The Neurobehavioral Symptom Inventory: Responses in OEF/OIF Veterans by TBI and PTSD status Kerry Grohman, Ph.D., Michelle Alt, B.A., Sarah Piwowarczyk, M.A., & Kerry Donnelly, Ph.D., ABPP-CN STUDY PURPOSE The purpose of this study is to determine if there are discernable response patterns on the Neurobehavioral Symptoms Inventory in a sample of OEF/OIF veterans based on history of TBI and current PTSD symptoms. METHODS Participants  169 OEF/OIF veterans were examined as part of a larger, multicenter study of symptoms associated with OEF/OIF service.  Participants were assigned to one of four groups:  Participants classified as TBI+ sustained an alteration and/or loss of consciousness with associated post-concussive symptoms.  Participants classified as PTSD+ scored >50 on the PCLM. Measures  Structured Interview for TBI Diagnosis  Neurobehavioral Symptom Inventory (NSI; see Table 1)  PTSD Checklist – Military (PCLM)  Beck Depression Inventory (BDI2)  Beck Anxiety Inventory (BAI) Procedures  Participants were diagnosed for presence of TBI by a board- certified clinical neuropsychologist, based on a structured interview.  Testing was completed in a single session, and participants were given feedback on their performance and were compensated for their time. Figure 1. * Bars represent percent in group endorsing individual NSI items. Yellow line represents percent in each group endorsing three or more items as severe / very severe. Acknowledgements: This study was funded in part by VA HSR&D (SDR ). Contact information: This poster was presented at the April 2010 National Meeting on Mental Health and Substance Use Disorders of VA’s HSR&D in Little Rock, Arkansas. Analyses  2 x 2 between-subjects multivariate comparison s and post-hoc univariate comparisons using Bonferroni adjustment were used to examine group differences on the NSI scores.  Correlations were computed to examine the relationship between the total NSI score and symptoms ratings of depression (BDI2), generalized anxiety (BAI), and PTSD (PCLM). RESULTS  Multivariate analyses of between group differences on the NSI total scores were significant (F (3, 165) = , p <.001). Post-hoc analyses revealed the NSI total score means for the PTSD+ and the PTSD+/TBI+ groups were significantly higher than the PTSD-/TBI- and TBI+ group (see Figure 1).  Examination of the individual items found that veterans in the PTSD+ groups endorsed three or more items as “severe” or “very severe” at rates of 85% when TBI history was negative and 100% when TBI history was positive. The veterans in the PTSD- groups endorsed the items at rates of 32% when TBI history was negative and 47% when TBI history was positive (see Figure 1).  In the full sample, the NSI total score was highly correlated with the BDI2, BAI, and PCLM (see Figure 2). IMPLICATIONS  The findings in this study suggest the NSI total score reflects PTSD symptoms to a greater extent than TBI-related symptoms in this OEF/OIF veteran sample. These data argue against interpreting NSI symptoms as specific to TBI. Nonetheless, the NSI appears to be useful for tracking symptoms more generally in the OEF/OIF cohort. Figure 2. *All correlations significant at the p ≤.001 level and include the total sample. Table 1. Neurobehavioral Symptom Inventory Items 1. Feeling dizzy 12. Change in appetite 2. Loss of balance 13. Poor concentration 3. Poor coordination 14. Forgetfulness 4. Headaches 15. Difficulty making decisions 5. Nausea 16. Slowed thinking 6. Vision problems 17. Fatigue 7. Sensitivity to light 18. Sleep problems 8. Hearing difficulty 19. Anxious/tense 9. Sensitivity to noise 20. Depressed/sad 10. Numbness / tingling 21. Irritability 11. Change in taste / smell 22. Poor frustration tolerance Ratings: None Mild Moderate Severe Very Severe