Symptoms of post-traumatic stress: intrusion and avoidance 6 and 12 months after TBI

(1) To examine survivors with traumatic brain injury (TBI) for symptoms of avoidance and intrusion, two dimensions of post-traumatic stress (PTS) at 6 and 12 months post-injury. (2) To identify risk factors associated with these symptoms.

Prospective follow-up study.

Georgia and North Carolina Model Brain Injury Systems participants (n = 198) with mild (19%), moderate (21%) and severe (60%) TBI were interviewed by telephone at 6 and 12 months post-injury. The Impact of Event Scale (IES) was used to identify intrusion and avoidance symptoms.

Symptoms consistent with severe PTS increased from 11% at 6 months to 16% 12 months post-injury (p < 0.003). African-Americans (p < 0.01) and women (p < 0.05) reported greater symptomatology at 12 months compared to their counterparts. TBI severity and memory of the event were not associated with PTS-like symptoms. Symptoms increased over time when examined by race, injury intent, gender and age (p < 0.05).

Regardless of severity, survivors with TBI are at risk for developing symptoms consistent with PTS. Amnesia for the injury event was not protective against developing these symptoms. African-Americans appear to be at greatest risk.