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Mild TBI and Co-Occurring PTSD Symptoms in Service Member Populations

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Traumatic Brain Injury

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Abstract

Posttraumatic stress disorder (PTSD) after traumatic brain injury (TBI) can and does co-occur in both civilian and military populations. The evidence is now clear that TBI is a known risk factor for the development of PTSD in both populations. Given the lack of objective markers for mTBI and PTSD, as well as the overlapping symptoms, the disentanglement of PTSD and mTBI can be challenging. However, there are clear guidelines on how to approach treating the symptoms of each individually. While there is a paucity of research about how to treat these comorbid conditions in a comprehensive way, there are general guidelines that can be useful when treating this population, keeping in mind the use of clinical judgment and the individual needs of the patient being treated. This chapter serves to provide an overview of mild TBI and PTSD in military service member populations, outlines our current understanding of their interaction with one another, provides the current diagnostic criteria for both, outlines a high-level discussion of the interaction between mTBI and PTSD, highlights the empirical treatments for both disorders, and provides recommendations for future directions in understanding the interaction between mTBI and PTSD.

The identification of specific products or scientific instrumentation is considered an integral part of the scientific endeavor and does not constitute endorsement or implied endorsement on the part of the author, Department of Defense or any component agency. The views expressed in this chapter are those of the authors and do not reflect the official policy of the Department of the Army/Navy/Air Force, Department of Defense, or U.S. Government.

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Abbreviations

AOC:

Alteration of consciousness

ART:

Accelerated Response Therapy

CAPS:

Clinician Administered Posttraumatic Stress Disorder Scale

CBT:

Cognitive Behavioral Therapy

CPG:

Clinical Practice Guideline

CPT:

Cognitive Processing Therapy

DoD:

Department of Defense

DoDI 6490.11:

Department of Defense INSTRUCTION 6490.11

DVBIC:

Defense Veterans Brain Injury Center

EMDR:

Eye Movement Desensitization and Reprocessing

GCS:

Glasgow Coma Scale

GWOT:

Global War on Terror

LOC:

Loss of Consciousness

MACE:

Military Acute Concussion Exam

mTBI:

Mild Traumatic Brain Injury

OEF:

Operation Enduring Freedom

OFS:

Operation Freedom’s Sentinel

OIF:

Operation Iraqi Freedom

OIR:

Operation Inherent Resolve

OND:

Operation New Dawn

PCL:

Posttraumatic Disorder Checklist

PE:

Prolonged Exposure Therapy

PTA:

Posttraumatic amnesia

PTSD:

Posttraumatic Stress Disorder

SAC:

Sideline Assessment of Concussion

TBI:

Traumatic Brain Injury

VA/DoD:

Veterans Health Administration/Department of Defense

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Authors and Affiliations

  1. Walter Reed National Military Medical Center, National Intrepid Center of Excellence for Psychological Health and Traumatic Brain Injury, Bethesda, MD, USA

    Jonathan Wolf

  2. Walter Reed National Military Medical Center, National Intrepid Center of Excellence, Bethesda, MD, USA

    Jeannine B. Mielke

  3. Walter Reed National Military Medical Center, Department of Behavioral Health, Bethesda, MD, USA

    Johanna M. Wolf

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Correspondence to Johanna M. Wolf .

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  1. The University of Tennessee Health Science Center, Memphis, TN, USA

    Jack W. Tsao

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Wolf, J., Mielke, J.B., Wolf, J.M. (2020). Mild TBI and Co-Occurring PTSD Symptoms in Service Member Populations. In: Tsao, J. (eds) Traumatic Brain Injury. Springer, Cham. https://doi.org/10.1007/978-3-030-22436-3_13

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