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  • Journal of the International Neuropsychological Society, Volume 9, Issue 4
  • May 2003, pp. 663-676

Coexistence of posttraumatic stress disorder and traumatic brain injury: Towards a resolution of the paradox

  • DOI:
  • Published online: 01 May 2003

The coexistence of posttraumatic stress disorder (PTSD) and traumatic head or brain injury (TBI) in the same individual has been proposed to be paradoxical. It has been argued that individuals who sustain a TBI and have no conscious memory of their trauma will not experience fear, helplessness and horror during the trauma, nor will they develop reexperiencing symptoms or establish the negative associations that underlie avoidance symptoms. However, single case reports and incidence studies suggest that PTSD can be diagnosed following TBI. We highlight critical issues in assessment, definitions, and research methods, and propose two possible resolutions of the paradox. One resolution focuses on ambiguity in the criteria for diagnosing PTSD. The other involves accepting that TBI patients do experience similar symptoms to other PTSD patients, but that there are crucial differences in symptom content. (JINS, 2003, 9, 663–676.)

Corresponding author
Reprint requests to: Allison Harvey, Department of Experimental Psychology, University of Oxford, South Parks Road, Oxford OX1 3UD, UK. E-mail:
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Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
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