Electronic Theses and Dissertations





Document Type


Degree Name

Doctor of Philosophy




Clinical Psychology

Committee Chair

Meghan McDevitt-Murphy

Committee Member

James Murphy

Committee Member

Melloni Cook

Committee Member

Ellen Crouse


The most common psychological and cognitive sequelae associated with deployments to Afghanistan (OEF) and Iraq (OIF) are mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD). Each of these injuries places Veterans at risk for long-term health problems. One long-term problem associated with mTBI is the development of persistent, postconcussive symptoms, although relations between postconcussive symptoms, PTSD, and objective and subjective health indices have not been empirically explored. This study examined whether PTSD mediates relations between persistent, postconcussive symptoms related to mTBI and two indices of medical disease burden: the number of disease categories positive for a diagnosis, or system disease burden, and total number of physical diagnoses, or cumulative disease burden. The study also examined whether PTSD mediates relations between postconcussive symptoms and self-reported physical health functioning. Participants were 573 OEF/OIF Veterans screened in a VA primary care clinic. Medical records of participants seeking VA health care were reviewed for a history of mTBI, postconcussive symptoms, and physician diagnoses, which were used to derive system and cumulative disease burden variables. Evidence suggests that PTSD did not mediate relations between postconcussive symptoms and cumulative disease burden. These results were also supported after removing nonspecific symptoms from the postconcussive and PTSD symptom variables. These findings join an emerging body of literature suggesting that the residual effects of TBI have a direct, lasting impact on Veterans' physical health above and beyond the effects of PTSD.


Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to the local University of Memphis Electronic Theses & dissertation (ETD) Repository.