Associations between health-related behaviors and self-reported cognitive symptoms in U.S. military personnel injured on deployment

Sarah M. Jurick*, Cameron T. McCabe, Jessica R. Watrous, Andrew J. MacGregor, Samuel R. Walton, Ian J. Stewart, Lauren E. Walker, Michael R. Galarneau

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Health behaviors may be core contributors to cognition and mental health following mild traumatic brain injury (TBI). The aims of the present study examined: (1) whether health behaviors including sleep duration, alcohol use, and physical activity differed in injured military personnel with and without deployment-related mild TBI history and (2) the relative contributions of health behaviors and deployment-related mild TBI history to self-reported cognitive, posttraumatic stress disorder (PTSD), and depressive symptoms. Participants included 3076 military personnel injured on deployment participating in the Wounded Warrior Recovery Project, an ongoing web-based study. Military personnel with deployment-related mild TBI history reported similar rates of physical activity and levels of alcohol problems as those without, but were less likely to report receiving the recommended duration of sleep. When adjusting for demographic and injury variables, all three health behaviors were associated with cognitive, PTSD, and depressive symptoms. Alcohol problems demonstrated significant but small effects across all outcomes measures (ηp2=.01) whereas physical activity was associated with slightly larger effects albeit still within the small range (ηp2=.02-0.04). Duration of sleep bordered a medium effect for cognitive symptoms (ηp2=.05) and was in the medium range for PTSD and depressive symptoms (ηp2=.06). Although deployment-related mild TBI history was significant in all models, effect sizes were small (ηp2=.01). Findings from the present study provide support that health behaviors have stronger effects with regard to cognitive, PTSD, and depressive symptoms compared to deployment-related mild TBI history in military personnel and, given their modifiable nature, may represent treatment targets in this population.

Original languageEnglish
Pages (from-to)48-55
Number of pages8
JournalJournal of Psychiatric Research
StatePublished - Sep 2023
Externally publishedYes


  • Cognitive functioning
  • Depression
  • Mild traumatic brain injury
  • PTSD
  • Physical activity
  • Sleep


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