Assessment and diagnosis of mild traumatic brain injury, posttraumatic stress disorder, and other polytrauma conditions: Burden of adversity hypothesis.

Brenner, Lisa A.; Vanderploeg, Rodney D.; Terrio, Heidi

doi:10.1037/a0016908

Cited by 174 publications

(154 citation statements)

References 50 publications

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“…In 2010, an estimated 408,167 Veterans treated at VA medical centers and clinics had a primary or secondary diagnosis of PTSD [19]. Overlap exists among the symptoms of PTSD and those of mTBI [21], and these symptoms contribute to road rage, anxious driving, and other forms of risky driving [4,[13][14]. The previous studies offer findings about the impact of mTBI and/or PTSD on driving behaviors.…”

Section: Introductionmentioning

confidence: 99%

Exploratory pilot study of driving perceptions among OIF/OEF Veterans with mTBI and PTSD

Hannold¹,

Classen²,

Winter³

et al. 2013

J Rehabil Res Dev

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Abstract-Veterans of Iraq and Afghanistan may experience driving-related challenges postdeployment, including more atfault crashes. Causes may include defensive driving tactics learned for combat zones and consequences of traumatic brain injuries (TBIs) and posttraumatic stress disorder (PTSD). Tailoring driver interventions to meet Veterans' needs requires an understanding of their driving perceptions. We explored the driving perceptions of five combat Veterans (4 men, 1 woman) with mild TBI and PTSD using grounded theory methods. Veterans participated in single, semistructured interviews during a comprehensive driving evaluation. Interviews were digitally recorded, transcribed verbatim, verified, and imported into NVivo 8 software for coding and analysis. Veterans were insightful about driving and identified specific environmental triggers for anxious driving, speeding, and road rage. Veterans used strategies to moderate driving behaviors, but continued to drive aggressively. Themes were used to develop a conceptual framework of driving postdeployment, laying the foundation for intervention studies.

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Section: Introductionmentioning

confidence: 99%

Exploratory pilot study of driving perceptions among OIF/OEF Veterans with mTBI and PTSD

Hannold¹,

Classen²,

Winter³

et al. 2013

J Rehabil Res Dev

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show abstract

“…This can lead to incomplete evaluation of symptoms that are not reported immediately. In fact, the initial evaluation may be accurate because some symptoms of PTSD may not even occur until several months later [2][3][4]. Even when symptoms are fully reported, there is considerable overlap with screening for TBI and PTSD because both may be present [2,[5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Postdeployment symptom changes and traumatic brain injury and/or posttraumatic stress disorder in men

Macera¹,

Aralis²,

MacGregor³

et al. 2012

JRRD

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Abstract-In Operation Iraqi Freedom and Operation EnduringFreedom, blast-related injuries associated with combat are frequent and can result in traumatic brain injury (TBI) symptoms that may be difficult to distinguish from psychological problems. Using data from the Post-Deployment Health Assessment and Reassessment, we identified 12,046 male U.S. Navy sailors and Marines with reported combat exposure from 2008 to 2009. Symptoms potentially associated with blast-related TBI and posttraumatic stress disorder (PTSD) that were reported immediately after deployment were compared with symptoms present several months later. Our study supports others that have found that subjects with blast-related injuries may experience the development or worsening of symptoms during the months following deployment. Additionally, our study found that those who screened positive for PTSD and TBI formed a unique group, with the presence of TBI exacerbating development of PTSD symptoms at reassessment. Providers should recognize the late development of symptoms, consider the possibility of comorbidity, and be prepared to treat multiple symptoms rather than a specific diagnostic category.

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“…PTSD symptom reporting increases in service members sustaining an MTBI, 3,19 and post-concussion symptom endorsement increases in service members with ongoing PTSD. 2,20,21 There is a growing clinical movement to address the commonalities between these maladies [22][23][24] rather than trying to separate the two phenomena into their component parts.…”

mentioning

confidence: 99%

A Multisite Study of the Relationships between Blast Exposures and Symptom Reporting in a Post-Deployment Active Duty Military Population with Mild Traumatic Brain Injury

Reid

Miller

Lange

et al. 2014

Journal of Neurotrauma

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Explosive devices have been the most frequent cause of traumatic brain injury (TBI) among deployed contemporary U.S. service members. The purpose of this study was to examine the influence of previous cumulative blast exposures (that did or did not result in TBI) on later post-concussion and post-traumatic symptom reporting after sustaining a mild TBI (MTBI). Participants were 573 service members who sustained MTBI divided into four groups by number of blast exposures (1, 2, 3, and 4-10) and a nonblast control group. Post-concussion symptoms were measured using the Neurobehavioral Symptom Inventory (NSI) and post-traumatic stress disorder (PTSD) symptoms using the Post-traumatic Checklist-Civilian version (PCL-C). Results show groups significantly differed on total NSI scores ( p < 0.001), where symptom endorsement increased as number of reported blast exposures increased. Total NSI scores were significantly higher for the 3-and 4-10 blast groups compared with the 1-and 2-blast groups with effect sizes ranging from small to moderate (d = 0.31 to 0.63). After controlling for PTSD symptoms using the PCL-C total score, NSI total score differences remained between the 4-10-blast group and the 1-and 2-blast groups, but were less pronounced (d = 0.35 and d = 0.24, respectively). Analyses of NSI subscale scores using PCL-C scores as a covariate revealed significant between-blast group differences on cognitive, sensory, and somatic, but not affective symptoms. Regression analyses revealed that cumulative blast exposures accounted for a small but significant amount of the variance in total NSI scores (4.8%; p = 0.009) and total PCL-C scores (2.3%; p < 0.001). Among service members exposed to blast, post-concussion symptom reporting increased as a function of cumulative blast exposures. Future research will need to determine the relationship between cumulative blast exposures, symptom reporting, and neuropathological changes.

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Assessment and diagnosis of mild traumatic brain injury, posttraumatic stress disorder, and other polytrauma conditions: Burden of adversity hypothesis.

Abstract: The importance of early screening for both conditions is highlighted. In addition, the authors suggest that current best practices include treating symptoms regardless of etiology to decrease military personnel and veteran burden of adversity.

Cited by 174 publications

References 50 publications

Exploratory pilot study of driving perceptions among OIF/OEF Veterans with mTBI and PTSD

Exploratory pilot study of driving perceptions among OIF/OEF Veterans with mTBI and PTSD

Postdeployment symptom changes and traumatic brain injury and/or posttraumatic stress disorder in men

A Multisite Study of the Relationships between Blast Exposures and Symptom Reporting in a Post-Deployment Active Duty Military Population with Mild Traumatic Brain Injury

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