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Traumatic Brain Injury, Sleep Quality, and Suicidal Ideation in Iraq/Afghanistan Era Veterans

DeBeer, Bryann B. PhD*†‡; Kimbrel, Nathan A. PhD§∥¶; Mendoza, Corina MA*†; Davidson, Dena PhD*†‡; Meyer, Eric C. PhD*†‡; La Bash, Heidi PhD*†‡#; Gulliver, Suzy Bird PhD‡**; Morissette, Sandra B. PhD††

The Journal of Nervous and Mental Disease: July 2017 - Volume 205 - Issue 7 - p 512–516
doi: 10.1097/NMD.0000000000000695
Original Articles

The objective of this study was to test the hypothesis that sleep quality mediates the association between traumatic brain injury (TBI) history and current suicidal ideation. Measures of TBI history, sleep quality, and suicidal ideation were administered to 130 Iraq/Afghanistan veterans. As expected, sleep quality mediated the effect of TBI history on current suicidal ideation (indirect effect, 0.0082; 95% confidence interval, 0.0019–0.0196), such that history of TBI was associated with worse sleep quality, which was, in turn, associated with increased suicidal ideation. These findings highlight the importance of assessing TBI history and sleep quality during suicide risk assessments for veterans.

*Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco; †Central Texas Veterans Healthcare System; ‡Texas A&M University, College of Medicine, Temple, Texas; §Durham Veterans Affairs Medical Center; ∥VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center; ¶Duke University Medical Center, Durham, North Carolina; #Advanced Fellowship Program in Mental Illness Research and Treatment, Office of Academic Affiliations, US Department of Veterans Affairs, Washington, DC; **Warriors Research Institute, Baylor, Scott & White Healthcare System, Waco; and ††University of Texas, San Antonio, San Antonio, Texas.

Send reprint requests to Bryann B. DeBeer, PhD, VA VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Veterans Memorial Drive, 151-C, Waco, TX 76711. E-mail:

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