Aspects of Executive Dysfunction and Racial/Ethnic Minority Status are Associated with Unemployment Duration in Veterans with a History of Mild-to-Moderate Traumatic Brain Injury.

Aspects of Executive Dysfunction and Racial/Ethnic Minority Status are Associated with Unemployment Duration in Veterans with a History of Mild-to-Moderate Traumatic Brain Injury.

Clark, Jillian M R;Seewald, P Michelle;Wu, Kevin;Jak, Amy J;Twamley, Elizabeth W;
archives of physical medicine and rehabilitation 2020
294
clark2020aspectsarchives

Abstract

To examine demographic, psychiatric symptom, and neuropsychological performance factors associated with duration of unemployment in Iraq/Afghanistan Veterans with a history of mild-to-moderate traumatic brain injury (TBI).Cross-sectional, secondary data analysis of baseline measures in a supported employment study.VA medical center.Participants (n=50) were Veterans with a history of mild-to-moderate TBI who were unemployed, stating a goal of returning to work, and had documented impairment in at least one neuropsychological domain. Participants were referred from VA vocational and assessment-based clinics.Not applicable.Duration of unemployment, neuropsychological and psychiatric symptom assessments.Bivariate correlations revealed that longer duration of unemployment was associated with greater PTSD (p<.10) and depressive (p<.05) symptom severity, worse executive functioning (p<.05), and racial/ethnic minority status (p<.05). A multiple linear regression analysis including these independent variables explained 26.5% of the variance in duration of unemployment. Worse executive functioning, specifically reasoning and set-shifting, and minority status were each associated with longer duration of unemployment, in the context of multiple independent variables.Our results underscore the importance of objective assessment of cognitive functioning in job-seeking Veterans with TBI histories. It may be useful to target aspects of executive functioning in vocational rehabilitation interventions and to provide additional assistance to Veterans from racial/ethnic minority groups.

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