Factors associated with employment and work perception in combat-exposed veterans.
Victoria C Merritt, Sarah M Jurick, Laura D Crocker and 3 others
PMID 32297778WHAT IT FOUND
Depression and pain symptoms predicted unemployment, but objective cognitive test scores did not.
History of mild TBI predicted the belief that work ability had declined, not actual unemployment. Clinicians should target negative self-perceptions rather than assuming cognitive deficits are the primary barrier to work.
Key findings
01Higher depression scores were significantly associated with unemployment, whereas PTSD symptoms were not.
02Objective cognitive performance measured by neuropsychological tests was not associated with either employment status or the perception of work ability.
03History of TBI was associated with perceiving a decline in work ability but was not associated with actual unemployment status.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is cross-sectional, so it cannot determine whether poor work perception leads to unemployment or vice versa. Employment and work perception were measured with single-item yes/no questions, which may lack sensitivity. The sample excluded those with severe TBI, psychosis, or active substance dependence, limiting generalizability to more complex cases. The study was not powered to detect differences between part-time and full-time employment. Results may not generalize to female Veterans, non-combat Veterans, or civilians.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not conclude that cognitive deficits are irrelevant to employment. This study found no association between test scores and work outcomes, but it did not measure the functional impact of those deficits in the workplace, nor did it account for the specific demands of the jobs held by the employed participants.