The Influence of Posttraumatic Stress Disorder on Perceptions of Injury

描述（由申请人提供）： 越来越多的文献承认心理因素对脑损伤恢复的影响。其中一个因素是对伤害本身的看法或信念。近年来，对接受急性康复服务的有创伤性脑损伤（TBI）史的平民的研究表明，损伤信念和感知影响症状和功能结果（Saltapidas & Ponsford，2008; Whittaker，肯普，& House，2007）。虽然这些发现是有希望的，因为它们确定了潜在的治疗目标，但患有共同发生的精神问题，如创伤后应激障碍（PTSD）的个体已被排除在研究参与之外。因此，很少有研究直接检查情绪因素的影响，特别是与精神障碍相关的负面情感状态，对TBI的看法和信念（Weinman & Petrie，1997）。鉴于持久自由行动/伊拉克自由行动（OEF/OIF）退伍军人中mTBI和PTSD共病率很高，了解PTSD如何与认知过程相互作用是很重要的（例如，信念，感知）已被证明会影响mTBI后的恢复和功能。这项试点研究的目的是研究创伤后应激障碍的影响的看法和信念的身体伤害的退伍军人与历史的战斗mTBI或非TBI损伤。鉴于对创伤后应激障碍认知过程的重视，以及大脑在影响这些过程中的作用，本研究的主要目的是研究创伤后应激障碍对损伤感知的影响是否与那些有mTBI病史的人不同，与那些损伤与非TBI相关的人相比。本研究采用2 × 2析因设计，旨在比较四组定义明确的退伍军人的伤害感知：（1）mTBI和当前症状和并发PTSD的退伍军人;（2）mTBI和当前症状和无PTSD的退伍军人;（3）非TBI身体伤害和当前症状和并发PTSD的退伍军人;（4）非创伤性脑损伤和当前症状且无创伤后应激障碍者。该拨款提案直接支持康复研究与发展目标，即通过潜在地确定最终可能用于开发循证干预措施的因素，最大限度地提高TBI患者的功能恢复，这些干预措施针对的是促进及时恢复和康复的潜在心理过程退伍军人与战斗相关的伤害和共病PTSD的历史。

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.