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Disentangling Mild Traumatic Brain Injury and Stress Reactions Richard Bryant, PhD, New England Journal of Medicine (page 2 of 2) Page 2 of 2

There are two very important outcomes of the study by Hoge and colleagues. First, soldiers who have mild traumatic brain injury are at greater risk for health-related problems. Second, soldiers should not be led to believe that they have a brain injury that will result in permanent change. Previous military conflicts have led to syndromes that have involved specific constellations of symptoms that are ascribed to some cause. After the first Gulf War, many soldiers had unexplained somatic symptoms - the so-called Gulf War syndrome - which many commentators ascribed to concern about chemical agents, even though exhaustive tests failed to determine a neurologic basis for the symptoms.14 If troops currently serving in Iraq or Afghanistan are informed about a postconcussive syndrome and persistent problems emerging from mild traumatic brain injury, a new syndrome could arise from the current conflict in which soldiers attribute a range of common stress reactions to the effects of brain injury. This could be damaging to morale and to the person's future mental health, because it could lead to the expectation of poor recovery. In contrast, the normalization of many of these reactions and the recognition that stress-related conditions can be managed with evidence-based strategies may minimize the unnecessary attribution of common stress reactions to pathology and facilitate resilience after mild traumatic brain injury.

No potential conflict of interest relevant to this article was reported.

Source Information

From the School of Psychology, University of New South Wales, Sydney.

References

  1. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. soldiers returning from Iraq. N Engl J Med 2008;358:453-463. [Free Full Text]
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  13. Wessely S, Unwin C, Hotopf M, et al. Stability of recall of military hazards over time: evidence from the Persian Gulf War of 1991. Br J Psychiatry 2003;183:314-322. [Free Full Text]
  14. Jones E, Hodgins-Vermaas R, McCartney H, et al. Post-combat syndromes from the Boer war to the Gulf war: a cluster analysis of their nature and attribution. BMJ 2002;324:321-324. [Erratum, BMJ 2002;324:397.] [Free Full Text]  
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From The New England Journal of Medicine. www.nejm.org.

 Comments [1]

Dear Colleague, In my opinion, there is not discrepancy between mild brain injuries -- if there is such a diagnosis as a brain injury is a brain injury -- and stress reactions. My name is Craig Phillips and I would like to be of service men and women of the armed services and their families. I am an individual living with a brain injury and an invisible disability, a master's level rehabilitation counselor, an author, an educator, a coach, a motivational speaker and an advocate. My brain injury occurred in 1967 when I was 10 years old. For more information please read my About page http://wp.me/P3atD-D. On February 6, 2007 I created Second Chance to Live www.secondchancetolive.wordpress.com to share the strategies that have enabled me to succeed far beyond all reasonable expectations. To date I have written and published 713 articles for Second Chance to Live. I write articles to encourage, motivate, empower and provide hope to individuals impacted by trauma, abuse and adversity. I write articles from the power of identification. See my article The Power of Identification http://wp.me/p3atD-1j and my Testimonial / Endorsement page http://wp.me/P3atD-nD. Articles from Second Chance to Live have been included internationally Publications / Honors page http://wp.me/P3atD-oK. To empower my readers I have created several features on Second Chance to Live. How to Increase / Decrease Font Size http://wp.me/P3atD-3t, How to Translate Second Chance to Live in to your Language http://wp.me/P3atD-13U and How to use Second Chance to Live http://wp.me/P3atD-RV. Second Chance to Live is being used as an educational resource by several consortium's Intute http://wp.me/p3atD-Uv and The Center on Disability Studies at the University of Hawai'i at Manoa http://wp.me/p3atD-YH for both educators and students. Please consider using Second Chance to Live as a resource on your website to serve the individuals that you serve. In the event that you would like to use one of my articles to generate discussion in your support group, please let me know my friend. In the event that you would like to include an article in your upcoming newsletter or other publication, please let me know. For more information, please consult my Media Page http://wp.me/P3atD-d0. I look forward to being of service. Have a pleasant and rewarding day. Craig J. Phillips MRC, BA Second Chance to Live www.secondchancetolive.wordpress.com Our circumstances are not meant to keep us down, but they are meant to build us up.

Mar 14th, 2011 12:04am