Back to Top Skip to main content Skip to sub-navigation

Distinguishing between TBIs, psychological conditions key to treatment

Military personnel holding a gun A soldier assigned to Charlie Company, 2nd Battalion, 35th Infantry Regiment, 3rd Infantry Brigade Combat Team, 25th Infantry Division conducts battle drill training at Schofield Barracks, Hawaii on Feb. 10. PHCoE section chief Dr. Marjorie Campbell said injuries experienced in battle, including firefights and improvised explosive device explosions, can result in both TBI and conditions such as PTSD (Photo by: Army 1st Lt. Angelo Mejia)

Recommended Content:

Traumatic Brain Injury Center of Excellence | A Head for the Future | Traumatic Brain Injury | Brain Injury Awareness Month | Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit | TBI and Total Force Fitness

Dr. Marjorie Campbell, section chief for prevention and early intervention at the Defense Health Agency's Psychological Health Center of Excellence , says traumatic brain injuries and the psychological effects of experiencing a traumatic event can go hand in hand, but they don't have to.

Campbell, a clinical psychologist at the Silver Spring, Maryland-based PHCoE, has studied the overlap between psychological health and TBI extensively, including being embedded at Naval Hospital Camp Pendleton's Concussion Care Clinic in California. The key, she explained, is figuring out which adverse outcomes can be attributed to TBIs, which can be attributed to conditions like post-traumatic stress disorder, and where there is potential overlap.

"There are three severity levels of TBIs - mild, moderate, and severe," Campbell said. "Over 82% of TBIs in the military are actually considered mild and are better known as concussions."

The severity of a TBI is based on factors including length of loss of consciousness and post-event amnesia, with concussions being at the low end of severity.

Although technically true, referring to concussions as TBIs carries with it an expectation that there is no chance of recovery, which is usually not the case, she explained.

"Within three weeks or so, 90% of individuals sustaining concussions will recover," Campbell said. "Only about 10% go on to develop post-concussion syndrome."

Campbell specializes in studying that 10%.

"When they don't recover, we want to know why," Campbell said. "What's in that group that's continuing to have post-concussive symptoms versus those that get better? I strongly believe it's the psychological health component."

She explained that the possibility likely rests in how that individual sustained the injury. A fall or a sports injury obviously does not carry with it the amount of psychological trauma that an automobile accident or an improvised explosive device explosion during combat does.

"It seems to be that element of trauma that might explain who goes on to develop longer-lasting symptoms," Campbell said.

Symptoms like headaches, sensitivity to light and sound, malaise, fatigue, irritability, depression, anxiety, and dizziness can be associated with a TBI, but are not TBI-specific.

These symptoms are, however, more prevalent in people who have suffered both a concussion and psychological trauma at the same time, Campbell noted.

"What people don’t realize is that there isn’t a strict division between the consequences of experiencing a traumatic brain injury, that seem physically concrete and therefore compelling, and an emotional trauma, which is invisible and might seem 'airy-fairy'," Campbell said.

Watching the World Trade Center fall, being in a motor vehicle accident or experiencing an intense firefight while in combat have the potential to change the brain "without being hit on the head," Campbell explained.

"Trauma alone can change the brain, but when you have the double whammy of a traumatic event and a concussion, determining to which degree psychological aspects versus brain aspects affect them can be difficult to figure out." Campbell said. "We try and do that, and what research has found is that it's the psychological health component that causes these lingering symptoms."

The tendency, she said, is to separate the two, and this does a disservice to everyone, especially the patient.

"The psychological component is probably the bigger burden in terms of outcomes. If you compare someone with post-traumatic stress disorder, or PTSD, and someone with PTSD and a concussion, the person with PTSD and a concussion generally does worse," Campbell said. "But it's counterproductive to over-focus on the concussion when they should have recovered from the acute effects within the first month. If they're not recovering, there's a different reason than the concussion."

Campbell also said that the study of psychological health is integral to the study of TBI and understanding what TBI is.

Her advice to anyone who experiences the short-term impacts of a concussion, whether that be the individual or those around them, is that the symptoms should go away. If they don't, that may be an indicator of another issue.

"The main thing to know is that a bump on the head can distress you and can cause some mild symptoms that should resolve themselves relatively quickly," Campbell said. "In the event that you've had a traumatic event, then you're already compounding the concussion with psychological trauma. If symptoms last longer than four weeks or get worse, the psychological part of it needs to be tended to."

Individuals with lasting symptoms may not necessarily have PTSD, she said, but they're probably experiencing post-concussive symptoms. The bottom line is that a person suffering from the combination of a concussion and a traumatic event usually fares worse.

"People need to know that these two things are related, and they should have someone to talk to," Campbell said.

Looking beyond Campbell's studies, the Psychological Health Center of Excellence is uniquely positioned to collaborate across the Department of Defense, Department of Veterans Affairs, and other agencies to provide leadership and expertise, inform policy and drive improvements in psychological health outcomes.

PHCoE initiatives, such as the Real Warriors Campaign and the inTransition program, address concussions and TBIs in their efforts to help ensure that active-duty and reserve service members, veterans, and retirees have access to both short- and long-term mental health care. PHCoE also collaborates with the Traumatic Brain Injury Center of Excellence to study the overlap of psychological health and TBI conditions.

You also may be interested in...

2010 DoD Worldwide Numbers for TBI

Publication
8/10/2020

DVBIC is the Defense Department’s office of responsibility for tracking TBI data in the U.S. military. On this page you’ll find annual and quarterly reports that provide data on the number of active-duty service members — anywhere U.S. forces are located — with a first-time TBI diagnosis since 2000.

Recommended Content:

Traumatic Brain Injury Center of Excellence | DoD TBI Worldwide Numbers | TBI Educators | Patient and Family Resources | Provider Resources | TBICoE Research | A Head for the Future | Armed Forces Health Surveillance Branch | Defense Medical Surveillance System | Surveillance Case Definitions | Traumatic Brain Injury | TBI Resources

2011 DoD Worldwide Numbers for TBI

Publication
8/10/2020

DVBIC is the Defense Department’s office of responsibility for tracking TBI data in the U.S. military. On this page you’ll find annual and quarterly reports that provide data on the number of active-duty service members — anywhere U.S. forces are located — with a first-time TBI diagnosis since 2000.

Recommended Content:

Traumatic Brain Injury Center of Excellence | DoD TBI Worldwide Numbers | TBI Educators | Patient and Family Resources | Provider Resources | TBICoE Research | A Head for the Future | Armed Forces Health Surveillance Branch | Defense Medical Surveillance System | Surveillance Case Definitions | Traumatic Brain Injury | TBI Resources

2016 DoD Worldwide Numbers for TBI

Publication
8/10/2020

DVBIC is the Defense Department’s office of responsibility for tracking TBI data in the U.S. military. On this page you’ll find annual and quarterly reports that provide data on the number of active-duty service members — anywhere U.S. forces are located — with a first-time TBI diagnosis since 2000.

Recommended Content:

Traumatic Brain Injury Center of Excellence | DoD TBI Worldwide Numbers | TBI Educators | Patient and Family Resources | Provider Resources | TBICoE Research | A Head for the Future | Armed Forces Health Surveillance Branch | Defense Medical Surveillance System | Surveillance Case Definitions | Traumatic Brain Injury | TBI Resources

2018 DoD Worldwide Numbers for TBI

Publication
8/10/2020

DVBIC is the Defense Department’s office of responsibility for tracking TBI data in the U.S. military. On this page you’ll find annual and quarterly reports that provide data on the number of active-duty service members — anywhere U.S. forces are located — with a first-time TBI diagnosis since 2000.

Recommended Content:

Traumatic Brain Injury Center of Excellence | DoD TBI Worldwide Numbers | TBI Educators | Patient and Family Resources | Provider Resources | TBICoE Research | A Head for the Future | Armed Forces Health Surveillance Branch | Defense Medical Surveillance System | Surveillance Case Definitions | Traumatic Brain Injury | TBI Resources

2017 DoD Worldwide Numbers for TBI

Publication
8/10/2020

DVBIC is the Defense Department’s office of responsibility for tracking TBI data in the U.S. military. On this page you’ll find annual and quarterly reports that provide data on the number of active-duty service members — anywhere U.S. forces are located — with a first-time TBI diagnosis since 2000.

Recommended Content:

Traumatic Brain Injury | TBI Resources | Armed Forces Health Surveillance Branch | Defense Medical Surveillance System | Surveillance Case Definitions | Traumatic Brain Injury Center of Excellence | DoD TBI Worldwide Numbers | TBI Educators | Patient and Family Resources | Provider Resources | TBICoE Research | A Head for the Future

AHFTF Ride Right Fact Sheet

Fact Sheet
8/6/2020

This bicycle safety fact sheet provides tips to protect your head and help prevent TBI while riding a bike. It also includes the signs and symptoms of TBI, and how to get help if you think you sustained a brain injury.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | Patient and Family Resources | A Head for the Future | Traumatic Brain Injury | TBI Prevention | TBI Resources

Respect the Road

Fact Sheet
8/6/2020

One of the leading causes of military traumatic brain injury is motor vehicle crashes. This car safety fact sheet provides tips to help prevent TBI while driving a motor vehicle and safety measures to take to keep passengers safe. It also includes the signs and symptoms of TBI, and how to get help if you think you sustained a brain injury.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | Patient and Family Resources | A Head for the Future | Traumatic Brain Injury | TBI Prevention | TBI Resources

Head Check: Know Your Helmet, Bicycle and Motorcycle

Fact Sheet
8/6/2020

A Head for the Future aims to raise awareness about TBI among service members, veterans and their families. This fact sheet provides tips for choosing the right helmet for the right ride, with information about different safety features in helmets for bicycling and riding motorcycles.

Recommended Content:

Traumatic Brain Injury | TBI Prevention | TBI Symptoms | TBI Resources | Traumatic Brain Injury Center of Excellence | TBI Educators | Patient and Family Resources | A Head for the Future

Head Check: Know Your Helmet, Football and Baseball

Fact Sheet
8/6/2020

A Head for the Future aims to raise awareness about TBI among service members, veterans and their families. This fact sheet provides tips for choosing the right helmet for the right sport, with information about different safety features in helmets for football and baseball.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | Patient and Family Resources | A Head for the Future | Traumatic Brain Injury | TBI Prevention | TBI Resources

Cruise with Control

Fact Sheet
8/6/2020

One of the leading causes of military traumatic brain injury is motor vehicle crashes. This fact sheet provides tips on how to stay safe on motorcycles to help prevent TBI while riding. It also includes the signs and symptoms of TBI, and how to get help if you think you sustained a brain injury.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | Patient and Family Resources | A Head for the Future | Traumatic Brain Injury | TBI Prevention | TBI Resources

Heads Up; Sports Safety

Fact Sheet
8/6/2020

This fact sheet provides sports safety tips to prevent or minimize sports-related traumatic brain injury. It also includes the signs and symptoms of TBI, and how to get help if you think you sustained a brain injury.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | Patient and Family Resources | A Head for the Future | Traumatic Brain Injury | TBI Prevention | TBI Resources

Head Check: Know Your Helmet, Winter Sports

Fact Sheet
8/6/2020

A Head for the Future aims to raise awareness about TBI among service members, veterans and their families. This fact sheet provides tips for choosing the right helmet for the right sport, with information about different safety features in helmets for skiing, snowboarding and snowmobiling.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | Patient and Family Resources | A Head for the Future | Traumatic Brain Injury | TBI Prevention | TBI Resources

2003 DoD Worldwide Numbers for TBI

Publication
8/6/2020

DVBIC is the Defense Department’s office of responsibility for tracking TBI data in the U.S. military. On this page you’ll find annual and quarterly reports that provide data on the number of active-duty service members — anywhere U.S. forces are located — with a first-time TBI diagnosis since 2000.

Recommended Content:

Traumatic Brain Injury Center of Excellence | DoD TBI Worldwide Numbers | TBI Educators | Patient and Family Resources | Provider Resources | TBICoE Research | A Head for the Future | Armed Forces Health Surveillance Branch | Defense Medical Surveillance System | Surveillance Case Definitions | Traumatic Brain Injury | TBI Resources

2004 DoD Worldwide Numbers for TBI

Publication
8/6/2020

DVBIC is the Defense Department’s office of responsibility for tracking TBI data in the U.S. military. On this page you’ll find annual and quarterly reports that provide data on the number of active-duty service members — anywhere U.S. forces are located — with a first-time TBI diagnosis since 2000.

Recommended Content:

Traumatic Brain Injury Center of Excellence | DoD TBI Worldwide Numbers | TBI Educators | Patient and Family Resources | Provider Resources | TBICoE Research | A Head for the Future | Armed Forces Health Surveillance Branch | Defense Medical Surveillance System | Surveillance Case Definitions | Traumatic Brain Injury | TBI Resources

2000 DoD Worldwide Numbers for TBI

Publication
8/6/2020

DVBIC is the Defense Department’s office of responsibility for tracking TBI data in the U.S. military. On this page you’ll find annual and quarterly reports that provide data on the number of active-duty service members — anywhere U.S. forces are located — with a first-time TBI diagnosis since 2000.

Recommended Content:

Traumatic Brain Injury | TBI Resources | DoD TBI Worldwide Numbers | Traumatic Brain Injury Center of Excellence | TBI Educators | Patient and Family Resources | Provider Resources | TBICoE Research | A Head for the Future | Defense Medical Surveillance System | Surveillance Case Definitions | Armed Forces Health Surveillance Branch
<< < ... 6 7 8 9 10  ... > >> 
Showing results 76 - 90 Page 6 of 15

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.