Combat-Related mTBI: Patient Subtypes, Empirical Evidence, and Treatment Implications
Jason Bailie, PhD
Seminar date: 12/6/2016
Description: Mild traumatic brain injury (mTBI) is associated with a complex array of symptoms that range from emotional problems to neurosensory dysfunction. To complicate matters, these symptoms vary not only across individuals, but even within the same individual their symptoms will vary over time. As such, a single treatment plan will not fit all patients. Though symptoms are variable, subtypes of mTBI do exist. Specifically in combat-related mTBI, cluster analysis has revealed a unique taxonomy that includes four subtypes: Primarily Psychiatric group, a Cognitive group, a Mixed Symptom group, and a Good Recovery group. The Psychiatric subtype experiences symptoms primarily related to hyperarousal and dissociation/depression with few complaints related to cognition or headaches. The Cognitive group primarily complained of memory and attention issues along with headaches, but few mood symptoms. The Mixed profile has a combination of mood complaints (hyperarousal and dissociation/depression),
cognitive complaints and headaches. The largest cluster of patients had the overall lowest symptom profile and are consistent with the "Good Recovery" typically expected from mTBI. These subtypes are differentiated on multiple external variables which can help in their identification and treatment needs. By characterizing patients with these taxonomy we can better construct treatment plans moving away from a "one size fits all" approach to defined treatment programs that are tailored to the patients' needs based on empirical evidence.
Intended audience: Medical and Mental Health professionals who provide treatment for veterans and active duty military personnel.