Mild traumatic brain injury and posttraumatic stress disorder and their associations with health symptoms

Vanderploeg, Rodney D.; Belanger, H. G.; Curtiss, G.

doi:10.1037/e717692011-007

Cited by 48 publications

(63 citation statements)

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“…Thus, the final persistent PCS summary variable ranged from 0 (no endorsement of PCS) to 3 (endorsement of all three PCS: headaches, balance problems or dizziness, and memory problems). With the exception of sleep problems, these final 3 symptoms are consistent with results from Vanderploeg et al (2009) who demonstrated that mTBI was associated with headaches, memory problems and fainting, after controlling for PTSD and other psychiatric problems. Internal consistency (Chronbach's alpha) for this three-item persistent PCS scale was .81 in this sample.…”

Section: Methodssupporting

confidence: 78%

“…Belanger, Kretzmer, Vanderploeg and French (2010) likewise found that TBI was significantly related to PCS, but the association disappeared after controlling for PTSD severity, suggesting that symptom complaints in mTBI may be related to emotional distress. Conversely, in a separate study, these authors found that mTBI was associated with PCS even after controlling for PTSD and suggested that PTSD and mTBI have independent additive contributions to the presentation of PCS, with PTSD having a stronger effect on current symptoms (Vanderploeg, Belanger, & Curtiss, 2009). Notably, the presence of a mTBI was associated with lower likelihood of recovery from PTSD over time (Vanderploeg et al, 2009).…”

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confidence: 99%

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Deployment-related TBI, persistent postconcussive symptoms, PTSD, and depression in OEF/OIF veterans.

Morissette

Woodward

Kimbrel

et al. 2011

Rehabilitation Psychology

113

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Objective-A substantial proportion of the more than 2 million service members who have served in Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) have experienced a traumatic brain injury (TBI). Understanding the long-term impact of TBI is complicated by the non-specific nature of postconcussive symptoms (PCS) and the high rates of co-occurrence among TBI, posttraumatic stress disorder (PTSD), and depression. The goal of the present research was to examine the relations among TBI, persistent PCS, and symptoms of PTSD and depression among returning OEF/OIF Veterans.Design-Two-hundred and thirteen OEF/OIF Veterans (87% male) completed a semi-structured screening interview assessing deployment-related TBI and current, persistent PCS. Participants also completed self-report measures of combat exposure and current symptoms of PTSD and depression.Results-Nearly half (46%) of sampled Veterans screened positive for TBI, the majority of whom (85%) reported at least one persistent PCS after removing PCS that overlapped with PTSD and depression. Veterans with deployment-related TBI reported higher levels of combat exposure and symptoms of PTSD and depression. Structural equation modeling was used to assess the fit of three models of the relationships among TBI, combat exposure, persistent PCS, PTSD, and depression. Consistent with hypotheses, the best fitting model was one in which the effects of TBI on both PTSD and depression were fully mediated by non-overlapping persistent PCS.Implications-These findings highlight the importance of addressing persistent PCS in order to facilitate the functional recovery of returning war Veterans.Understanding the long-term effects of traumatic brain injury (TBI) has important public health implications. Estimates suggest that one to two million Americans sustain a TBI annually (Faul, Xu, Wald, & Coronado, 2010;Gerberding & Binder, 2003;Sosin, Sniezek, & Thurman, 1996;Thurman, Alverson, Dunn, Guerrero, & Sniezek, 1999;. Moreover, the large number of Veterans of the wars in Iraq and Afghanistan add to the global incidence of TBI. Since the inception of the current conflicts in Iraq and Afghanistan, more than two million U.S. troops have been deployed as part of (Stein & McAllister, 2009;Vanderploeg, Curtiss, Luis, & Salazar, 2007; Zaloshnja, Miller, Langlois, & Selassie, 2008). U.S. Department of Veterans AffairsIn general, following sports-related mTBI, post-injury cognitive effects (i.e., performance on neuropsychological tests) tend to resolve within 5-7 days (Guskiewicz et al., 2003), and PCS generally resolve within 2 weeks (Carroll et al., 2004). For mTBIs arising from non-sportsrelated events, post-injury cognitive effects tend to resolve within several weeks to 3 months (e.g., Belanger, Curtis, Demery, Lebowitz, & Vanderploeg, 2005;Carroll et al., 2004); however, PCS following mTBI may persist for one year post-injury or longer in adult civilian (Carroll et al., 2004) and Veteran (Stein & McAllister, 2009) samples. Despite the expectation of full recovery in most...

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Section: Methodssupporting

confidence: 78%

mentioning

confidence: 99%

Deployment-related TBI, persistent postconcussive symptoms, PTSD, and depression in OEF/OIF veterans.

Morissette

Woodward

Kimbrel

et al. 2011

Rehabilitation Psychology

113

View full text Add to dashboard Cite

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“…Given their cumulative nature and the risk of long lasting symptoms punches to the head are a major health concern (8). Multiple MBls can lead to a transitory post-concussive syndrome which can develop into a chronic post traumatic stress disorder (9). Given that the probability and severity of post-concussive syndrome are greater for females (10), and children ( 11), the possibility of neurological damage being incurred in any sport that includes both participant groups, warrants closer investigation.…”

mentioning

confidence: 99%

Direct Hits to the Head during Amateur Boxing is Associated with a Rise in Serum Biomarkers for Brain Injury

Graham

Myers

Evans

et al. 2011

Int J Immunopathol Pharmacol

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Boxing exposes participants to the physiological response to high intensity exercise and also to direct body and brain trauma. Amateur boxing is increasing and females have also been included in the Olympics. The aim of this study is to assess the stress response and possible brain injury incurred during a match by measuring serum biomarkers associated with stress and cellular brain injury before and after combat. Sixteen male amateur boxers were studied retrospectively. The study population was divided into two groups: (a) a group that received predominantly punches to the head (PTH) and (b) a group that received predominantly punches to the body (PTB). Blood samples were taken before and five minutes after each contest. They were analysed for S-100B, neuron-specific enolase (NSE), creatine kinase (CK) and cortisol. The PTH group received direct contacts to the head (not blocked, parried or avoided) and to the body (n=8, age: 17.6 ± 5.3, years; height: 1.68 ± 0.13, meters; mass: 65.4 ± 20.3, kg). The PTB group received punches to the body including blocked and parried punches, but received no direct punches to the head, (n=8, mean ± SD, age: 19.1 ± 3.2 years; height: 1.70 ± 0.75, meters; mass: 68.5 ± 15 kg). Significant increases (P<0.05) were observed between pre-and post-combat serum concentrations in serum concentrations in PTH of S-100B (0.35 ± 0.61 vs. 0.54 ± 0.73, Jig.VI) NSE (19.7 ± 14 vs.31.1 ± 26.6, ng.ml") and cortisol (373 ± 202 vs. 756 ± 93, nmel.L"), Significant increases (P<0.05) of creatine kinase were recorded in both groups. This study demonstrates significant elevations in neurochemical biomarkers in boxers who received direct blows to the head. However, further work is required to quantify this volumetric brain damage and long term clinical sequelae.Children as young as 11 years of age are eligible to compete in boxing bouts that involve full contact blows to the head (1). Furthermore, female amateur boxing has also recently been included as an Olympic sport and is a testament to equality in sport and the assumed confidence in the safety of amateur boxing (2). The perception of safety surrounding the sport can be attributed to the lack of consensus in the scientific literature on the potential dangers involved in boxing (3-5), compounded by the assumed protection afforded by the mandatory use of headguards. This position is often assumed to be due to

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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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Mild traumatic brain injury and posttraumatic stress disorder and their associations with health symptoms

Cited by 48 publications

References 0 publications

Deployment-related TBI, persistent postconcussive symptoms, PTSD, and depression in OEF/OIF veterans.

Deployment-related TBI, persistent postconcussive symptoms, PTSD, and depression in OEF/OIF veterans.

Direct Hits to the Head during Amateur Boxing is Associated with a Rise in Serum Biomarkers for Brain Injury

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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