Misdiagnosing TBI As PTSD Research Proposal

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PTSD as TBI

Introduction

Post traumatic stress disorder (PTSD) and traumatic brain injury (TBI) bear similar appearances in terms of symptoms. However, treating the two issues requires completely different methods and interventions and therefore it is important to be able to tell the two problems apart. However, as the symptoms are sometimes indistinguishable a thorough and complete understanding of both is necessary so that a health care provider can make an appropriate determination as to which is which.

Background

PTSD emerged in the 1980s as an explanation for behavioral problems that it was then believed stemmed from some kind of external experience that harmed the psychological makeup of the individual. It was used to diagnose soldiers, for instance, who returned home from wars abroad and found it difficult to cope with civilian life. They often turned to drinking or to drugs or gambling or some other form of self-destructive behavior. For their symptoms they were given treatment—a combination of drugs and therapy.

This is different from TBI, as that is a brain injury which is caused by some trauma to the head. It is a physical condition that requires usually a physical intervention. PTSD on the other hand has been described as a catchall diagnosis that is not really valid for all patients who receive this diagnosis.

Defining PTSD and TBI

PTSD has been defined as “a disabling condition, resulting from exposure to traumatic events. Symptoms include intrusive re-experiencing of the trauma, avoidance of trauma-related stimuli, and alterations in cognition, mood, arousal, and reactivity” (Christova et al. 2695). The symptoms of TBI can be similar but can also include speech impairments, fatigue, fainting, nausea, and difficulty concentrating. Likewise, the methods of treatment differ. This is because PTSD relates to an earlier trauma that was suffered by the individual which has caused the person to suppress feelings or thought so as to not have to deal directly with the trauma. In many cases, the individual tries to self-medicate by using drugs or alcohol to help stifle the impulses and feelings that emanate from the PTSD and the underlying trauma that has never been adequately addressed by a professional care provider.

TBI on the other hand stems from a brain injury that alters the physical condition of the brain in some way, which impedes the body’s natural ability to function according to acceptable normative patterns of behavior.

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In many cases TBI and PTSD are co-morbidities that occur in the patient together (Walter et al. 442). As the problem is a physical condition rather than a psychological, emotional or psychosocial condition, TBI treatment usually relies upon methods such as surgery, medication and therapy in order to address the issues that stem from the physical damage caused to the brain. In the case of TBI, the problem is a physical one that debilitates one’s ability to act, while PTSD is a psychological or emotional one that limits the individual’s ability to cope (Groves).

AIS Health and Stress states that PTSD actually stands for Poor Treatment from Slipshod Diagnoses (1). This tongue in cheek way of putting it comes from the fact that the AIS organization has found PTSD to be an easy way for doctors to diagnose a patient whom they don’t understand or have not taken the time to figure out: “Since the term first appeared in the American Psychiatric Association's 1980 DSMIII (Third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders) it is often assumed that PTSD is a new disorder. Its purpose was to describe a set of symptoms resulting from exposure to a traumatic event ‘considered to be outside the range of usual human experience’” (AIS Health and Stress 1). However, if doctors were eager to actually uncover the problems that the person has faced and has learned to probe to see whether other issues and variables might be impacting the patient (such as TBI for instance), the care giver would probably arrive at an alternate diagnosis—one that actually gets to the root o the problem and helps the patient to solve the issues that are plaguing him.

The Problem That Emerges

As AIS Health and Stress points out, the problem of too quickly labeling a disorder as a symptom of PTSD is that the patient may have a serious issue that is not getting treated because the patient is only receiving treatment for PTSD, which usually focuses on helping the patient to cope with some event or experience that has traumatized the person. This intervention can come by way of cognitive behavioral therapy (CBT) for instance or by way of cognitive processing therapy (CPT);….....

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