Prevalence, Assessment, and Treatment of Mild Traumatic Brain Injury and Posttraumatic Stress Disorder

Carlson, Kathleen F.; Kehle, Shannon M.; Meis, Laura; Greer, Nancy; MacDonald, Russell D.; Rutks, Indulis; Sayer, Nina A.; Dobscha, Steven K.; Wilt, Timothy J

doi:10.1097/htr.0b013e3181e50ef1

Cited by 260 publications

(192 citation statements)

References 60 publications

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“…This would agree with findings in other anxiety disorders. However, the majority of patients seen clinically and recruited into the study had both PTSD and mTBI, which is consistent with the observations of other investigators (Carlson et al, 2011;Taylor et al, 2012). Thus, the question is whether combat Veterans with PTSD (most with mTBI as well, but some with PTSD-only) will show deficits in error monitoring as indexed by the ERN.…”

Section: Introductionsupporting

confidence: 82%

Intact error monitoring in combat Veterans with post-traumatic stress disorder

Swick

Honzel

Turken

2015

Psychiatry Research: Neuroimaging

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The error-related negativity (ERN) is a neuroelectric signature of performance monitoring during speeded response time tasks. Previous studies indicate that individuals with anxiety disorders show ERN enhancements that correlate with the degree of clinical symptomology. Less is known about the error monitoring system in post-traumatic stress disorder (PTSD). PTSD is characterized by impairments in the regulation of fear and other emotional responses, as well as deficits in maintaining cognitive control. Here, combat Veterans with PTSD were compared to control Veterans in two different versions of the flanker task (n=13 or 14 per group). Replicating and extending previous findings, PTSD patients showed an intact ERN in both experiments. In addition, task performance and error compensation behavior were intact. Finally, ERN amplitude showed no relationship with self-reported PTSD, depression, or post-concussive symptoms. These results suggest that error monitoring represents a relative strength in PTSD that can dissociate from cognitive control functions that are impaired, such as response inhibition and sustained attention. A healthy awareness of errors in external actions could be leveraged to improve interoceptive awareness of emotional state. The results could have positive implications for PTSD treatments that rely on self-monitoring abilities, such as neurofeedback and mindfulness training.

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Section: Introductionsupporting

confidence: 82%

Intact error monitoring in combat Veterans with post-traumatic stress disorder

Swick

Honzel

Turken

2015

Psychiatry Research: Neuroimaging

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“…Owing to increased awareness of the prevalence of TBI and high rates of co-occurrence between PTSD and TBI among OEF/OIF Veterans (Hoge et al, 2008;Carlson et al, 2011), few studies have examined the effect of PTSD on neuropsychological test performance independent of the effect of TBI. The Neurocognition Deployment Health Study (NDHS) examined cognitive functioning among soldiers before and after deployment to Iraq (OIF) and found an interaction between PTSD symptom severity and time since deployment on sustained attention (Marx et al, 2009a).…”

Section: Attention and Executive Functioningmentioning

confidence: 99%

“…Studies of OEF/OIF military Veterans are complicated by the variable and often lengthy duration between the time of injury(ies) and formal neuropsychological assessment, high rates of co-occurrence between mTBI and PTSD in this population (e.g., Carlson et al, 2011;Hoge et al, 2008), symptom overlap between mTBI and PTSD, as well as the potential influence of post-secondary gain (e.g., Nelson, Hoelzle, McGuire, Gerrier-Auerbach, Charlesworth, & Sponheim, 2010).…”

Section: Neuropsychology Of Mtbimentioning

confidence: 99%

Neuropsychological Sequelae of PTSD and TBI Following War Deployment among OEF/OIF Veterans

et al. 2012

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Posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) are highly prevalent among Veterans of the conflicts in Iraq and Afghanistan. These conditions are associated with common and unique neuropsychological and neuroanatomical changes. This review synthesizes neuropsychological and neuroimaging studies for both of these disorders and studies examining their co-occurrence. Recommendations for future research, including utilizing combined neuropsychological and advanced neuroimaging techniques to study these disorders alone and in concert, are presented. It is clear from the dearth of literature that more attention in the literature should be given to examining temporal relationships between PTSD and mTBI, risk and resilience factors associated with both disorders and their co-occurrence, and mTBI-specific factors such as time since injury and severity of injury, utilizing comprehensive, yet targeted cognitive tasks.

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“…As described elsewhere [46], International Classification of Diseases, 9th Revision, Clinical Modification [47] diagnostic codes in VHA administrative data for posttraumatic stress disorder (PTSD) and depression were used to identify these common disorders documented in OIF/OEF veterans [6,46,[48][49]. We limited this identification to codes assigned in two or more encounters [48] in primary care, mental health, women's health, or rehabilitation clinics or from an inpatient stay during fiscal years 2007-2009.…”

Section: Psychiatric Diagnosesmentioning

confidence: 99%

Multisensory impairment reported by veterans with and without mild traumatic brain injury history

Pogoda¹,

Hendricks²,

Iverson³

et al. 2012

JRRD

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Abstract-With the use of Veterans Health Administration and Department of Defense databases of veterans who completed a Department of Veterans Affairs comprehensive traumatic brain injury (TBI) evaluation, the objectives of this study were to (1) identify the co-occurrence of self-reported auditory, visual, and vestibular impairment, referred to as multisensory impairment (MSI), and (2) examine demographic, deployment-related, and mental health characteristics that were potentially predictive of MSI. Our sample included 13,746 veterans with either a history of deployment-related mild TBI (mTBI) (n = 9,998) or no history of TBI (n = 3,748). The percentage of MSI across the sample was 13.9%, but was 17.4% in a subsample with mTBI history that experienced both nonblast and blast injuries. The factors that were significantly predictive of reporting MSI were older age, being female, lower rank, and etiology of injury. Deployment-related mTBI history, posttraumatic stress disorder, and depression were also significantly predictive of reporting MSI, with mTBI history the most robust after adjusting for these conditions. A better comprehension of impairments incurred by deployed servicemembers is needed to fully understand the spectrum of blast and nonblast dysfunction and may allow for more targeted interventions to be developed to address these issues.

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Prevalence, Assessment, and Treatment of Mild Traumatic Brain Injury and Posttraumatic Stress Disorder

Abstract: The wide range of mTBI/PTSD frequency levels was likely due to variation across studyparameters, including aims and assessment methods. Studies using consistent, validated methods to define and measure mTBI history andPTSD are needed.

Cited by 260 publications

References 60 publications

Intact error monitoring in combat Veterans with post-traumatic stress disorder

Intact error monitoring in combat Veterans with post-traumatic stress disorder

Neuropsychological Sequelae of PTSD and TBI Following War Deployment among OEF/OIF Veterans

Multisensory impairment reported by veterans with and without mild traumatic brain injury history

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