Thesis_Defense_PDF

Self-Reported Cognitive Symptoms in Military

Veteran College Students Kelly Allen

Introduction

•  Post-9/11 GI Bill: provides educational benefits to veterans who served on active duty since September 11, 2001.

•  The veteran population is at a higher risk for traumatic brain injury (TBI), Post Traumatic Stress Disorder (PTSD), and depression.

•  Some conditions, particularly mild TBI, are not diagnosed or treated until long after the injury when the person realizes they have cognitive difficulties.

Introduction

ò  Even mild cognitive problems can hinder learning in an academic setting, but there is little data on the frequency and severity of cognitive deficits in veteran college students.

ò  A better understanding of the pattern of self-reported symptoms will help researchers and clinicians determine the veterans who are at higher risk for cognitive and academic difficulties.

Traumatic Brain Injury

ò  TBI is defined as an alteration in brain function, or other evidence of brain pathology, caused by an external force.

Untreated and Undiagnosed

ò  Military culture expectations and the emphasis placed on American individualism.

ò  Health problems could negatively impact their career, as they will be perceived as weak or undependable.

ò  If others around them have visible injuries.

ò  Reporting the injury may delay their release back to the base or home.

ò  Many people do not experience symptoms immediately following their mTBI.

ò  Lack of objective and imprecise measures to diagnose.

Research Aims

ò  How do self-reported cognitive symptoms in veteran students compare to civilian students and how do those symptoms relate to service-related conditions?

Method

ò  137 military veterans and 212 civilian students enrolled at Arizona State University, community college, or college preparatory programs, participated in this study.

ò  The survey contained sections consisting of questions about the participant’s demographic information, developmental and educational history, military or work background, and medical history (including history of depression, PTSD, and concussion/head injuries).

ò  The self-assessment questions related to their memory, attention, and anxiety levels in academic and daily life contexts. The entire survey contained 99 multiple choice and short answer questions.

Example Questions

ò  Select the statement that best describes your OVERALL memory (your memory in your everyday life):

ò  My memory is much better than other people my age.

ò  My memory is somewhat better than other people my age.

ò  My memory is about the same as other people my age.

ò  My memory is somewhat worse than other people my age.

ò  My memory is much worse than other people my age.

Example Questions

ò  Select the statement that best describes your memory for information taught IN CLASSES:

ò  My memory for class information is much better than other students.

ò  My memory for class information is somewhat better than other students.

ò  My memory for class information is about the same as other students.

ò  My memory for class information is somewhat worse than other students.

ò  My memory for class information is much worse than other students

Example Questions

ò  Please rate your OVERALL level of anxiety (anxiety experienced in your everyday life)

ò  0 = No anxiety

ò  1 = Some anxiety

ò  2 = Moderate anxiety

ò  3 = Fairly Severe Anxiety

ò  4 = Extremely Severe Anxiety

Table 1: Demographic Information for Civilian and Veteran Students

Table 1: Demographic Information for Civilian and Veteran Students Table 1: Demographic Information for Civilian and Veteran Students Table 1: Demographic Information for Civilian and Veteran Students

Table 2: Frequency of Conditions in the Civilian and Veteran Groups

8%

30%

39%

20%

3% Civilian Overall Anxiety

None

Some

Moderate

Fairly Severe

Very Severe

9%

29%

43%

18%

1% Veteran Overall Anxiety

None

Some

Moderate

Fairly Severe

Very Severe

1%

14%

37% 38%

10%

Civilian Overall Memory

Much Worse

Somewhat Worse

The Same

Somewhat BeDer

Much BeDer

9%

25%

24%

29%

13%

Veteran Overall Memory

Much Worse Somewhat Worse The Same Somewhat BeDer Much BeDer

8%

30%

39%

20%

3% Civilian Overall Anxiety

None

Some

Moderate

Fairly Severe

Very Severe

9%

29%

43%

18%

1% Veteran Overall Anxiety

None

Some

Moderate

Fairly Severe

Very Severe

1%

14%

37% 38%

10%

Civilian Overall Memory


9%

25%

24%

29%

13%

Veteran Overall Memory


0%

10%

39% 41%

10%

Civilian Class Memory

Much Worse

Somewhat Worse

The Same

Somewhat Better

6%

17%

42%

27%

8%

Veteran Class Memory

Much Worse

Somewhat Worse

The Same

Somewhat Better

0%

20%

40%

60%

80%

Worse No Change BeDer

Prop

or5o

n Re

por5ng

Reported Anxiety Changes

Civilian Students Veteran Students

0%

20%

40%

60%

80%


Prop

or5o

n Re

por5ng



0%

20%

40%

60%

80%


Prop

or5o

n Re

por5ng



0%

20%

40%

60%

80%


Prop

or5o

n Re

por5ng



0%

20%

40%

60%

80%


Prop

or5o

n Re

por5ng

Reported Memory Changes


0%

20%

40%

60%

80%


Prop

or5o

n Re

por5ng



0%

20%

40%

60%

80%


Prop

or5o

n Re

por5ng

Reported A;en5on Changes


Comparisons of Self-Ratings Across Conditions for Veteran and Civilian Groups

Results of Multiple Regression Analyses

Discussion

ò  A higher proportion of veteran students reported a history of PTSD and Depression, relative to the civilian students.

ò  The proportion of reported TBI was similar across the groups. Memory ratings for participants with TBI were lower than those with no TBI.

ò  Relative to civilians, a larger proportion of veterans reported their memory as being “somewhat” or “much worse” than their peers (Veterans: 35% vs. Civilians: 15%).

Discussion

ò  Veterans were more likely than civilians to report negative changes in memory, attention abilities, and anxiety level over time.

ò  For both groups, history of TBI was the strongest predictor of Memory self-ratings, and history of Depression was the strongest predictor of Anxiety self-ratings.

ò  The results show that veteran college students show higher rates of service-related conditions and are more likely than civilian students to report cognitive difficulties.

Acknowledgments

ò  I wish to express my sincere thanks to Dr. Azuma, for mentoring me and for all her time and encouragement.

ò  My sincere thank you to Karen Gallagher for taking me on as a research assistant and her continuous encouragement.

ò  Pat Tillman Center for providing the necessary resources for the research.

ò  My family and friends for all their support.

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