Article

Mild traumatic brain injury and posttraumatic stress disorder in returning veterans: perspectives from cognitive neuroscience.

Psychology Service and VA National Center for PTSD, VA Boston Healthcare System, (116B), 150 S. Huntington Ave., Boston, MA 02130, USA.
Clinical psychology review (Impact Factor: 7.18). 09/2009; 29(8):674-84. DOI: 10.1016/j.cpr.2009.08.004
Source: PubMed

ABSTRACT A significant proportion of military personnel deployed in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) has been exposed to war-zone events potentially associated with traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). There has been significant controversy regarding healthcare policy for those service members and military veterans who returned from OEF/OIF deployments with both mild TBI and PTSD. There is currently little empirical evidence available to address these controversies. This review uses a cognitive neuroscience framework to address the potential impact of mild TBI on the development, course, and clinical management of PTSD. The field would benefit from research efforts that take into consideration the potential differential impact of mild TBI with versus without persistent cognitive deficits, longitudinal work examining the trajectory of PTSD symptoms when index trauma events involve TBI, randomized clinical trials designed to examine the impact of mild TBI on response to existing PTSD treatment interventions, and development and examination of potential treatment augmentation strategies.

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Available from: Jennifer Vasterling, Jun 21, 2015
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    ABSTRACT: Although loss of consciousness associated with moderate or severe traumatic brain injury (TBI) is thought to interfere with encoding of the TBI event, little is known about the effects of mild TBI (mTBI), which typically involves only transient disruption in consciousness. Blast-exposed Afghanistan and Iraq War veterans were asked to recall the blast event. Participants were stratified based on whether the blast was associated with probable mTBI (n = 50) or not (n = 25). Narratives were scored for organizational structure (i.e., coherence) using the Narrative Coherence Coding Scheme (Reese et al., 2011) and episodic recollection using the Autobiographical Interview Coding Procedures (Levine et al., 2002). The mTBI group produced narratives that were less coherent but contained more episodic details than those of the no-TBI group. These results suggest that mTBI interferes with the organizational quality of memory in a manner that is independent of episodic detail generation. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Neuropsychology 04/2015; DOI:10.1037/neu0000198 · 3.43 Impact Factor
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    ABSTRACT: Objective: Although loss of consciousness associated with moderate or severe traumatic brain injury (TBI) is thought to interfere with encoding of the TBI event, little is known about the effects of mild TBI (mTBI), which typically involves only transient disruption in consciousness. Method: Blast-exposed Afghanistan and Iraq War veterans were asked to recall the blast event. Participants were stratified based on whether the blast was associated with probable mTBI (n=50) or not (n =25). Narratives were scored for organizational structure (i.e., coherence) using the Narrative Coherence Coding Scheme (Reese et al., 2011) and episodic recollection using the Autobiographical Interview coding procedures (Levine et al., 2002). Results: The mTBI group produced narratives that were less coherent but contained more episodic details than those of the no-TBI group. Conclusions: These results suggest that mTBI interferes with the organizational quality of memory in a manner that is independent of episodic detail generation.
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