Mild Traumatic Brain Injury Does not Produce Post-Traumatic Stress Disorder

Abstract

It has been widely assumed that patients who sustain mild traumatic brain injury (MTBI) or post-concussive syndrome develop post-traumatic stress disorder (PTSD) in response to their cognitive difficulties, diminished coping skills, or other losses. This study examined 70 patients who had previously been diagnosed as having either PTSD or MTBI. Each patient was asked to provide a highly detailed chronological history of the events which preceded, followed, and occurred during the traumatic event, to indicate whether they were rendered unconscious or had amnesia for the event, and to describe the various symptoms they developed. All (100.0%) of the PTSD patients were able to provide a highly detailed and emotionally charged recollection of the events which occurred within 15 minutes of the traumatic event in comparison to none (0.0%) of the MTBI patients. None of the MTBI patients reported symptoms such as intrusive recollections of the traumatic event, nightmares, hypervigilance, phobic or startle reactions, or became upset when they were asked to describe the traumatic event or were exposed to stimuli associated with it. These data suggest that PTSD and MTBI are two mutually exclusive disorders, and that it is highly unlikely that MTBI patients develop PTSD symptoms. Furthermore, these findings suggest that clinicians should exercise considerable caution in ruling out PTSD prior to making the diagnosis of MTBI.

Veterans with history of mild traumatic brain injury and posttraumatic stress disorder: Challenges from provider perspective

“…This uncertainty is understandable in light of known difficulties disentangling physical from emotional etiology and the lack of health services and treatment outcome studies focused on mTBI/PTSD [27]. Most scientific literature on co-occurring PTSD and TBI has focused on the controversy as to whether PTSD can occur after a TBI in which amnesia occurs [28][29][30][31][32][33].…”

Posttraumatic stress disorder and posttraumatic stress disorder-like symptoms and mild traumatic brain injury

“…A debate is ongoing as to whether PTSD occurs after a TBI in which amnesia for the traumatic event occurs [40]. Some reports indicate that PTSD does not develop without conscious awareness of the event [41][42][43][44]. Other findings demonstrate that PTSD can occur despite the presence of PTA [24,[36][37][45][46][47].…”

Post-traumatic amnesia and the nature of post-traumatic stress disorder after mild traumatic brain injury

“…Much of the debate has focused on the extent to which PTSD can develop after MTBI. Some commentators have argued that people who sustain a MTBI are unlikely to develop PTSD, because they suffer impaired consciousness secondary to the brain injury, and accordingly, do not encode the necessary mental representations of the traumatic experience to cause fear reactions (Sbordone & Liter, 1995 ). In contrast, others have argued that PTSD can occur after MTBI, because following MTBI, people can still have islands of memory for the traumatic experience, and some fear conditioning can occur despite impaired consciousness, and much trauma can occur following resolution of posttraumatic amnesia.…”