Data recently collected and reviewed from soldiers serving in Afghanistan and Iraq who sustained a traumatic brain injury reveals a correlation between Traumatic Brain Injury (TBI) and Post-traumatic Stress Disorder (PTSD).

In observance of March 2017 Brain Injury Awareness Month, researchers at the Uniformed Services University of the Health Sciences (USU) and the Defense and Veterans Brain Injury Center published this month in the journal Neurology results of their study “Epidemiology and Prognosis of mTBI in Returning Soldiers: A Cohort Study.”

Reviewing data from screenings for Traumatic Brain Injury (TBI) of about 1,500 soldiers returning from Afghanistan and Iraq between 2009 and 2014, the researchers found that nearly 50% of recently-deployed soldiers who sustained TBI reported at least one severe or very severe post-concussive symptom three months after returning home. Symptoms included headaches, sleep disturbances, forgetfulness, irritability, and trouble concentrating. Consistent with prior research, the study found that many of the soldiers with TBI also reported concurrent health issues such as post-traumatic stress.

Earlier Study First to Establish TBI PTSD Link

Findings published February 15, 2012 in the journal Biological Psychiatry following data collected from the 2012 Marine Resiliency Study (MRS), funded by the National Institutes of Health, US Department of Defense, and UCLA Brain Injury Research Center, showed the first evidence of a causal link between TBI and increased susceptibility to Post-traumatic Stress Disorder (PTSD). The researchers theorized that PTSD could be a reaction to the same event that caused the TBI. Findings from lab research in the study showed that brain injury effects a part of the brain called the Amygdala, leaving it in a more excitable state, in preparation for more trauma.

The main causes of TBI in the military are blasts, motor vehicle accidents, and gunshot wounds. Most soldiers in the study reported having experienced one or more TBI before their most recent deployment, either before joining the military or during an earlier deployment. The rate of PTSD after brain injury is much higher in veterans than civilians due to multiple and prolonged exposure to combat, and symptoms last much longer (18-24 months on average) after the TBI.

Comparing TBI with PTSD Symptoms

While TBI is a neurological disorder caused by trauma to the brain, PTSD is a mental disorder. In civilian life, anyone (child, adolescent, adult, or elderly) who is exposed to a life-threatening trauma such as from a car crash, shooting, flood, fire, assault, and kidnapping, can develop PTSD.

Symptoms of PTSD can include:

  • Repeated memories of the life-threatening event
  • Flashbacks
  • Avoidance of people, places, sights, or sounds that are reminders of the event
  • Feelings of detachment from people and emotional numbness
  • Shame about what happened and was done
  • Survivor guilt with loss of friends or comrades
  • Hypervigilance or constant alertness for threats

Depression, anxiety, changes in memory and concentration, fatigue, substance abuse, and sleep problems are common with both TBI and PTSD, so that when PTSD and TBI coexist, one basically reinforces the other.

There are some differences with TBI symptoms compared with PTSD. For example, while there is memory loss after a TBI, a person with PTSD is plagued and often haunted by unwanted and continuing memories of what happened. Along with passive behavior, a survivor of TBI may experience unexpected uncontrollable bursts of emotion; those with PTSD will feel heightened and overwhelming anxiety combined with emotional numbness and deadened feelings. Survivors of a TBI will retell the traumatic event repeatedly, while a PTSD victim will avoid talking about the trauma.

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