B - 47 Assessing Subjective Cognitive Outcomes in Military Veterans: a Comparative Study of Million Veteran Program Participants with and without TBI History and PTSD

Abstract Objective We examined the distinct impacts of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) on subjective cognitive symptoms in Iraq/Afghanistan-era military Veterans who enrolled in the Million Veteran Program (MVP) and completed the Veterans Affairs TBI Screening and Evaluation Program. Method Veterans initially screened for possible deployment-related TBI (Screen+/Screen-). If a Veteran screened positive, they completed the Comprehensive Traumatic Brain Injury Evaluation to establish TBI diagnosis (CTBIE+/CTBIE-). Self-reported PTSD status (PTSD+/PTSD-) was collected from the MVP baseline survey. Veterans also completed the Medical Outcomes Study Cognitive Functioning Scale (MOS-Cog-R), a self-report measure of cognitive symptoms (6 items with total score 6–36). Veterans (N = 7774; 77.4% male) were categorized into six exclusive diagnostic groups based on screening, TBI diagnosis, and PTSD status: (1) Screen-/CTBIE-/PTSD- (n = 7537); (2) Screen-/CTBIE-/PTSD+ (n = 747); (3) Screen+/CTBIE-/PTSD- (n = 380); (4) Screen+/CTBIE-/PTSD+ (n = 633); (5) Screen+/CTBIE+/PTSD- (n = 397); and (6) Screen+/CTBIE+/PTSD+ (n = 1080). ANCOVAs adjusted for sociodemographic characteristics evaluated the association between diagnostic group and MOS-Cog-R total score. Results Results showed a significant association of diagnostic group with MOS-Cog-R total score (p < 0.001, $\square{\!\!\!?}\, $p2 = 0.29). Post-hoc analyses showed that all groups endorsed significantly greater symptoms than the Screen-/CTBIE-/PTSD- group (p’s < 0.001, $\square{\!\!\!?}\, $p2 = 0.04–0.31). Additionally, each PTSD+ group endorsed significantly greater symptoms compared to their counterpart PTSD- groups (p’s < 0.001, $\square{\!\!\!?}\, $p2 = 0.08–0.11). Conclusions This is the first study to investigate distinct impacts of TBI and PTSD on subjective cognitive symptoms using TBI Screening and Evaluation Program data. Results reinforce prior work suggesting that PTSD greatly contributes to subjective cognitive distress, supporting that interventions should prioritize mental health treatment in this unique population.