Citation

McAllister TW, Stein MB. Ann. N. Y. Acad. Sci. 2010; 1208: 46-57.

Affiliation

Department of Psychiatry, Section of Neuropsychiatry, Dartmouth Medical School, Lebanon, New Hampshire. Departments of Psychiatry, and Family and Preventive Medicine, University of California San Diego, La Jolla, California, and VA San Diego Healthcare System, San Diego, California.

Copyright

(Copyright © 2010, John Wiley and Sons)

DOI

10.1111/j.1749-6632.2010.05720.x

PMID

20955325

PMCID

PMC3169086

Abstract

The current conflicts in Iraq and Afghanistan have resulted in a large cohort of military personnel exposed to combat-related psychological trauma as well as biomechanical trauma, including proximity to blast events. Historically, the long-term effects of both types of trauma have been viewed as having different neural substrates, with some controversy over the proper attribution of such symptoms evident after each of the major conflicts of the last century. Recently, great effort has been directed toward distinguishing which neuropsychiatric sequelae are due to which type of trauma. Of interest, however, is that the chronic effects of exposure to either process are associated with a significant overlap in clinical symptoms. Furthermore, similar brain regions are vulnerable to the effects of either psychological or biomechanical trauma, raising the possibility that shared mechanisms may underlie the clinically observed overlap in symptom profile. This paper reviews the literature on the neural substrate of biomechanical and psychological injury and discusses the implications for evaluation and treatment of the neuropsychiatric sequelae of these processes.

Language: en