Putting the pieces together to understand anger: PTSD, Sleep Apnea, TBI, and Pain as Contributors

Thursday, October 22, 2020

4:10 PM – 4:27 PM EST

Presenting Author(s)

Shannon Miles, PhD

Clinical Psychologist
James A Haley Veterans Hospital
Tampa, Florida

Presentation Slides Presentation + Audio

Non-presenting Author(s)

Marc A. Silva, PhD

Neuropsychologist
James A Haley Veterans Hospital
Tampa, Florida
SM

Sarah L. Martindale, PHD

Research Scientist
Salisbury VA Medical Center
Salisbury, North Carolina
MT

Maya Troyanskaya, MD

MD
Baylor College of Medicine
Tampa, Florida
Risa Nakase-Richardson, Ph.D.

Professor, Research Neuropsychologist
James A. Haley Veterans Hospital & University of South Florida
Tampa, Florida

This study uses a large cohort of combat Veterans and Service Members (V/SM) to examine how posttraumatic stress disorder (PTSD), obstructive sleep apnea (OSA) risk, history of mild traumatic brain injury (mTBI), and pain contribute to anger in V/SM. All participants completed a baseline assessment for Chronic Effects of Neurotrauma Consortium (N=1,418). Participants were predominantly male (87%), White (72%), with a mean age of 40 years (SD=9.6). Most of the sample (81%) reported a history of at least one mTBI (average mTBIs=2.2, SD=2.0). A hierarchical multiple regression model used blocks to examine variables associated with anger. Age, male sex, number of mTBIs, PTSD symptoms, OSA risk, and chronic pain were associated with anger. Contributors of anger are multifaceted, so focusing on the whole health of the V/SM is critical. PTSD symptoms were the strongest predictor of anger across blocks, thus PTSD treatment is a logical first treatment step.

Learning Objectives:

Recognize the negative psychological, interpersonal, and health consequences that can arise from anger in combat Veterans / Service Members with and without traumatic brain injury.
Be able to screen for and identify psychiatric and medical comorbidities associated with anger in Veterans and Service Members with traumatic brain injury.
Describe how treatments for PTSD, sleep apnea, and pain can be integrated to best reduce anger in Veterans and Service members with traumatic brain injury.