Characteristics of PTSD in connection with TBI Loss of consciousness and amnesia Joseph and Masterson [ 1 ] define traumatic brain injury

Background: Severe traumatic stressors such as war, rape, or life-threatening accidents can result in a debilitating psychopathological development conceptualised as Posttraumatic Stress Disorder (PTSD). Pathological memory formation during an alarm response may set the precondition for PTSD to occur. If true, a lack of memory formation by extended unconsciousness in the course of the traumatic experience should preclude PTSD. Methods: 46 patients from a neurological rehabilitation clinic were examined by means of questionnaires and structured clinical interviews. All patients had suffered a TBI due to an accident, but varied with respect to falling unconscious during the traumatic event. Results: 27% of the sub-sample who were not unconscious for an extended period but only 3% (1 of 31 patients) who were unconscious for more than 12 hours as a result of the accident were diagnosed as having current PTSD (P < .02). Furthermore, intrusive memories proved to be far more frequent in patients who had not been unconscious. This was also the case for other reexperiencing symptoms and for psychological distress and physiological reactivity to reminders of the traumatic event. Conclusion: TBI and PTSD are not mutually exclusive. However, victims of accidents are unlikely to develop a PTSD if the impact to the head had resulted in an extended period of unconsciousness. Background Introduction Posttraumatic Stress Disorder (PTSD) may result from psychological trauma, i.e. highly stressful experiences such as rape, severe accidents or war experiences that elicit an extreme alarm response. In the course of the accident, a blow to the head can be so severe that the victim falls unconscious and memory formation becomes interrupted. It is currently not sufficiently known how neurological trauma, resulting in traumatic brain injury (TBI) exactly interferes with the emergence of PTSD. The present study aims to contribute to the resolve of the previously contradictory study outcomes by clarifying the role of unconsciousness. Published: 09 March 2004 BMC Psychiatry 2004, 4:5 Received: 18 November 2003 Accepted: 09 March 2004 This article is available from: http://www.biomedcentral.com/1471-244X/4/5 © 2004 Glaesser et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.