Experts formulate research related to psychological adjustment and traumatic brain injury

Five U.S. federal agencies recently cosponsored a set of expert work groups to formulate common data elements for research related to psychological adjustment and traumatic brain injury (TBI). Danny G. Kaloupek, PhD, associate professor of psychiatry and behavioral neuroscience at Boston University School of Medicine, chaired the work group on posttraumatic stress disorder (PTSD). Dr. Kaloupek's work at the National Center for PTSD at VA Boston Healthcare helped to guide identification of key PTSD-related characteristics and evidence-based measures that might be used in future research. The results have been published in the November 2010 issue of Archives of Physical Medicine and Rehabilitation.

PTSD has an estimated prevalence of approximately 8 percent among U.S. adults, with much higher rates in subpopulations that include combat exposed military personnel. Potential for co-occurrence of psychological trauma and TBI exists because the same types of violent and life-threatening experiences can cause both conditions. In addition, some of the ways that PTSD can affect functioning are similar to the effects of an increasingly recognized condition labeled mild TBI. For these reasons, PTSD-related measures are likely to be relevant for many studies focusing on TBI.

The work group members were experts from across the U.S. selected to provide a wide range of PTSD expertise. Individual members reviewed published evidence and held discussions to determine which characteristics and factors are most important to future research. Eight categories were identified and reviewed including exposure to traumatic stressors, factors that moderate life stress, PTSD symptoms, mental health history, and domains of functioning.

The work group agreed with several previous recommendations on PTSD measurement but also expanded the scope and updated coverage of the evidence. They described common trends such as greater prevalence of PTSD in women than men and elevated risk for PTSD among ethnic minorities in the U.S. They also noted that childhood adversity involving abuse or serious deprivation has increasingly been recognized as an element in the lives of many people who subsequently develop PTSD. The work group was careful to recognize that the scientific advantages associated with a common set of measures must be balanced with the benefits of innovation and emerging evidence. As Dr. Kaloupek comments, "the work group effort contributes to greater integration of knowledge regarding PTSD and TBI, with the ultimate aim of benefiting the lives of those who experience trauma."

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