Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-05-30T17:03:30.826Z Has data issue: false hasContentIssue false

20 - Deployment Stress and Concussive Brain Injury: Diagnostic Challenges in Polytrauma Care

from Part III - Diagnosis and Management of Concussion

Published online by Cambridge University Press:  22 February 2019

By
Colleen E. Jackson ,
Rebecca L. Wilken  and
Jennifer J. Vasterling
Edited by
Jeff Victoroff  and
Erin D. Bigler
Jeff Victoroff
Affiliation:
University of Southern California, Torrance
Erin D. Bigler
Affiliation:
Brigham Young University, Utah
Get access

Summary

Earlier chapters in this volume discussed the organicity of all neurological symptoms, and the currently insoluble mystery of differentiating between brain changes due to the dispersion of the forces of impact, due to the pre-morbid nature of the victim, due to the "emotional" (meaning, physiological) effects of stress directly and immediately due to brain rattling, and due to the post-concussive milieu. Perhaps the most salient present-day Western example of the clinical conundrum created by that mystery is how to deal with the overlap between CBI and so-called Post Traumatic Stress Disorder (PTSD) in war fighters post-deployment. One way to frame that intractably interdigitated combination of harms is to employ the term "polytrauma." Recent political/military interventions by Western actors, mostly in the Middle East, have generated large numbers of survivors of polytrauma. The authors of the present chapter address that phenomenon. Their conclusion is important: etiological attribution will only matter when different safe and effective treatments are known to mitigate different diagnosable conditions. Unfortunately, the lack of biomarkers currently paralyzes progress toward such targeted medical management.
Type
Chapter
Information
Concussion and Traumatic Encephalopathy
Causes, Diagnosis and Management
 , pp. 683 - 693
Publisher: Cambridge University Press
Print publication year: 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Department of Veterans Affairs. Analysis of VA health care utilization among Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) veterans. 2014 [updated 2014 June 25; cited 2014 Sept 10]. Available at: www.publichealth.va.gov/epidemiology/reports/oefoifond/health-care-utilization/index.asp.Google Scholar
Tanielian, TL, Jaycox, LH. Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica, CA: RAND Corporation, 2008.Google Scholar
Hayward, P. Traumatic brain injury: The signature of modern conflicts. Lancet Neurol 2008; 7: 200–201.Google Scholar
Hendricks, AM, Amara, J, Baker, E, Charns, MP, Gardner, JA, Iverson, KM, et al. Screening for mild traumatic brain injury in OEF-OIF deployed US military: An empirical assessment of VHA’s experience. Brain Inj 2013; 27: 125–134.CrossRefGoogle ScholarPubMed
Hoge, CW, McGurk, D, Thomas, JL, Cox, AL, Engel, CC, Castro, CA. Mild traumatic brain injury in U.S. soldiers returning from Iraq. N Engl J Med 2008; 358: 453–463.Google Scholar
Schneiderman, AI, Braver, ER, Kang, HK. Understanding sequelae of injury mechanisms and mild traumatic brain injury incurred during the conflicts in Iraq and Afghanistan: Persistent postconcussive symptoms and posttraumatic stress disorder. Am J Epidemiol 2008; 167: 1446–1452.Google Scholar
Fischer, H. A guide to U.S. military casualty statistics: Operation New Dawn, Operation Iraqi Freedom, and Operation Enduring Freedom. Congressional Research Service. [updated 2014 Feb 19; cited 2014 Sept 10]. 2014. Available at: www.fas.org/sgp/crs/natsec/RS22452.pdf.Google Scholar
Veterans Health Administration. Polytrauma/TBI system of care. 2014 [updated 2014 Aug 18; cited 2014 Sept 10]. Available at: www.polytrauma.va.gov/.Google Scholar
Brenner, LA, Vanderploeg, RD, Terrio, H. Assessment and diagnosis of mild traumatic brain injury, posttraumatic stress disorder, and other polytrauma conditions: Burden of adversity hypothesis. Rehabil Psychol 2009; 54: 239–246.Google Scholar
Geiling, J, Rosen, JM, Edwards, RD. Medical costs of war in 2035: Long-term care challenges for veterans of Iraq and Afghanistan. Milit Med 2012; 1777: 1235–1244.Google Scholar
Department of Defense Task Force on Mental Health. An achievable vision: Report of the Department of Defense Task Force on Mental Health. Falls Church: Defense Health Board, 2007.Google Scholar
Kok, BC, Herrell, RK, Thomas, JL, Hoge, CW. Posttraumatic stress disorder associated with combat service in Iraq or Afghanistan: Reconciling prevalence differences between studies. J Nerv Ment Dis 2013; 200: 444–450.Google Scholar
Ramchand, R, Schell, TL, Karney, BR, Osilla, KC, Burns, RM, Caldarone, LB. Disparate prevalence estimates of PTSD among service members who served in Iraq and Afghanistan: Possible explanations. J Trauma Stress 2010; 23: 59–68.Google Scholar
Carlson, KF, Kehle, SM, Meis, LA, Greer, N, MacDonald, R, Rutks, I, et al. Prevalence, assessment, and treatment of mild traumatic brain injury and posttraumatic stress disorder: A systematic review of the evidence. J Head Trauma Rehabil 2011; 26: 103–115.Google Scholar
Jones, E, Wessely, S. War syndromes: The impact of culture on medically unexplained symptoms. Med Hist 2005; 49: 55–78.Google Scholar
Crocq, M-A, Crocq, L. From shell shock and war neurosis to posttraumatic stress disorder: A history of psychotraumatology. Dialogues Clin Neurosci 2000; 2: 47–55.Google Scholar
Mott, FW. Special discussion on shell shock without visible signs of injury. Proc R Med 1916; 9: i–xxiv.Google Scholar
Jones, E, Fear, NT, Wessely, S. Shell shock and mild traumatic brain injury: A historical review. Am J Psychiatry 2007; 164: 1641–1645.Google Scholar
Shively, SB, Perl, DP. Traumatic brain injury, shell shock, and posttraumatic stress disorder in the military – Past, present, and future. J Head Trauma Rehabil 2012; 27: 234–239.Google Scholar
Thomas, HV, Stimpson, NJ, Weightman, AL, Dunstan, F, Lewis, G. Systematic review of multi-symptom conditions in Gulf War veterans. Psychol Med 2006; 36: 735–747.Google Scholar
Bigler, ED. Neuropsychology and clinical neuroscience of persistent post-concussive syndrome. J Int Neuropsychol Soc 2008; 14: 1–22.Google Scholar
Ruff, RM, Camenzuli, L, Mueller, J. Miserable minority: emotional risk factors that influence the outcome of a mild traumatic brain injury. Brain Inj 1996; 10: 551–565.Google Scholar
Wood, R. Understanding the ‘miserable minority’: A diathesis-stress paradigm for post-concussional syndrome. Brain Inj 2004; 18: 1135–1153.CrossRefGoogle Scholar
Dikmen, S, Machamer, J, Fann, JR, Temkin, NR. Rates of symptom reporting following traumatic brain injury. J Int Neuropsychol Soc 2010; 16: 401–411.Google Scholar
Bigler, ED. Neuroimaging biomarkers in mild traumatic brain injury (mild TBI). Neuropsychol Rev 2013; 23: 169–209.Google Scholar
Bigler, ED. Neuropsychological results and neuropathological findings at autopsy in a case of mild traumatic brain injury. J Int Neuropsychol Soc 2004; 10: 794–806.Google Scholar
Brenner, LA, Ivins, B, Schwab, K, Warden, D, Nelson, LA, Jaffee, M, et al. Traumatic brain injury, posttraumatic stress disorder, and postconcussive symptom reporting among troops returning from Iraq. J Head Trauma Rehabil 2010; 25: 307–312.Google Scholar
Lagarde, EM, Salmi, LR, Holm, LW, Contrand, B, Masson, F, Ribéreau-Gayon, R, et al. Association of symptoms following mild traumatic brain injury with posttraumatic stress disorder vs postconcussion syndrome. JAMA Psychiatry 2014; 71: 1032–1040.CrossRefGoogle ScholarPubMed
McAllister, TW. Neurobiological consequences of traumatic brain injury. Dialogues Clin Neurosci 2011; 13: 287–300.Google Scholar
Schell, TL, Marshall, GN, Jaycox, LH. All symptoms are not created equal: The prominent role of hyperarousal in the natural course of posttraumatic psychological distress. J Abnorm Psychol 2004; 113: 189–197.Google Scholar
Ponsford, J, Cameron, P, Fitzgerald, M, Grant, M, Mikocka-Walus, A, Schönberger, M. Predictors of postconcussive symptoms 3 months after mild traumatic brain injury. Neuropsychology 2012; 26: 304–313.Google Scholar
O’Neil, ME, Carlson, KF, Storzbach, D, Brenner, LA, Freeman, M, Quiñones, A, et al. Complications of mild traumatic brain injury in veterans and military personnel: A systematic review. J Int Neuropsychol Soc 2014; 20: 1–13.Google Scholar
Vasterling, JJ, Verfaellie, M, Sullivan, KD. Mild traumatic brain injury and posttraumatic stress disorder in returning veterans: Perspectives from cognitive neuroscience. Clin Psychol Rev 2009; 29: 674–684.Google Scholar
Carlson, KF, Nelson, D, Orazem, RJ, Nugent, S, Cifu, DX, Sayer, NA. Psychiatric diagnoses among Iraq and Afghanistan war veterans screened for deployment-related traumatic brain injury. J Trauma Stress 2010; 23: 17–24.Google Scholar
Maguen, S, Lau, KM, Madden, E, Seal, K. Relationship of screen-based symptoms for mild traumatic brain injury and mental health problems in Iraq and Afghanistan veterans: Distinct or overlapping symptoms? J Rehabil Res Devel 2012; 49: 1115–1126.Google Scholar
West, SL. Substance use among persons with traumatic brain injury: A review. Neuro Rehabil 2011; 29: 1–8.Google Scholar
Sirratt, D, Ozanian, A, Traenkner, B. Epidemiology and prevention of substance use disorders in the military. Milit Med 2012; 177: 21–28.Google Scholar
Halbauer, JD, Ashford, JW, Zeitzer, JM, Adamson, MM, Lew, HL, Yesavage, JA. Neuropsychiatric diagnosis and management of chronic sequelae of war-related mild to moderate traumatic brain injury. J Rehabil Res Devel 2009; 46: 757–796.Google Scholar
Olson-Madden, JH, Brenner, L, Harwood, JEF, Emrick, CD, Corrigan, JD, Thompson, C. Traumatic brain injury and psychiatric diagnoses in veterans seeking outpatient substance abuse treatment. J Head Trauma Rehabil 2010; 25: 470–479.CrossRefGoogle ScholarPubMed
Brenner, LA, Harwood, JEF, Homaifar, BY, Cawthra, E, Waldman, J, Adler, LE. Psychiatric hospitalization and veterans with traumatic brain injury: A retrospective study. J Head Trauma Rehabil 2008; 23: 401–406.Google Scholar
Lew, HL, Pogoda, TK, Baker, E, Stolzmann, KL, Meterko, M, Cifu, DX, et al. Prevalence of dual sensory impairment and its association with traumatic brain injury and blast exposure in OEF/OIF veterans. J Head Trauma Rehabil 2011; 26: 489–496.Google Scholar
Sayer, NA, Chiros, CE, Sigford, B, Scott, S, Clothier, B, Pickett, T, et al. Characteristics and rehabilitation outcomes among patients with blast and other injuries sustained during the global war on terror. Arch Phys Med Rehabil 2008; 89: 163–170.Google Scholar
Romesser, J, Booth, J, Benge, J, Pastorek, N, Helmer, D. Mild traumatic brain injury and pain in Operation Iraqi Freedom/Operation Enduring Freedom veterans. J Rehabil Res Dev 2012; 49: 1127–1136.Google Scholar
Cifu, DX, Taylor, BC, Carne, WF, Bidelspach, D, Sayer, NA, Scholten, J, et al. Traumatic brain injury, posttraumatic stress disorder, and pain diagnoses in OIF/OEF/OND veterans. J Rehabil Res Dev 2013; 50: 1169–1176.Google Scholar
Shipherd, JC, Keyes, M, Jovanovic, T, Ready, DJ, Baltzell, D, Worley, V, et al. Veterans seeking treatment for posttraumatic stress disorder: What about comorbid chronic pain? J Rehabil Res Dev 2007; 44: 153–166.Google Scholar
Runnals, JJ, Van Voorhees, E, Robbins, AT, Brancu, M, Straits-Troster, K, Beckham, JC, et al. Self-reported pain complaints among Afghanistan/Iraq era men and women veterans with comorbid posttraumatic stress disorder and major depressive disorder. Pain Med 2013; 14: 1529–1533.Google Scholar
Lew, HL, Otis, JD, Tun, C, Kerns, RD, Clark, ME, Cifu, DX. Prevalence of chronic pain, posttraumatic stress disorder, and persistent postconcussive symptoms in OIF/OEF veterans: Polytrauma clinical triad. J Rehabil Res Dev 2009; 46: 697–702.Google Scholar
Lew, HL, Poole, JH, Vanderploeg, RD, Goodrich, GL, Dekelboum, S, Guillory, SB, et al. Program development and defining characteristics of returning military in a VA Polytrauma Network Site. J Rehabil Res Dev 2007; 44: 1027–1034.Google Scholar
Cauda, F, Palermo, S, Costa, T, Torta, R, Duca, S, Vercelli, U, et al. Gray matter alterations in chronic pain: A network-oriented meta-analytic approach. Neuroimage Clin 2014; 4: 676–685.Google Scholar
Lutz, J, Jäger, L, de Quervain, D, Krauseneck, T, Padberg, F, Wichnalek, M, et al. White and gray matter abnormalities in the brain of patients with fibromyalgia. Arthritis Rheum 2008; 58: 3960–3969.Google Scholar
Teepker, M, Menzler, K, Belke, M, Heverhagen, JT, Voelker, M, Mylius, V, et al. Diffusion tensor imaging in episodic cluster headache. Headache 2011; 52: 274–282.Google Scholar
Otis, JD, Fortier, CB, Keane, TM. Chronic pain. In: Vasterling, JJ, Bryant, RA, Keane, TM, editors. PTSD and mild traumatic brain injury. New York: Guilford Press, 2012, pp. 105–123.Google Scholar
Wessely, S, Unwin, C, Hotopf, M, Hull, L, Ismail, K, Nicolaou, V, et al. Stability of recall of military hazards over time: Evidence from the Persian Gulf War of 1991. Br J Psychiatry 2003; 183: 314–322.Google Scholar
Candel, I, Merckelbach, H. Peritraumatic dissociation as a predictor of post-traumatic stress disorder: A critical review. Compr Psychiatry 2004; 45: 44–50.Google Scholar
Schwartz, ED, Kowalski, JM, McNally, RJ. Malignant memories: Post-traumatic changes in memory in adults after a school shooting. J Trauma Stress 1993; 6: 545–553.Google Scholar
Southwick, SM, Morgan, CA III, Nicolaou, AL, Charney, DS. Consistency of memory for combat-related traumatic events in veterans of Operation Desert Storm. Am J Psychiatry 1997; 154: 173–177.Google ScholarPubMed
Management of Concussion/Mild TBI Workgroup. VA/DoD clinical practice guideline for management of concussion/mild traumatic brain injury. J Rehabil Res Dev 2009; 46: CP1–CP58.Google Scholar
The Management of Concussion-mild Traumatic Brain Injury Working Group. VA/DoD clinical practice guideline for the management of concussion-mild traumatic brain injury. Version 2.0 – 2016 Available at: www.healthquality.va.gov/guidelines/Rehab/mtbi/mTBICPGFullCPG50821816.pdf.Google Scholar
Corrigan, JD, Bogner, JA. Initial reliability and validity of the OSU TBI identification method. J Head Trauma Rehabil 2007; 22: 318–329.Google Scholar
Fortier, CB, Amick, MM, Grande, L, McGlynn, S, Kenna, A, Morra, L, et al. The Boston Assessment of Traumatic Brain Injury – Lifetime (BAT-L) semistructured interview: Evidence of research utility and validity. J Head Trauma Rehabil 2013; 29: 89–98.Google Scholar
Donnelly, KT, Donnelly, JP, Dunnam, M, Warner, GC, Kittleson, CJ, Constance, JE, et al. Reliability, sensitivity, and specificity of the VA Traumatic Brain Injury Screening tool. J Head Trauma Rehabil 2011; 26: 439–453.Google Scholar
Ulloa, EW, Marx, BP, Vanderploeg, RD, Vasterling, JJ. Assessment. In: Vasterling, JJ, Bryant, RA, Keane, TM, editors. PTSD and mild traumatic brain injury. New York: Guilford Press, 2012, pp. 149–173.Google Scholar
Vanderploeg, RD, Groer, S, Belanger, HG. Initial developmental process of VA semistructured clinical interview for TBI identification. J Rehabil Res Dev 2012; 49: 545–556.Google Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition. Arlington, VA: American Psychiatric Publishing, 2013.Google Scholar
Weathers, FW, Keane, TM, Foa, FB. Assessment and diagnosis of adults. In: Foa, E, Friedman, MJ, Cohen, JA, editors. Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies. New York: Guilford Press, 2009, pp. 23–61.Google Scholar
Krinsley, KE. Psychometric review of The Evaluation of Lifetime Stressors Questionnaire and Interview. In: Stamm, BH, editor. Measurement of stress, trauma, and adaptation. Luberville: Sidran Press, 1996.Google Scholar
Gray, M, Litz, B, Hsu, J, Lombardo, T. Psychometric properties of the Life Events Checklist. Assessment 2004; 11: 330–341.Google Scholar
Kubany, E, Haynes, S, Leisen, M, Owens, J, Kaplan, A, Watson, S, et al. Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: The Traumatic Life Events Questionnaire. Psychol Assess 2000; 12: 210–224.Google Scholar
Otis, JD, McGlinchey, R, Vasterling, JJ, Kerns, RD. Complicating factors associated with mild traumatic brain injury: Impact on pain and posttraumatic stress disorder treatment. J Clin Psychol Med Settings 2011; 18: 145–154.Google Scholar
Cicerone, KD, Kalmar, K. Persistent post-concussion syndrome: The structure of subjective complaints after mild traumatic brain injury. J Head Trauma Rehabil 1995; 10: 1–17.Google Scholar
King, PR, Donnelly, KT, Donnelly, JP, Dunnam, M, Warner, G, Kittleson, CJ, et al. Psychometric study of the Neurobehavioral Symptom Inventory. J Rehabil Res Dev 2012; 49: 879–888.Google Scholar
Weathers, FW, Litz, BT, Keane, TM, Palmieri, PA, Marx, BP, Schnurr, PP. The PTSD Checklist for DSM-5 (PCL-5). 2013 [updated 2014 May 2, cited 2014 Sept 15]. Available at: www.ptsd.va.gov.Google Scholar
Beck, AT, Steer, RA, Brown, GK. Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation, 1996.Google Scholar
Howe, LLS. Giving context to post-deployment post-concussive-like symptoms: Blast-related potential mild traumatic brain injury and comorbidities. Clin Neuropsychol 2009; 23: 1315–1337.CrossRefGoogle ScholarPubMed
Elhai, JD, Sweet, JJ, Guidotti Breting, LM, Kaloupek, D. Assessment in contexts that threaten response validity. In: Vasterling, JJ, Bryant, RA, Keane, TM, editors. PTSD and mild traumatic brain injury. New York, Guilford Press, 2012, pp. 174–198.Google Scholar
Greiffenstein, MF, Baker, WJ. Validity testing in dually diagnosed post-traumatic stress disorder and mild closed head injury. Clin Neuropsychol 2008; 22: 565–582.Google Scholar
Milliken, CS, Auchterlonie, JL, Hoge, CW. Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. JAMA 2007; 298: 2141–2148.Google Scholar
Vogt, D. Mental health-related beliefs as a barrier to service use for military personnel and veterans: a review. Psychiatr Serv 2011; 62: 135–142.Google Scholar
Hoge, CW, Castro, CA, Messer, SC, McGurk, D, Cotting, DI, Koffman, RL. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med 2004; 351: 13–22.Google Scholar
Stecker, T, Fortney, JC, Hamilton, F, Ajzen, I. An assessment of beliefs about mental health care among veterans who served in Iraq. Psychiatr Serv 2007; 58: 1358–1361.Google Scholar
Villemure, R, Nolin, P, LeSage, N. Self-reported symptoms during post-mild traumatic brain injury in acute phase: Influence of interviewing method. Brain Inj 2011; 25: 53–64.Google Scholar
Freeman, T, Powell, M, Kimbrell, T. Measuring symptom exaggeration in veterans with chronic posttraumatic stress disorder. Psychiatry Res 2008; 158: 374–380.Google Scholar
Iverson, GL, Brooks, BL, Ashton, VL, Lange, RT. Interview versus questionnaire symptom reporting in people with the postconcussion syndrome. J Head Trauma Rehabil 2010; 25: 23–30.Google Scholar
Lange, RT, Iverson, GL, Rose, A. Post-concussion symptom reporting and the good-old days bias following mild traumatic brain injury. Arch Clin Neuropsychol 2010; 25: 442–450.CrossRefGoogle ScholarPubMed
Vasterling, JJ, Brailey, K, Proctor, SP, Kane, R, Heeren, T, Franz, M. Neuropsychological outcomes of mild traumatic brain injury, post-traumatic stress disorder and depression in Iraq-deployed US Army soldiers. Br J Psychiatry 2012; 201: 186–192.Google Scholar
Weathers, FW, Blake, DD, Schnurr, PP, Kaloupek, DG, Marx, BP, Keane, TM. The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). 2013 [updated 2014 May 2, cited 2014 Sept 15]. Available at: www.ptsd.va.gov.Google Scholar
Reardon, AF, Brief, DJ, Miller, MW, Keane, TM. Assessment of PTSD and its comorbidities in Adults. In: Friedman, MJ, Keane, TM, Resick, PA, editors. Handbook of PTSD: Science and practice. New York: Guilford Press, 2014, pp. 369–390.Google Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th edition. Washington, DC: American Psychiatric Association, 1994.Google Scholar
Weathers, F, Litz, B, Herman, D, Huska, J, Keane, T. The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Paper presented at: The Annual Convention of the International Society for Traumatic Stress Studies; 1993; San Antonio, TX.Google Scholar
Blake, DD, Weathers, F, Nagy, LM, Kaloupek, DG, Klauminzer, G, Charney, DS, et al. A clinician rating scale for assessing current and lifetime PTSD: The CAPS-1. Behav Ther 1990; 13: 187–188.Google Scholar
Forbes, D, Creamer, M, Biddle, D. The validity of the PTSD checklist as a measure of symptomatic change in combat-related PTSD. Behav Res Ther 2001; 39: 977–986.Google Scholar
Goodwin, BE, Sellbom, M, Arbisi, PA. Posttraumatic stress disorder in veterans: The utility of the MMPI-2-RF validity scales in detecting overreported symptoms. Psychol Assess 2013; 25: 671–678.Google Scholar
Castro, F, Hayes, JP, Keane, TM. Issues in the assessment of PTSD. In: Moor, BA, Penk, WE, editors. Treating PTSD in military personnel: A clinical handbook. New York: Guilford Press, 2011, pp. 23–41.Google Scholar
Koucky, EM, Dickstein, BD, Chard, KM. Cognitive behavioral treatments for posttraumatic stress disorder: Empirical foundation and new directions. CNS Spectr 2013; 18: 73–81.Google Scholar
Ponsford, J. Treatment of mild traumatic brain injury. In: Vasterling, JJ, Bryant, RA, Keane, TM, editors. PTSD and mild traumatic brain injury. New York: Guilford Press, 2012, pp. 199–218.Google Scholar
Wortzel, HS, Arciniegas, DB. Treatment of post-traumatic cognitive impairments. Curr Treat Options Neurol 2012; 14: 493–508.Google Scholar
Mitchell, MD, Gehrman, P, Perlis, M, Umscheid, CA. Comparative effectiveness of cognitive behavioral therapy for insomnia: A systematic review. BMC Fam Pract 2012; 13: 40–50.Google Scholar
Taylor, DJ, Pruiksma, KE. Cognitive and behavioural therapy for insomnia (CBT-I) in psychiatric populations: A systematic review. Int Rev Psychiatry 2014; 26: 205–213.Google Scholar
Jungquist, CR, O’Brien, C, Matteson-Rusby, S, Smith, MT, Pigeon, WR, Xia, Y, et al. The efficacy of cognitive-behavioral therapy for insomnia in patients with chronic pain. Sleep Med 2010; 11: 302–309.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×