“…Furthermore, besides psychological stress, the physical injuries that occur in TBI are also associated with an increased risk for comorbid PTSD (Stein et al, 2019;Yurgil et al, 2014), anxiety disorders (Mallya et al, 2015), and fear of symptoms known as fear avoidance (e.g., withdrawal from environments that trigger symptoms) that can contribute to persistent symptoms (Silverberg et al, 2018). Preclinical models of TBI also support heightened and prolonged defensive behaviors (Almeida-Suhett et al, 2014;Jones et al, 2008;Reger et al, 2012), increased sensory sensitivity that promotes exaggerated fear learning (Hoffman et al, , 2020, and increased fear generalization (Hoffman, Watson, et al, 2022;McGowan et al, 2024). Significant stressors, trauma exposure, traumatic injuries, and prior close calls with a predator have a profound impact on subsequent responses and appraisal of threat and potential threat cues.…”