SALISBURY, NC — Chronic mental health symptoms including post-traumatic stress, depression and neurobehavioral issues increase proportionately with blast exposure severity, according to a new study.
The article in the Journal of Psychiatric Research pointed out that blast exposure is common among servicemembers, but it is not clear what chronic psychiatric effects are associated with blast exposure independent of a resulting mild traumatic brain injury (TBI).1
The analysis led by researchers from the W. G. (Bill) Hefner VA Healthcare System and Wake Forest School of Medicine in Winston-Salem, NC, evaluated whether blast exposure severity was independently associated with or just exacerbated symptom reports beyond post-traumatic stress disorder (PTSD) and mild TBI.
Included in the study were 275 Iraq and Afghanistan combat veterans, 86.55% male. Most, 71.27%, had a history of blast exposure, 29.82% had a current diagnosis of PTSD, and 45.45% had been diagnosed with mild TBI.
Diagnostic interviews were conducted for PTSD, lifetime TBI and lifetime blast exposure. Participants self-reported psychiatric and health outcomes, including post-traumatic stress symptoms, depressive symptoms, neurobehavioral symptoms, sleep quality, pain interference and quality of life.
Results indicated that blast severity was associated with PTSD (B = 2.00), depressive (B = 0.76), and neurobehavioral (B = 1.69) symptoms beyond PTSD diagnosis and mild TBI history, researchers advised.
“Further, blast severity accounted entirely (i.e., indirect/mediation effect) for the association between TBI and post-traumatic stress (B = 1.62), depressive (B = 0.61), and neurobehavioral (B = 1.38) symptoms,” they added. The authors added that no interaction effects were present.
“Exposure to blast is an independent factor influencing psychiatric symptoms in veterans beyond PTSD and mild TBI,” the study concluded. “Results highlight that blast exposure severity may be a more relevant risk factor than deployment mild TBI in combat veterans and should be considered in the etiology of psychiatric symptom presentation and complaints. Further, severity of psychological distress due to the combat environment may be an explanatory mechanism by which blast exposure mediates the relationship between mild TBI and symptom outcomes.”
The researchers said their “results demonstrate that blast exposure severity explains significant aspects of the relationship between deployment mild TBI history with post-traumatic stress, depressive, and neurobehavioral symptoms in this cohort of Iraq and Afghanistan combat veterans. Though prior studies have reported similar findings acutely following blast exposure, this is the first demonstration of increased severity of psychiatric symptoms in the chronic phase (i.e., greater than one year) following blast exposure.”
Furthermore, they pointed out that their study demonstrated that higher blast severity was associated with higher chronic mental health symptoms, adding, “Findings suggest that blast severity may be a more relevant risk factor than deployment mild TBI in the symptom presentation among Iraq and Afghanistan combat veterans.”
- Martindale SL, Ord AS, Rule LG, Rowland JA. Effects of blast exposure on psychiatric and health symptoms in combat veterans. J Psychiatr Res. 2021 Sep 3;143:189-195. doi: 10.1016/j.jpsychires.2021.09.021. Epub ahead of print. PMID: 34500348.
