ABSTRACT
Objective: Returning Veterans often have conditions (e.g. posttraumatic stress disorder [PTSD], depression, and history of traumatic brain injury [TBI]) associated with cognitive dysfunction and problems with work, school, housing, and relationships. Rehabilitative efforts in Veterans aim to promote community reintegration, or successful adjustment in one's home, community, and desired social roles. We examined associations between neuropsychological performance, neurobehavioral symptoms, and community reintegration in Veterans. Method: 89 Iraq/Afghanistan Veterans at risk for homelessness and receiving residential mental healthcare completed a neuropsychological assessment and the Community Reintegration for Service Members-Computer Adaptive Test (CRIS-CAT). Neuropsychological components were derived using Principal Component Analysis. Bivariate Pearson correlations between neuropsychological variables, neurobehavioral symptoms, and CRIS-CAT scales (Extent of Participation, Perceived Limitations, and Satisfaction) were used to determine significant correlates of community reintegration. Regression models were used to examine associations between bivariate-significant neuropsychological components, neurobehavioral symptoms, and CRIS-CAT scales. Results: Bivariate analyses revealed that better community reintegration was associated with better performance in attention/executive functioning and fewer neurobehavioral symptoms. Three regression models examining predictors of variance in Extent of Participation, Perceived Limitations, and Satisfaction in community reintegration were statistically significant overall, with only fewer affective symptoms emerging as significantly and uniquely associated with greater participation and greater satisfaction in community functioning. Conclusions: Veterans with fewer affective symptoms reported greater participation and satisfaction with community functioning. Future longitudinal research examining associations between neurobehavioral symptoms, cognition, and risk factors of poorer community reintegration in unstably housed Veterans is warranted.
ABSTRACT
Suicide prevention among Veterans is a national priority. Overlap exists between conditions that may increase risk for suicide (e.g., mental health conditions, financial stressors, lack of social support) and homelessness among Veterans. We examined predictors of variance in suicidal ideation (SI) among 58 Iraq/Afghanistan Veterans at risk for homelessness who were receiving residential mental health treatment. Participants were classified as SI nonendorsers (n = 36) or SI endorsers (n = 22), based on their Patient Health Questionnaire-9 (PHQ-9) responses. Independent t tests and chi-square tests were used to examine group differences on baseline demographic variables, neuropsychological measures, and emotional/physical health symptom measures. Compared to nonendorsers, SI endorsers were significantly younger and reported less Veterans Affairs (VA) disability income, less total monthly income, less physical pain, lower quality of life overall and in the psychological health domain, lower community reintegration satisfaction, and more severe anxiety. Groups did not significantly differ on cognitive measures. A subsequent logistic regression revealed that only younger age uniquely predicted variance in SI endorsement. Younger age may be a particularly important factor to consider when assessing suicide risk in Veterans at risk for homelessness. Identifying predictors of variance in SI may help inform future treatment and suicide prevention efforts for Veterans at risk for homelessness. Future longitudinal research examining predictors of suicidality is warranted. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
