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Objective: To describe rates of mild traumatic brain injury (mTBI) with and without concurrent posttraumatic stress disorder a sample of former and current military personnel, and to compare the factor structure of the Neurobehavioral Symptom Inventory (NSI) based on whether participants sustained mTBI with and without a positive posttraumatic stress disorder (PTSD) screen. Setting: Participants recruited and tested at 7 Veterans Affairs (VA) sites and 1 military training facility as part of a national, longitudinal study of mental health, physical, and cognitive outcomes among veterans and service members. Participants: Total of 1540 former and current military personnel with a history of combat exposure. Design: Cross-sectional analysis of observational data, including confirmatory factor analysis. Main Measures: NSI and PTSD Checklist for DSM-5 (PCL-5). Results: Most participants (81.5%) had a history of mTBI and almost half of these screened positive for PTSD (40.5%); only 23.9% of participants without a history of mTBI screened positive for PTSD. Participants with a history of mTBI reported higher elevations of NSI and PCL-5 symptoms compared with those without a history of mTBI. Confirmatory factor analyses of the NSI demonstrated good model fit using a 4-factor structure (somatosensory, affective, cognitive, and vestibular symptoms) among groups of participants both with and without a history of mTBI. Conclusion: Symptoms of mTBI and PTSD are strongly associated with each other among veterans and service members with a history of combat exposure. The 4-factor NSI structure is supported among participants with and without a history of mTBI. These findings suggest the potential benefit of a holistic approach to evaluation and treatment of veterans and service members with concurrent and elevated postconcussive and posttraumatic stress symptoms. [ABSTRACT FROM AUTHOR]

Counselor educators are tasked with preparing counselors to effectively engage a wide range of topics and populations within counseling practice. The cultural experience of clients is often a significant focus both in content and experiential learning opportunities. Given the attention within the profession of counseling on our ability to effectively serve military service members and veterans, this begs the question as to the degree the context of the military is viewed as a unique culture within the field of counselor education. This article describes a research study of counselor educators' perceptions of the military as a unique culture. In addition, current and potential strategies designed to address the experience of military service members, veterans, and their families employed within counselor training programs was also surveyed. The study found counselor educators did view the military as a unique culture. Participants also indicated their view of the potential to utilize a wide range of strategies to enhance understanding on the part of counselors-in-training of the unique experience of military service members, veterans, and their families. Limitations of the study, implications for practice, and future research ideas are also provided. [ABSTRACT FROM AUTHOR]