Abstract
Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) are associated with increased risk for suicidal thoughts and behaviors. This chapter explores possible underlying neurocognitive and neuroanatomical factors related to PTSD and TBI that may contribute to increased susceptibility to suicidal thoughts and behaviors. The neurocognitive working model of suicidal behavior is used as a guiding framework (Jollant et al. 2011). Possible mechanisms involving altered modulation of value attribution, impaired regulation of emotional and cognitive responses, and facilitation of acts in an emotional context are explored within PTSD, TBI, and their co-occurrence. Discussion of clinical implications and limitations of this conceptual model, as well as directions for future research are provided.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Arlington (Print)
Aupperle RL et al (2012) Executive function and PTSD: disengaging from Trauma. Neuropharmacology 62(2):686–694
Bahraini NH et al (2014) Traumatic brain injury and posttraumatic stress disorder. Psychiatr Clin North Am 37(1):55–75
Bahraini NH et al (2013) Suicidal ideation and behaviours after traumatic brain injury: a systematic review. Brain Impairment 14(1):99–112
Barnes SM, Walter KH, Chard KM (2012) Does a history of mild traumatic brain injury increase suicide risk in veterans with PTSD? Rehabil Psychol 57(1):18–26
Bechara A et al (1994) Insensitivity to future consequences following damage to human pre-frontal cortex. Cognition 50(1–3):7–15
Belanger HG, Vanderploeg RD (2005) The neuropsychological impact of sports-related concussion: a meta-analysis. J Int Neuropsychol Soc 11(4):345–357
Bigler ED (2001) The lesion(s) in traumatic brain injury: implications for clinical neuropsychology. Arch Clin Neuropsychol 16(2):95–131
Bigler ED (2007) Anterior and middle cranial fossa in traumatic brain injury: relevant neuroanatomy and neuropathology in the study of neuropsychological outcome. Neuropsychology 21(5):515–531
Brenner LA (2011) Neuropsychological and neuroimaging findings in traumatic brain injury and post-traumatic stress disorder. Dialogues Clin Neurosci 13(3):311–323
Brenner LA et al (2011a) Posttraumatic stress disorder, traumatic brain injury, and suicide attempt history among veterans receiving mental health services. Suicide Life-Threat Behav 41(4):416–423
Brenner LA, Ignacio RV, Blow FC (2011b) Suicide and traumatic brain injury among individuals seeking veterans health administration services. J Head Trauma Rehabil 26(4):257–264
Brenner LA et al (2013) Prevalence and screening of traumatic brain injury among veterans seeking mental health services. J Head Trauma Rehabil 28(1):21–30
Brenner LA et al (2009a) An exploratory study of neuroimaging, neurologic, and neuropsychological findings in veteran with traumatic brain injury and/or posttraumatic stress disorder. Mil Med 174(4):347–352
Brenner LA, Rodney DV, Heidi T (2009b) Assessment and diagnosis of mild traumatic brain injury, posttraumatic stress disorder, and other polytrauma conditions: burden of adversity hypothesis. Rehabil Psychol 54(3):239–246
Brenner LA et al (2010) Traumatic brain injury, posttraumatic stress disorder, and postconcussive symptom reporting among troops returning from Iraq. J Head Trauma Rehabil 25(5):307–312
Breshears RE et al (2010) Predicting suicidal behavior in veterans with traumatic brain injury: the utility of the personality assessment inventory. J Pers Assess 92(4):349–355
Brown VM, Morey RA (2012) Neural systems for cognitive and emotional processing in posttraumatic stress disorder. Front Psychol 3:1–14
Bryant RA et al (2010) The psychiatric sequelae of traumatic injury. Am J Psychiatry 167(3):312–320
Bullman TA, Kang HK (1994) Posttraumatic stress disorder and the risk of traumatic deaths among vietnam veterans. J Nerv Ment Dis 182(11):604–610
Bush G, Luu P, Posner MI (2000) Cognitive and emotional influences in anterior cingulate cortex. Trends Cogn Sci 4(6):215–222
Carlson KF et al (2011) Prevalence, assessment, and treatment of mild traumatic brain injury and posttraumatic stress disorder: a systematic review of the evidence. J Head Trauma Rehabil 26(2):103–115
Christodoulou C et al (2001) Functional magnetic resonance imaging of working memory impairment after traumatic brain injury. J Neurol Neurosurg Psychiatry 71(2):161–168
Department of Veterans Affairs and The Department of Defense (2009) VA/DoD clinical practice guideline for management of concussion/mild traumatic brain injury. http://mhs.osd.mil/Content/docs/pdfs/policies/2007/07-030.pdf
Desai RA, Dausey DJ, Rosenheck RA (2005) Mental health service delivery and suicide risk: the role of individual patient and facility factors. Am J Psychiatry 162(2):311–318
Dikmen SS et al (2003) Outcome 3 to 5 years after moderate to severe traumatic brain injury. Arch Phys Med Rehabil 84(10):1449–1457
Dougherty DM et al (2004) Laboratory measured behavioral impulsivity relates to suicide attempt history. Suicide Life-Threat Behav 34(4):374–385
Draper K, Ponsford J (2008) Cognitive functioning ten years following traumatic brain injury and rehabilitation. Neuropsychology 22(5):618–625
Eisenberger NI, Lieberman MD, Williams KD (2003) Does rejection hurt? an FMRI study of social exclusion. Science 302(5643):290–292
Etkin A, Wager TD (2007) Functional neuroimaging of anxiety: a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia. Am J Psychiatry 164(10):1476
Fischer H (2013) United States military casualty statistics: operation iraqi freedom and operation enduring freedom. Library of Congress Washington DC Congressional Research Service
Gutierrez PM, Brenner LA, Huggins JA (2008) A preliminary investigation of suicidality in psychiatrically hospitalized veterans with traumatic brain injury. Arch Suicide Res 12(4):336–343
Hanks RA et al (1999) Measures of executive functioning as predictors of functional ability and social integration in a rehabilitation sample. Arch Phys Med Rehabil 80(9):1030–1037
Hayes JP, VanElzakker M, Shin LM (2012) Emotional and cognitive interactions in ptsd: a review of neurocognitive and neuroimaging studies. Front Integr Neurosci 6:1–14
Heaton RK et al (1993) Wisconsin card sorting test: computer version 2. Psychological Assessment Resources, Odessa
Hoge CW et al (2008) Mild traumatic brain injury in US soldiers returning from Iraq. New Engl J Med 358(5):453–463
Homaifar BY et al (2012a) Traumatic brain injury, executive functioning, and suicidal behavior: a brief report. Rehabil Psychol 57(4):337–341
Homaifar BY et al (2012b) Executive functioning as a component of suicide risk assessment: clarifying its role in standard clinical applications. J Mental Health Couns 34(2):110–120
Ilgen MA et al (2010) Psychiatric diagnoses and risk of suicide in veterans. Arch Gen Psychiatry 67(11):1152–1158
Jakupcak M et al (2009) Posttraumatic stress disorder as a risk factor for suicidal ideation in Iraq and Afghanistan war veterans. J Trauma Stress 22(4):303–306
Jantzen KJ et al (2004) A prospective functional MRI imaging study of mild traumatic brain injury in college football players. Am J Neuroradiol 25(5):738–745
Jollant F et al (2011) The suicidal mind and brain: a review of neuropsychological and neuroimaging studies. World J Bio Psychiatry 12(5):319–339
Kessler RC et al (2005a) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 62(6):593–602
Kessler RC et al (2005b) Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 62(6):617–627
Krysinska K, Lester D (2010) Post-traumatic stress disorder and suicide risk: a systematic review. Arch Suicide Res 14(1):1–23
LeardMann CA et al (2013) Risk factors associated with suicide in current and former US military personnel. JAMA 310(5):496–506
Liberzon I, Chandra SS (2007) The functional neuroanatomy of PTSD: a critical review. Prog Brain Res 167:151–169
Marshall RD et al (2001) Comorbidity, impairment, and suicidality in subthreshold PTSD. Am J Psychiatry 158(9):1467–1473
Matthews SC et al (2012) Combat-exposed war veterans at risk for suicide show hyperactivation of prefrontal cortex and anterior cingulate during error processing. Psychosom Med 74(5):471–475
Matthews SC et al (2011) A multimodal imaging study in U. S. veterans of operations Iraqi and enduring freedom with and without major depression after blast-related concussion. Neuroimage 54(1):S69–S75
Meythaler JM et al (2001) Current concepts: diffuse axonal injury–associated traumatic brain injury. Arch Phys Med Rehabil 82(10):1461–1471
Morrison R, O’Connor RC (2008) A systematic review of the relationship between rumination and suicidality. Suicide Life-Threat Behav 38(5):523–538
Nelson LA et al (2009) Relationship between processing speed and executive functioning performance among OEF/OIF veterans: implications for postdeployment rehabilitation. J Head Trauma Rehabil 24(1):32–40
Panagioti M, Gooding PA, Tarrier N (2012) A meta-analysis of the association between posttraumatic stress disorder and suicidality: the role of comorbid depression. Compr Psychiatry 53(7):915–930
Panagioti M, Gooding P, Tarrier N (2009) Post-traumatic stress disorder and suicidal behavior: a narrative review. Clin Psychol Rev 29(6):471–482
Pompili M et al (2013) Posttraumatic stress disorder and suicide risk among veterans: a literature review. J Nerv Mental Dis 201(9):802–812
Ragsdale KA et al (2013) Posttraumatic stress disorder in OEF/OIF veterans with and without traumatic brain injury. J Anxiety Disord 27(4):420–426
Ramchand R et al (2010) Disparate prevalence estimates of PTSD among service members who served in Iraq and Afghanistan: possible explanations. J Trauma Stress 23(1):59–68
Richardson LK, Frueh BC, Acierno R (2010) Prevalence estimates of combat-related post-traumatic stress disorder: critical review. Aust NZJ Psychiatry 44(1):4–19
Romesser J et al (2011) A preliminary study of the effect of a diagnosis of concussion on PTSD symptoms and other psychiatric variables at the time of treatment seeking among veterans. Mil Med 176(3):246–252
Schneiderman AI, Braver ER, Kang HK (2008) 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 167(12):1446–1452
Shin LM, Rauch SL, Pitman RK (2006) Amygdala, medial prefrontal cortex, and hippocampal function in PTSD. Ann NY Acad Sci 1071(1):67–79
Shin LM et al (2005) A functional magnetic resonance imaging study of amygdala and medial prefrontal cortex responses to overtly presented fearful faces in posttraumatic stress disorder. Arch Gen Psychiatry 62(3):273–281
Shvil E et al (2013) Neural, psychophysiological, and behavioral markers of fear processing in PTSD: a review of the literature. Curr Psychiatry Rep 15(5):1–10
Simpson G, Tate R (2007) Suicidality in people surviving a traumatic brain injury: prevalence, risk factors and implications for clinical management. Brain Inj 21(13–14):1335–1351
Stein MB, McAllister TW (2009) Exploring the convergence of posttraumatic stress disorder and mild traumatic brain injury. Am J Psychiatry 166(7):768–776
Stuss DT (2011) Traumatic brain injury: relation to executive dysfunction and the frontal lobes. Curr Opin Neurol 24(6):584–589
Takahashi H et al (2004) Brain activation associated with evaluative processes of guilt and embarrassment: an Fmri study. Neuroimage 23(3):967–974
Tanielian TL, Jaycox LH (eds) (2008) Invisible wounds of war: psychological and cognitive injuries, their consequences, and services to assist recovery, vol 720. Rand Corporation
Tateno A, Jorge RE, Robinson RG (2003) Clinical correlates of aggressive behavior after traumatic brain injury. J Neuropsychiatry Clin Neurosci 15(2):155–160
Teasdale TW, Engberg AW (2001) Suicide after traumatic brain injury: a population study. J Neurol Neurosurg Psychiatry 71(4):436–440
Terrio H et al (2009) Traumatic brain injury screening: preliminary findings in a US army brigade combat team. J Head Trauma Rehabil 24(1):14–23
Tsaousides T, Cantor JB, Gordon WA (2011) Suicidal ideation following traumatic brain injury: prevalence rates and correlates in adults living in the community. J Head Trauma Rehabil 26(4):265–275
Van Der Naalt J et al (1999) Computed tomography and magnetic resonance imaging in mild to moderate head injury: early and late imaging related to outcome. Ann Neurol 46(1):70–78
Weber DL (2008) Information processing bias in post-traumatic stress disorder. Open Neuroimaging J 2:29–51
Wood RL, Williams C (2008) Inability to empathize following traumatic brain injury. J Int Neuropsychol Soc 14(02):289–296
Wortzel HS, Brenner LA, Arciniegas DB (2013) Traumatic brain injury and chronic traumatic encephalopathy: a forensic neuropsychiatric perspective. Behav Sci Law 31(6):721–738
Zappala G, Thiebaut de Schotten M, Eslinger PJ (2012) Traumatic brain injury and the frontal lobes: what can we gain with diffusion tensor imaging? Cortex 48(2):156–165
Zivin K et al (2007) Suicide mortality among individuals receiving treatment for depression in the veterans affairs health system: associations with patient and treatment setting characteristics. Am J Public Health 97(12):2193–2198
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Nazem, S., Lonnquist, E., Monteith, L.L., Brenner, L.A. (2014). Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD) as Risk Factors for Suicidal Thoughts and Behaviors. In: Cannon, K., Hudzik, T. (eds) Suicide: Phenomenology and Neurobiology. Springer, Cham. https://doi.org/10.1007/978-3-319-09964-4_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-09964-4_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-09963-7
Online ISBN: 978-3-319-09964-4
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)