The Impact of Posttraumatic Stress and Traumatic Brain Injury

1
The Impact of Posttraumatic Stress and Traumatic
Brain Injury

• Wake Tech
• February 12, 2009
• Lisa McLaughlin, MSW, LCSW
• Greg Inman, Ph.D.

2
What is Trauma?

• Trauma is defined as an event where an individual
  experiences, witnesses -- or in the case of a
  family member, hears about -- an event where they
  are confronted with the death, threat of death
  and/or serious injury to themselves or another.
• Their response involves intense fear,
  helplessness or horror.

3
Goal-survival

• Feelings and physical reactions associated to
  trauma are the bodys natural, hardwired skills
  to help us survive these events. Normally, in
  time, these emotions and reactions will naturally
  diminish in intensity.

4
Combat veterans

• Multiple Traumas
• Multiple Deployments
• Additional stressors during deployment (home,
  work, family)
• TBI

5
Post deployment

• Survival skills in combat zone can lead to
  problems at home
• Heightened awareness
• Anger
• Emotional numbness

6
What isPost Traumatic Stress Disorder?

• PTSD develops when the natural reactions of a
  traumatic experience do not reduce and continue
  to be triggered with similar intensity by daily
  events.
• PTSD is often identified through three symptoms
  clusters.
• Reexperiencing
• Arousal
• Avoidance

7
Re-experiencing

• Nightmares
• Intrusive Thoughts
• Flashbacks

8
Arousal

• Anger and Irritability
• Hyperstartle response
• Hypervigilance
• Poor concentration
• Sleep disturbance
• Poor memory

9
Avoidance

• Avoiding thoughts, feelings or conversations that
  remind the veteran of the event
• Avoiding people, places and activities that
  remind them of the event.
• Feeling detached from family and friends
• Lack of participation in activities they used to
  enjoy.
• Overworking, substance abuse or participation in
  high-risk activities.

10
OK, So what is a TBI?

• Traumatic Brain Injury (TBI) is defined as a blow
  or jolt to the head or a penetrating head injury
  that disrupts the function of the brain. Not all
  blows or jolts to the head result in a TBI.
• Think concussion

11
Severity of TBI

• The severity of such an injury may range from
  mild (a brief change in mental status or
  consciousness) to severe (an extended period of
  unconsciousness or amnesia after the injury).
• TBI can result in short or long-term problems
  with independent functioning.

12
Signs and Symptoms of TBI

• Chronic headaches or neck pain
• Difficulty remembering, concentrating, or making
  decisions
• Slowness in thinking, speaking, acting or reading
• Getting lost or easily confused
• Feeling tired all the time, having no energy or
  motivation
• Mood changes (feeling sad or angry for no reason)

13
More Signs and Symptoms

• Changes in sleep patterns (sleeping a lot more or
  having a hard time sleeping)
• Light-headedness, dizziness or loss of balance
• Nausea
• Increased sensitivity to lights, sounds or
  distractions
• Blurred vision or eyes that tire easily
• Loss of sense of smell or taste
• Ringing in the ears (tinnitus)

14
So, is it TBI or PTSD?Or Both?

• Diagnosis can be difficult due to the significant
  number of common signs and symptoms that are
  present in both PTSD and TBI.
• Proper evaluation for both PTSD and TBI is
  essential to provide the most appropriate
  psychological and medical treatment for the
  soldier.

15
How a Veteran Might Present in Education
Environment
16
The Impact on Student Education

• Veteran getting lost in system and not being able
  to communicate his/her needs.
• Difficulty concentrating
• Difficulty completing assignments
• Irritability and interpersonal conflict
• Poor grades/ dropping out of school
• Substance abuse

17
Tips for Educators

• Consider educational needs
• Classroom/test environment
• Timeliness for completion of assignments
• Sensitivity
• Developing plan early
• Encourage independence.

18
More Tips

• Connect with counseling, information and
  education services through the Vet Center or VA
  Medical Center.
• When in doubt, refer for evaluation. Vet Centers
  offer screening and treatment for PTSD. Medical
  Centers provide evaluation treatment for both
  PTSD and TBI.

19
Vet Center Eligibility

• Combat veteran/ family member
• Military sexual trauma
• Bereavement

20
Services Offered

• Individual counseling (trauma and other)
• Couples and family counseling
• Groups
• Outreach and community education
• Off-site services (NC State, rural groups)

21
VA Resources

• Raleigh Vet Center
• 1649 Old Louisburg Road, Raleigh, NC 27604
  919-856-4616.
• Durham VA Medical Center
• OEF/OIF Program Contact Susan Watkins, LCSW at
  919-286-0411, extension 7040.
• Please see program brochures for details.

22
Additional Resources

• Defense and Veterans Brain Injury Center
• www.dvbic.org Offers information on blast
  injuries, patient care needs, and research and
  education on brain injury. Home of the 3
  Question DVBIC TBI Screening tool.
• Brain Injury Association of North Carolina
• www.bianc.net or in Raleigh 1-800-377-1464

23
Questions?
24
To All our Veterans and their FamiliesThank
you for your service!