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，对有创伤性脑损伤(TBI)病史的平民接受急性康复服务的研究表明，对伤害的信念和看法影响症状和功能结果(Salcapidas&Ponsford，2008；Whittaker，Kemp，&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，但患有创伤后应激障碍(PTSD)等共生精神问题的个人被排除在研究参与之外。因此，很少有研究直接考察情绪因素，特别是与精神障碍相关的负面情绪状态对对脑外伤的认知和信念的影响(Weinman&Petrie，1997)。鉴于持久自由行动/伊拉克自由行动(OEF/OIF)退伍军人合并创伤后应激障碍和创伤后应激障碍的高发病率，重要的是了解创伤后应激障碍如何与认知过程(例如，信念、感知)相互作用，这些过程已被证明影响了创伤后的恢复和功能。这项先导性研究的目的是考察创伤后应激障碍对有战斗创伤和非颅脑损伤病史的退伍军人对身体损伤的感知和信念的影响。鉴于创伤后应激障碍的认知过程以及大脑在影响这些过程中的作用，本研究的主要目的是检验创伤后应激障碍对创伤感知的影响是否与那些有mTBI病史的人和那些损伤与之无关的人不同。本研究采用2×2析因设计，试图比较四组明确的退伍军人对创伤的认知：(1)有mTBI和当前症状但同时存在PTSD的退伍军人；(2)有mTBI和当前症状但没有PTSD的退伍军人；(3)没有脑外伤且有当前症状和同时存在PTSD的退伍军人；(4)和那些没有受过脑创伤并有当前症状但没有PTSD的退伍军人。这项赠款提案直接支持康复研究和发展目标，即通过潜在地确定最终可能被用于开发以证据为基础的干预措施的因素，从而最大限度地促进脑外伤患者的功能恢复，这些干预措施针对的是潜在的心理过程，有助于有战斗相关伤害和合并创伤后应激障碍病史的退伍军人及时恢复和康复。

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.