Research Reports - Predicting posttraumatic stress symptoms following traumatic brain injury: The role of posttraumatic amnesia

J Head Trauma Rehabil. 2014 May 8

Al-Ozairi A(1), McCullagh S, Feinstein A

OBJECTIVE:: To explore the relation between posttraumatic amnesia (PTA) and
posttraumatic stress symptoms in traumatic brain injury.
DESIGN:: Single-site prospective cohort study.
PARTICIPANTS:: A total of 1114 individuals between the ages of 18 and 65 years
with a traumatic brain injury seen on average 3 months following injury.
Participants were divided into 4 groups according to their duration of PTA: less
than 1 hour; 1 to 24 hours; 24 hours to 1 week; and more than 1 week.
MAIN MEASURES:: Glasgow Coma Scale, PTA, computed tomographic brain scan
abnormalities, Impact of Event Scale, the 28-item General Health Questionnaire,
and Rivermead Postconcussion Disorder Questionnaire.
RESULTS:: The duration of PTA less than 1 hour was associated with more avoidant
(P < .01) and intrusive (P < .001) posttraumatic stress symptoms and more anxiety
according to the General Health Questionnaire (P < .01) than other groups.
Regression analysis identified PTA and 3 concussive symptoms (light sensitivity,
noise intolerance, and difficulties concentrating) as independent predictors of
intrusive posttraumatic stress symptoms.
CONCLUSION:: Our data, representative of the full range of traumatic brain injury
severity, indicate that a brief duration of PTA is a significant risk factor for
the development of posttraumatic stress disorder symptoms. The persistence of
certain symptoms of postconcussion disorder adds to the risk by possibly acting
as a trigger for reminders of the traumatic event.

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