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PTSD and Mild Traumatic Brain Injury in Iraq and Afghanistan War

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Comprehensive Guide to Post-Traumatic Stress Disorder

Abstract

For more than a decade, several million US and other coalition military forces have been deployed to support the military conflicts in and around Iraq and Afghanistan. Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) are two of the signature injuries sustained by deployed military personnel. This chapter reviews the symptomatology, epidemiology, etiology, assessment, and diagnosis of PTSD and mild TBI in Iraq and Afghanistan war veterans. The chapter also reviews the prevention and treatment of PTSD and mild TBI in these populations.

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Abbreviations

ANSF:

Afghan National Security Forces

CPT:

Cognitive processing therapy

DoD:

Department of Defense

HERRICK:

Code name for UK military operations in Afghanistan

IED:

Improvised explosive devices

ISAF:

International Security Assistance Force

ISIL:

Islamic State of Iraq and the Levant

ISIS:

Islamic State of Iraq and Syria

MNF-I:

Multi-National Force – Iraq

mTBI:

Mild traumatic brain injury

OEF:

Operation Enduring Freedom

OIF:

Operation Iraqi Freedom

OND:

Operation New Dawn

PCL:

PTSD Checklist

PCL-5:

PTSD Checklist for DSM-5

PCL-M:

PTSD Checklist Military Version

PCS:

Postconcussive syndrome

PDHA:

Post-Deployment Health Assessment

PDHRA:

Post-Deployment Health Re-Assessment

PE:

Prolonged exposure

PTSD:

Posttraumatic stress disorder

TBI:

Traumatic brain injury

TELIC:

Code name for UK military operations in Iraq

UK:

United Kingdom

US:

United States/United States of America

VA:

Department of Veterans Affairs

References

  • Adler AB, Castro CA, McGurk D. Time-driven Battlemind psychological debriefing: a group-level early intervention in combat. Mil Med. 2009;174:21–8.

    Article  PubMed  Google Scholar 

  • Armed Forces Health Surveillance Center. DoD worldwide numbers for TBI. Defense and Veterans Brain Injury Center. 2014. http://www.dvbic.org/TBI-Numbers.aspx. Accessed 8 Oct 2014.

  • Brenner LA, Ivins BJ, Schwab K, Warden D, et al. Traumatic brain injury, posttraumatic stress disorder, and postconcussive symptom reporting among troops returning from Iraq. J Head Trauma Rehabil. 2010;25:307–12.

    Article  PubMed  Google Scholar 

  • Browne T, Hull L, Horn O, et al. Explanations for the increase in mental health problems in UK reserve forces who have served in Iraq. Br J Psychiatry. 2007;190:484–9.

    Article  PubMed  Google Scholar 

  • Bryant RA, Harvey AG. Postconcussive symptoms and posttraumatic stress disorder following mild traumatic brain injury. J Nerv Ment Dis. 1999;187:302–5.

    Article  PubMed  Google Scholar 

  • Bryant RA, Moulds M, Guthrie R, et al. Treating acute stress disorder following mild traumatic brain injury. Am J Psychiatry. 2003;160:585–7.

    Article  PubMed  Google Scholar 

  • Carroll LJ, Cassidy JD, Peloso PM, et al. Prognosis of mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on mild traumatic brain injury. J Rehabil Med. 2004;43:84–105.

    Article  PubMed  Google Scholar 

  • Champion HR, Holcomb JB, Young LA. Injuries from explosions: physics, biophysics, pathology, and required research focus. J Trauma-Inj Infect Crit Care. 2009;66:1468–77.

    Article  Google Scholar 

  • Chard KM, Schumm JA, McIlvain SM, et al. Exploring the efficacy of a residential treatment program incorporating cognitive processing therapy-cognitive for veterans with PTSD and traumatic brain injury. J Trauma Stress. 2011;24(3):347–51.

    Article  PubMed  Google Scholar 

  • Cicerone KD, Dahlberg C, Malec JF, et al. Evidence-based cognitive rehabilitation: updated review of the literature from 1998 through 2002. Arch Phys Med Rehabil. 2005;86(8):1681–92.

    Article  PubMed  Google Scholar 

  • Cooper DB, Kennedy JE, Cullen MA, et al. Association between combat stress and post-concussive symptom reporting in OEF/OIF service members with mild traumatic brain injuries. Brain Inj. 2011;25:1–7.

    Article  PubMed  Google Scholar 

  • Cornum R, Matthews MD, Seligman MEP. Comprehensive soldier fitness: building resilience in a challenging institutional context. Am Psychol. 2011;66:4–9.

    Article  PubMed  Google Scholar 

  • Department of Defense. National Defense Authorization Act for Fiscal Year 2012, Section 724: report on memorandum regarding traumatic brain injuries. Washington, DC: Department of Defense; 2012.

    Google Scholar 

  • Department of Veterans Affairs & Department of Defense. VA/DoD clinical practice guideline for management of concussion/mild traumatic brain injury (mTBI). Washington, DC: Department of Veterans Affairs & Department of Defense; 2009. http://www.healthquality.va.gov/guidelines/Rehab/mtbi/concussion_mtbi_full_1_0.pdf. Accessed 8 Oct 2014.

    Google Scholar 

  • French LM, Parkinson GW. Assessing and treating veterans with traumatic brain injury. J Clin Psychol. 2008;64:1004–13.

    Article  PubMed  Google Scholar 

  • Gawande A. Casualties of war military care for the wounded from Iraq and Afghanistan. N Engl J Med. 2004;351:2471–5.

    Article  PubMed  Google Scholar 

  • Gaylord KM, Cooper DB, Mercado JM, et al. Incidence of posttraumatic stress disorder and mild traumatic brain injury in burned service members: preliminary report. J Trauma. 2008;64(2 Suppl):200S–6.

    Article  Google Scholar 

  • Hessen E, Nestvold K, Anderson V. Neuropsychological function 23 years after mild traumatic brain injury: a comparison of outcome after pediatric and adult head injuries. Brain Inj. 2007;21:963–79.

    Article  PubMed  Google Scholar 

  • Hoge CW, Auchterlonie JL, Milliken CS. Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. J Am Med Assoc. 2006;295(9):1023–1032.

    Google Scholar 

  • Hoge CW, Castro CA, Messer SC, et al. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med. 2004;351(1):13–22.

    Article  PubMed  Google Scholar 

  • Hoge CW, McGurk D, Thomas JL, et al. Mild traumatic brain injury in US soldiers returning from Iraq. N Eng J Med. 2008;358:453–63.

    Article  Google Scholar 

  • Institute of Medicine. Long-term effects of blast exposure, Gulf War and Health, vol. 9. Washington, DC: National Academies Press; 2014.

    Google Scholar 

  • Institute of Medicine (IOM). Treatment of posttraumatic stress disorder: an assessment of the evidence. Washington, DC: The National Academies Press; 2008.

    Google Scholar 

  • International Security Assistance Force. Troop contributing nations. NATO/OTAN. 4 Aug 2014. http://www.isaf.nato.int/images/media/140804placemat.pdf. Accessed 8 Oct 2014.

  • Kay T, Harrington D, Adams R, et al. Definition of mild traumatic brain injury. J Head Trauma Rehabil. 1993;8:86–7.

    Article  Google Scholar 

  • Kessler RC, Wang PS. The descriptive epidemiology of commonly occurring mental disorders in the United States. Annu Rev Public Health. 2008;29:115–29.

    Article  PubMed  Google Scholar 

  • Marx BP, Brailey K, Proctor SP, et al. Association of time since deployment, combat intensity, and posttraumatic stress symptoms with neuropsychological outcomes following Iraq war deployment. Arch Gen Psychiatry. 2009;66:996–1004.

    Article  PubMed  Google Scholar 

  • Masterson JS. Posttraumatic stress disorder and traumatic brain injury: are they mutually exclusive? J Trauma Stress. 1999;12:437–53.

    Article  PubMed  Google Scholar 

  • McAllister TW, Arciniegas D. Evaluation and treatment of postconcussive symptoms. NeuroRehabilitation. 2002;17:265–83.

    PubMed  Google Scholar 

  • McLay RN, Deal WE, Murphy JA, et al. On-the-record screenings versus anonymous surveys in reporting PTSD. Am J Psychiatry. 2008;165:775–6.

    Article  PubMed  Google Scholar 

  • Morissette SB, Woodward M, Kimbrel NA, et al. Deployment-related TBI, persistent postconcussive symptoms, PTSD, and depression in OEF/OIF veterans. Rehabil Psychol. 2011;56:340–50.

    Article  PubMed  Google Scholar 

  • Murray CK, Reynolds JC, Schroeder JM, et al. Spectrum of care provided at an echelon II medical unit during Operation Iraqi Freedom. Mil Med. 2005;170:516–20.

    Article  PubMed  Google Scholar 

  • National Institute for Clinical Excellence. Post-traumatic stress disorder (PTSD): the management of PTSD in adults and children in primary and secondary care. London: National Institute for Clinical Excellence; 2005.

    Google Scholar 

  • Okie S. Traumatic brain injury in the war zone. N Engl J Med. 2005;252:2043–7.

    Article  Google Scholar 

  • Owens BD, Kragh JF, Wenke JC, et al. Combat wounds in Operation Iraqi Freedom and Operation Enduring Freedom. J Trauma. 2008;64:295–9.

    Article  PubMed  Google Scholar 

  • Ozer EJ, Best SR, Lipsey TL, et al. Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol Bull. 2003;129:52–73.

    Article  PubMed  Google Scholar 

  • Peterson AL, Luethcke CA, Borah EV, et al. Assessment and treatment of combat-related PTSD in returning war veterans. J Clin Psychol Med Settings. 2011;18:164–75.

    Article  PubMed  Google Scholar 

  • Polusny MA, Kehle SM, Nelson NW, et al. Longitudinal effects of mild traumatic brain injury and posttraumatic stress disorder comorbidity on postdeployment outcomes in National Guard soldiers deployed to Iraq. Arch Gen Psychiatry. 2011;68:79–89.

    Article  PubMed  Google Scholar 

  • Ramchand R, Karney BR, Osilla KC, et al. Prevalence of PTSD, depression, and TBI among returning service members. In: Tanelian T, Jaycox LH, editors. Invisible wounds of war: psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica: RAND Corporation; 2008.

    Google Scholar 

  • Resick PA, Nishith P, Weaver TL, et al. A comparison of cognitive processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. J Consult Clin Psychol. 2002;70:867–79.

    Article  PubMed Central  PubMed  Google Scholar 

  • Resick PA, Williams LF, Suvak MK, et al. Long-term outcomes of cognitive–behavioral treatments for posttraumatic stress disorder among female rape survivors. J Consult Clin Psychol. 2012;80:201–10.

    Article  PubMed Central  PubMed  Google Scholar 

  • Richardson LK, Frueh BC, Acierno R. Prevalence estimates of combat-related post-traumatic stress disorder: critical review. Aust N Z J Psychiatry. 2010;44:4–19.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ryan PB, Lee-Wilk T, Kok BC, et al. Interdisciplinary rehabilitation of mild TBI and PTSD: a case report. Brain Inj. 2011;25:1019–25.

    Article  PubMed  Google Scholar 

  • Schneiderman AI, Braver ER, Kang HK. Understanding sequelae of injury mechanisms and mild traumatic brain injury incurred during the conflicts in Iraq and Afghanistan: persistent postconcussive symptoms and posttraumatic stress disorder. Am J Epidemiol. 2008;167:1446–52.

    Article  PubMed  Google Scholar 

  • Stein NR, Mills MA, Arditte K, et al. A scheme for categorizing traumatic military events. Behav Modif. 2012;36:787–807.

    Article  PubMed  Google Scholar 

  • Tanielian T, Jaycox LH, editors. Invisible wounds of war: psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica: RAND Corporation; 2008.

    Google Scholar 

  • Weathers FW, Litz BT, Herman DS, et al. The PTSD Checklist (PCL): reliability, validity, and diagnostic utility. Paper presented at: annual meeting of the International Society for Traumatic Stress Studies; October 1993; San Antonio.

    Google Scholar 

  • Weathers FW, Litz BT, Keane TM, et al. The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD. 2013. http://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp. Accessed 8 Oct 2014.

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Correspondence to Alan L. Peterson .

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Moring, J.C., Blankenship, A.E., Williams, J.M., Molino, A., Peterson, A.L. (2015). PTSD and Mild Traumatic Brain Injury in Iraq and Afghanistan War. In: Martin, C., Preedy, V., Patel, V. (eds) Comprehensive Guide to Post-Traumatic Stress Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-08613-2_69-1

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  • DOI: https://doi.org/10.1007/978-3-319-08613-2_69-1

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