Female Service Members and Symptom Reporting after Combat and Non-Combat-Related Mild Traumatic Brain Injury

J Neurotrauma. 2017 Jan 15;34(2):300-312. doi: 10.1089/neu.2016.4403. Epub 2016 Aug 5.

Abstract

Females are often excluded from military-related mild traumatic brain injury (mTBI) research because of its relatively low prevalence in this population. The purpose of this study was to focus on outcome from mTBI in female service members, compared with males. Participants were 172 United States military service members selected from a larger sample that had sustained an mTBI, and were evaluated within 24 months of injury (Age: mean = 28.9, SD = 8.1) at one of six military medical centers. Eighty-six women were matched to 86 men on nine key variables: TBI severity, mechanism of injury, bodily injury severity, days post-injury, age, number of deployments, theater where wounded, branch of service, and rank. Participants completed the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist (PCL-C). There were no meaningful gender differences across all demographic and injury-related variables (p > 0.05). There were significant group differences and medium effect sizes for the NSI total score and all four NSI cluster scores. Symptoms most affected related to nausea, sensitivity to light, change in taste/smell, change in appetite, fatigue, and poor sleep. There were significant group differences and small-medium effect sizes for the PCL-C total score and two of the three PCL-C cluster scores. Symptoms most affected related to poor concentration, trouble remembering a stressful event, and disturbing memories/thoughts/images. Females consistently experienced more symptoms than males. As females become more active in combat-related deployments, it is critical that future studies place more emphasis on this important military population.

Keywords: TBI; gender; military.

MeSH terms

  • Adult
  • Afghan Campaign 2001-
  • Amnesia / diagnosis
  • Amnesia / etiology
  • Amnesia / psychology
  • Brain Concussion / complications
  • Brain Concussion / diagnosis*
  • Brain Concussion / psychology
  • Combat Disorders / diagnosis*
  • Combat Disorders / etiology
  • Combat Disorders / psychology
  • Female
  • Humans
  • Iraq War, 2003-2011
  • Male
  • Military Personnel / psychology
  • Nausea / diagnosis
  • Nausea / etiology
  • Nausea / psychology
  • Neuropsychological Tests
  • Post-Concussion Syndrome / diagnosis*
  • Post-Concussion Syndrome / etiology
  • Post-Concussion Syndrome / psychology
  • Self Report*
  • Sex Characteristics*
  • United States / epidemiology
  • Young Adult