{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T15:06:49Z","timestamp":1789225609008,"version":"build-2803163510"},"reference-count":52,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;amp;R"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify group\u2010based patterns in suicidal ideation (SI) and posttraumatic stress disorder (PTSD) symptoms over the first 10\u2009years after traumatic brain injury (TBI) among Veterans and Service Members (V\/SMs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>V\/SMs enrolled in the Department of Veterans Affairs (VA) Polytrauma Rehabilitation Center (PRC) TBI Model Systems study who received inpatient rehabilitation at one of the VA's five PRCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A sample of 1057\u2009V\/SMs with TBI who completed at least one Patient Health Questionnaire\u20109 (PHQ\u20109) item 9 (assessing suicidal ideation) and at least one PTSD Checklist\u2010Civilian Version (PCL\u2010C) at follow\u2010up over the 10\u2010year interval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A k\u2010means cluster analysis was conducted to determine group\u2010based patterns of covarying PTSD and SI, and demographics, injury characteristics, and prior suicide attempt were compared with analyses of variance and chi\u2010squares.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Past 2\u2010week SI was assessed using PHQ\u20109 item 9, and PTSD symptoms in the past month were assessed using PCL\u2010C.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three group\u2010based patterns emerged: low PTSD\u2010low SI (Cluster 1); high PTSD\u2010low SI (Cluster 2); and high PTSD and SI (Cluster 3). The low PTSD\u2010low SI group comprised 62.2% of the sample and had the lowest functional independence at discharge and higher education. The high PTSD\u2010low SI included the most married V\/SMs preinjury. The highest risk group of V\/SMs with both high PTSD and SI exhibited greater preinjury mental health vulnerabilities, including a higher proportion of preinjury and past\u2010year suicide attempts which persisted at 2\u2010, 5\u2010, and 10\u2010year follow\u2010ups. This cluster also had a greater history of combat deployments and a higher representation of V\/SMs identifying as Asian.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings emphasize that PTSD plays a central role in the association with SI among V\/SMs with TBI, highlighting the critical need of comprehensive mental health and suicide risk evaluation and treatment through chronic recovery after TBI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmrj.70217","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T15:00:42Z","timestamp":1789225242000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Group trends in posttraumatic stress disorder and suicidal ideation over the 10\u2009years after traumatic brain injury among veterans\/service members: A\n                    <scp>VA<\/scp>\n                    model systems study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6995-1942","authenticated-orcid":false,"given":"Bani","family":"Malhotra","sequence":"first","affiliation":[{"name":"Department of Arts Leadership, Education and Therapy Florida State University  Tallahassee Florida USA"},{"name":"Department of Physical Medicine and Rehabilitation Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8505-0215","authenticated-orcid":false,"given":"Daniel W.","family":"Klyce","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Virginia Commonwealth University  Richmond Virginia USA"},{"name":"Mental Health Service Central Virginia VA Health Care System  Richmond Virginia USA"},{"name":"Psychology Service Sheltering Arms Institute  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4709-545X","authenticated-orcid":false,"given":"Shannon B.","family":"Juengst","sequence":"additional","affiliation":[{"name":"Brain Injury Research Center, The Institute for Rehabilitation Research Memorial Hermann  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelli G.","family":"Talley","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5333-4475","authenticated-orcid":false,"given":"Jacob A.","family":"Finn","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, Extended Care &amp; Rehabilitation Minneapolis VA Health Care System  Minneapolis Minnesota USA"},{"name":"Department of Psychiatry and Behavioral Sciences University of Minnesota \u2013 Twin Cities  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2070-215X","authenticated-orcid":false,"given":"Paul B.","family":"Perrin","sequence":"additional","affiliation":[{"name":"Mental Health Service Central Virginia VA Health Care System  Richmond Virginia USA"},{"name":"Department of Data Science and Psychology University of Virginia  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2021.0062"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2013.01.0006"},{"key":"e_1_2_10_4_1","unstructured":"US Department of Veteran Affairs.VA research on Traumatic Brain Injury (TBI). 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