Journal of the International Neuropsychological Society

Research Articles

Comparison of Concussive Symptoms, Cognitive Performance, and Psychological Symptoms Between Acute Blast-Versus Nonblast-Induced Mild Traumatic Brain Injury

Cynthia A. Luethckea1, Craig J. Bryana1 c1, Chad E. Morrowa2 and William C. Islera3

a1 Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas

a2 42 MDOS/SGOMH, Maxwell Air Force Base, Montgomery, Alabama

a3 Air Force Medical Operations Agency, San Antonio, Texas


Blast-related head injuries are one of the most prevalent injuries among military personnel deployed in service of Operation Iraqi Freedom. Although several studies have evaluated symptoms after blast injury in military personnel, few studies compared them to nonblast injuries or measured symptoms within the acute stage after traumatic brain injury (TBI). Knowledge of acute symptoms will help deployed clinicians make important decisions regarding recommendations for treatment and return to duty. Furthermore, differences more apparent during the acute stage might suggest important predictors of the long-term trajectory of recovery. This study evaluated concussive, psychological, and cognitive symptoms in military personnel and civilian contractors (N = 82) diagnosed with mild TBI (mTBI) at a combat support hospital in Iraq. Participants completed a clinical interview, the Automated Neuropsychological Assessment Metric (ANAM), PTSD Checklist-Military Version (PCL-M), Behavioral Health Measure (BHM), and Insomnia Severity Index (ISI) within 72 hr of injury. Results suggest that there are few differences in concussive symptoms, psychological symptoms, and neurocognitive performance between blast and nonblast mTBIs, although clinically significant impairment in cognitive reaction time for both blast and nonblast groups is observed. Reductions in ANAM accuracy were related to duration of loss of consciousness, not injury mechanism. (JINS, 2011, 17, 000–000)

(Received May 12 2010)

(Revised September 04 2010)

(Accepted September 07 2010)

(Online publication November 17 2010)


c1 Correspondence and reprint requests to: Craig J. Bryan, Department of Psychiatry, University of Texas Health Science Center at San Antonio, 7550 West IH-10, Suite 1325, San Antonio, TX 78229. E-mail:


The views expressed in this article are those of the authors and do not necessarily represent the official position or policy of the United States Government, Department of Defense, Department of the Air Force, or Department of the Army.