Traumatic brain injury, dissociation, and posttraumatic stress disorder in road traffic accident survivors

Abstract

This study investigated the symptom profiles of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in participants who did and did not sustain traumatic brain injury (TBI), following a road traffic accident. The participants were assessed at three time points: as soon as possible posttrauma as well as at 6 weeks and 3 months posttrauma. At the first assessment, fewer participants from the TBI group recalled feeling fear and helplessness at the time of the trauma, fewer TBI participants reported recurrent intrusive thoughts and images, and more TBI participants reported dissociation since the trauma, relative to the non-TBI group. At the second assessment, fewer participants from the TBI group recalled feeling intense helplessness at the time of the trauma. Fewer TBI participants also reported reliving and physiological reactions on trauma reminders relative to the non-TBI group. At 3 months posttrauma, there was no difference in PTSD symptom profile between non-TBI and TBI groups. Our findings indicate that the presence of TBI is likely to influence the distribution of certain symptoms, but need not be a significant barrier to diagnosing ASD and PTSD.

Exploring the Convergence of Posttraumatic Stress Disorder and Mild Traumatic Brain Injury

“…There are some discussions of comorbid PTSD and TBI in the literature (6)(7)(8)(9)(10)(11)(12)(13), but this association did not come to widespread attention until recent reports from the U.S. military in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom) (1,14,15). This relative inattention to TBI-PTSD comorbidity may reflect the fact that PTSD has been the province of mental health pro-STEIN AND MCALLISTER ajp.psychiatryonline.org fessionals, whereas TBI has been primarily the purview of neurologists, neurosurgeons, neuropsychologists, and physical medicine and rehabilitation specialists.…”

Screening for Traumatic Brain Injury in Prostituted Women

“…Among raped women, battered women, and prostituted women symptoms of TBI include irritability, cognitive deficits, and difficulties in ambulation and speech (Murphy, 1993). These symptoms are also associated with major depression, posttraumatic stress disorder, dissociation, and/or substance abuse (Bjork & Grant, 2009;Brenner et al, 2010;Hayes & Gilbertson, 2012;Hesdorffer, Rauch & Tamminga, 2009;Iverson, 2012;Jones, Harvey & Brewin, 2005;Taylor, Kreutzer, Demm & Meade, 2003).…”

Low predictive power of peritraumatic dissociation for PTSD symptoms in accident survivors

“…Therefore, the excluded cases of amnesia could be considered to be of organic rather than of dissociative nature. (Bryant & Harvey, 1997) as well as of ASD or PTSD (Jones, Harvey, & Brewin, 2005). Of 13 patients considered by the study physicians to suffer from TBI, 3 patients had a GCS score of 13, 3 patients had a GCS score of 14, while the remaining 7 patients had the maximum score of 15.…”