{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:40:51Z","timestamp":1777927251669,"version":"3.51.4"},"reference-count":62,"publisher":"SAGE Publications","issue":"22","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:p>\n                    Although post-traumatic stress disorder (PTSD) has been associated with worse cognitive outcomes after mild traumatic brain injury (TBI), its impact has not been evaluated after more severe TBI. This study aimed to determine whether PTSD symptoms are related to cognition after complicated mild, moderate, severe, and penetrating TBI. Service members (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009137) with a history of complicated mild\/moderate TBI (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200964) or severe\/penetrating TBI (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200973) were prospectively enrolled from United States Military Treatment Facilities. Participants completed a neuropsychological assessment one year or more post-injury. Six neuropsychological composite scores and an overall test battery mean (OTBM) were considered. Participants were excluded if there was evidence of invalid responding. Hierarchical linear regressions were conducted evaluating neuropsychological performance. The interaction between TBI severity and PTSD Checklist-Civilian version total score was significant for processing speed (\u03b2\u2009=\u20090.208,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.034) and delayed memory (\u03b2\u2009=\u20090.239,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.021) and trended toward significance for immediate memory (\u03b2\u2009=\u20090.190,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.057) and the OTBM (\u03b2\u2009=\u20090.181,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.063). For each of these composite scores, the relationship between PTSD symptoms and cognition was stronger in the complicated mild\/moderate TBI group than the severe\/penetrating TBI group. Within the severe\/penetrating TBI group, PTSD symptoms were unrelated to cognitive performance. In contrast, within the complicated mild\/moderate TBI group, PTSD symptoms were significantly related to processing speed (R\n                    <jats:sup>2<\/jats:sup>\n                    \u0394\u2009=\u20090.077, \u03b2\u2009=\u2009-0.280,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.019), immediate memory (R\n                    <jats:sup>2<\/jats:sup>\n                    \u0394\u2009=\u20090.197, \u03b2\u2009=\u2009-0.448,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001), delayed memory (R\n                    <jats:sup>2<\/jats:sup>\n                    \u0394\u2009=\u20090.176, \u03b2\u2009=\u2009-0.423,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001), executive functioning (R\n                    <jats:sup>2<\/jats:sup>\n                    \u0394\u2009=\u20090.100, \u03b2\u2009=\u2009-0.317,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.008), and the OTBM (R\n                    <jats:sup>2<\/jats:sup>\n                    \u0394\u2009=\u20090.162, \u03b2\u2009=\u2009-0.405,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001). The potential impact of PTSD symptoms on cognition, over and above the impact of brain injury alone, should be considered with service members and veterans with a history of complicated mild\/moderate TBI. In addition, in research comparing cognitive outcomes between patients with histories of complicated-mild, moderate, severe, and\/or penetrating TBI, it will be important to account for PTSD symptoms.\n                  <\/jats:p>","DOI":"10.1089\/neu.2021.0120","type":"journal-article","created":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T06:10:35Z","timestamp":1629353435000},"page":"3137-3145","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Post-Traumatic Stress Disorder Symptoms Are Related to Cognition after Complicated Mild and Moderate Traumatic Brain Injury but Not Severe and Penetrating Traumatic Brain Injury"],"prefix":"10.1177","volume":"38","author":[{"given":"Sara. M.","family":"Lippa","sequence":"first","affiliation":[{"name":"National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis M.","family":"French","sequence":"additional","affiliation":[{"name":"National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA."},{"name":"Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland, USA."},{"name":"Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracey A.","family":"Brickell","sequence":"additional","affiliation":[{"name":"National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA."},{"name":"Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland, USA."},{"name":"Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA."},{"name":"Contractor, General Dynamics Information Technology, Falls Church, Virginia, USA."},{"name":"Centre of Excellence on Post-traumatic Stress Disorder, Ottawa, ON, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela E.","family":"Driscoll","sequence":"additional","affiliation":[{"name":"National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan E.","family":"Glazer","sequence":"additional","affiliation":[{"name":"National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA."},{"name":"Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland, USA."},{"name":"Contractor, General Dynamics Information Technology, Falls Church, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corie E.","family":"Tippett","sequence":"additional","affiliation":[{"name":"National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA."},{"name":"Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland, USA."},{"name":"Contractor, General Dynamics Information Technology, Falls Church, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie K.","family":"Sullivan","sequence":"additional","affiliation":[{"name":"National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA."},{"name":"Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland, USA."},{"name":"Contractor, General Dynamics Information Technology, Falls Church, Virginia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rael T.","family":"Lange","sequence":"additional","affiliation":[{"name":"National Intrepid Center of Excellence, Walter Reed National 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