In the coming months, EP will explore the subject of traumatic brain injury (TBI) sustained by military personnel in the line of duty and will highlight the conditions that may result from TBI, such as depression and symptoms of post-traumatic stress disorders (PTSD).
The Marine's narrative above illustrates three specific wartime injuries: (1) traumatic brain injury (TBI) as well as neuropsychiatric sequelae (simply put, physical and mental health conditions that may be a result of the TBI), including (2) posttraumatic stress disorder (PTSD) and, (3) depression due to blast exposure.
Research Into TBI and PTSD
Traumatic events such as the September 11th attacks, the wars in Iraq and Afghanistan, and Hurricane Katrina have made the need for research into the areas of TBI and PTSD more imperative. Traumatic brain injury is any event that causes physical damage to the brain. PTSD is an accumulation of symptoms that occurr as a result of the damage sustained by the brain. Researchers need to learn more about TBI and PTSD to offer help and treat those who have sustained injury that is contiguous to the occurrence of the injury. Scientists have found that timely intervention of treatment may serve to limit the severity of neuropsychological consequences.
Symptoms of PTSD
According to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) and the ICD-10 (International Statistical Classification of Diseases and Related Health Problems, 10th Revision), post traumatic stress disorder occurs as a result of exposure to a traumatic event in which the subject has experienced or witnessed events that threatened death or serious injury. Furthermore, the individual's response involves a sense of fear and helplessness. Both the experience and the emotional response to the experience are necessary for the onset of PTSD. There is a marked tendency for the event to be re-experienced mentally in an intrusive fashion, which is difficult to control. This re-living of the experience is described as a flashback.
The flashback is associated with intense psychological distress. Typical features include dreams or nightmares, occurring against the persisting background of a sense of "numbness" and emotional blunting, detachment from other people, unresponsiveness to surroundings, anhedonia (the inability to gain pleasure from enjoyable experiences), and avoidance of activities and situations reminiscent of the trauma. There is usually a state of autonomic hyperarousal with hypervigilance, an enhanced startle reaction, and insomnia. Anxiety and depression are commonly associated with the above symptoms and signs, and suicidal ideation (thoughts about suicide) is not infrequent.
War and Injuries
The war in Iraq has been characterized by a large number of returning military personnel with severe brain injury. While most attention has been focused on penetrating wounds, with their dramatic and disastrous physical damage, other types of brain damage are also significant.
One of the most common sources of injury is blasts in which damage is primarily due to pressure changes resulting from explosions. This may be accompanied by injuries secondary to blunt trauma, due to sudden acceleration of the soldier or his collision with flying objects. Pure blast injuries and some of the more minor blunt trauma injuries result in MTBI (mild traumatic brain injury).
The Centers for Disease Control and Prevention (CDC) criteria for MTBIs include one or more of the following: any period of observed or self-reported transient confusion, disorientation, or impaired consciousness (i.e., altered mental state); dysfunction of memory around the time of injury; or loss of consciousness (LOC) less than 30 minutes; and/or other neuropsychological or neurological dysfunction.
This term is somewhat of a misnomer since MTBIs have other symptoms, including post-concussive syndromes and a variety of neurobehavioral disturbances. …