TBI-related factors that could not be assessed, such as severity and time since most recent TBI, might affect PTG more than TBI would in this population. Future research exploring these factors will help to elucidate any effect TBI might have on these positive psychological outcomes.
description: COVID-19-related stress significantly mediated the association between TBI and depression among rural women RNG Veterans. Stress about accessing daily necessities also mediated this association. Associations between past TBI and current PTSD were not statistically significant but were still mediated by COVID-19-related stress. Because the total effects for the TBI-PTSD models were not statistically significant, confounding factors, such as sexual violence victimization and other traumas, may have had a stronger effect on PTSD than TBI does.
description: Stress and TBI in conjunction are associated with mental health problems in military servicewomen. Future research might examine TBI-related factors, including temporality in relation to stress, number, and severity, to further elucidate this complex association.