The Role of Early Stress on the Development of PTSD After Blast Injury

PUBLIC ABSTRACT

Background: Blast traumatic brain injuries (BTBI), resulting mostly from improvised explosive devices (IEDs) currently represent the single largest cause of military traumatic brain injury. Individuals exposed to blast waves have been reported to suffer from complex neuropsychiatric symptoms. These include memory impairment and behavioral changes such as aggression, impulsivity, anxiety, impaired social interactions and judgment. Post-traumatic stress disorder (PTSD) is one of the leading disabilities after combat exposure that requires lifelong medical treatment. In addition to exposures to blasts, soldiers are also exposed to increased level of chronic stress.

Significance: The combinatorial effect of chronic stress and blast in the development of PTSD is currently not known, yet this combination is the most common combat experience affecting thousands of soldiers.

Hypothesis: The combination of chronic stress and mBTBI increases the risk for developing PTSD symptoms.

Rationale: If we identify factors that increase the vulnerability to develop PTSD, we will be able to identify individuals with increased susceptibility to develop PTSD and we will be able to develop early intervention to prevent the development of the condition or reduce the burden on the soldier and on the Department of Defense health care system. This paradigm may serve as a model for force readiness.

Objective: The objective of this proposal is to test the concept that the combined exposure to stress AND blast exacerbates PTSD symptomology.