Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Jan-Feb;29(1):89-98.
doi: 10.1097/HTR.0b013e3182865859.

The Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) semistructured interview: evidence of research utility and validity

Catherine Brawn Fortier  1 , Melissa M Amick, Laura Grande, Susan McGlynn, Alexandra Kenna, Lindsay Morra, Alexandra Clark, William P Milberg, Regina E McGlinchey
Affiliations

The Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) semistructured interview: evidence of research utility and validity

Catherine Brawn Fortier et al. J Head Trauma Rehabil. 2014 Jan-Feb.

Abstract

Objective: Report the prevalence of lifetime and military-related traumatic brain injuries (TBIs) in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans and validate the Boston Assessment of TBI-Lifetime (BAT-L).

Setting: The BAT-L is the first validated, postcombat, semistructured clinical interview to characterize head injuries and diagnose TBIs throughout the life span.

Participants: Community-dwelling convenience sample of 131 OEF/OIF veterans.

Design: TBI criteria (alteration of mental status, posttraumatic amnesia, and loss of consciousness) were evaluated for all possible TBIs, including a novel evaluation of blast exposure.

Main measures: BAT-L, Ohio State University TBI Identification Method (OSU-TBI-ID).

Results: About 67% of veterans incurred a TBI in their lifetime. Almost 35% of veterans experienced at least 1 military-related TBI; all were mild in severity, 40% of them were due to blast, 50% were due to some other (ie, blunt) mechanism, and 10% were due to both types of injuries. Predeployment TBIs were frequent (45% of veterans). There was strong correspondence between the BAT-L and the OSU-TBI-ID (Cohen κ = 0.89; Kendall τ-b = 0.95). Interrater reliability of the BAT-L was strong (κs >0.80).

Conclusions: The BAT-L is a valid instrument with which to assess TBI across a service member's lifetime and captures the varied and complex nature of brain injuries across OEF/OIF veterans' life span.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Consensus diagnosis of most severe lifetime TBI by severity in 131 OEF/OIF veterans. The number of veterans who sustained a grade I mTBI, grade II mTBI, grade III mTBI, moderate TBI, or severe TBI for each category of injury is reported. mTBI indicates mild traumatic brain injury; OEF/OIF, Operation Enduring Freedom and Operation Iraqi Freedom.
Figure 2
Figure 2
Total number of military TBIs (blast and other mechanism combined) by severity in 131 OEF/OIF veterans. All military injuries were mTBIs. The percentage of veterans experiencing a military grade I, II, or III injury is reported. mTBI indicates mild traumatic brain injury; OEF/OIF, Operation Enduring Freedom and Operation Iraqi Freedom; TBI, traumatic brain injury.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Vasterling JJ, Brailey K, Proctor SP, Kane R, Heeren T, Franz M. Neuropsychological outcomes of mild traumatic brain injury, posttraumatic stress disorder and depression in Iraq-deployed US Army soldiers. Br J Psychiatry. 2012;201(3):186–192. - PubMed
    1. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. soldiers returning from Iraq. N Engl J Med. 2008;358(5):453–463. - PubMed
    1. Terrio HP, Nelson LA, Betthauser LM, Harwood JE, Brenner LA. Postdeployment traumatic brain injury screening questions: sensitivity, specificity, and predictive values in returning soldiers. Rehabil Psychol. 2011;56(1):26–31. - PubMed
    1. Schell T, Marshall G, Tanielian T, Jayox L, editors. Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery. Vol 4. RAND; Santa Monica, CA: 2008. Survey of individuals previously deployed for OEF/OIF; pp. 87–116.
    1. Schneiderman AI, Braver ER, Kang HK. Understanding sequelae of injury mechanisms and mild traumatic brain injury incurred during the conflicts in Iraq and Afghanistan: persistent postconcussive symptoms and posttraumatic stress disorder. Am J Epidemiol. 2008;167(12):1446–1452. - PubMed

Publication types

MeSH terms