The Influence of Posttraumatic Stress Disorder on Perceptions of Injury

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DESCRIPTION (provided by applicant): There is a growing body of literature that acknowledges the impact of psychological factors on recovery from brain injury. One such factor is perceptions or beliefs about the injury itself. In recent years, studies of civilians with a history of traumatic brain injury (TBI) receiving acute rehabilitation services have shown that injury beliefs and perceptions influence both symptomatic and functional outcomes (Saltapidas & Ponsford, 2008; Whittaker, Kemp, & House, 2007). While these findings are promising in that they identify potential targets for treatment, individuals with co-occurring psychiatric problems, such as Posttraumatic Stress Disorder (PTSD), have been excluded from study participation. As such, there has been little research directly examining the impact of emotional factors, particularly negative affective states associated with psychiatric disorders, on perceptions and beliefs about TBI (Weinman & Petrie, 1997). Given high rates of mTBI and PTSD co-morbidity in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans, it is important to understand how PTSD interacts with cognitive processes (e.g., beliefs, perceptions) that have been shown to impact recovery and functioning following mTBI. The purpose of this pilot study is to examine the effect of PTSD on perceptions and beliefs about physical injury in Veterans with a history of combat mTBI or non-TBI injury. Given the emphasis on cognitive processes in PTSD, and the role of the brain in influencing these processes, the primary aim of this study is to examine whether the impact of PTSD on injury perceptions is different for those with a history of mTBI compared to those whose injuries are non-TBI related. Using a 2x2 factorial design, the present study seeks to compare injury perceptions among four well-defined groups of veterans: (1) those with mTBI and current symptoms and co-occurring PTSD; (2) those with mTBI and current symptoms and no PTSD; (3) those with non-TBI physical injury and current symptoms and co-occurring PTSD; (4) and those with non-TBI physical injury and current symptoms and no PTSD. This grant proposal is in direct support of the Rehabilitation Research and Development goal of maximizing functional recovery in those with TBI by potentially identifying factors that may ultimately be used to develop evidence-based interventions that target the underlying psychological processes that facilitate timely recovery and rehabilitation of Veterans with a history of combat-related injuries and co-morbid PTSD.