Posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) can each cause significant functional impairment--and these "invisible injuries" frequently co-occur. Events that lead to traumatic brain injury are often also psychologically traumatic. This authoritative volume brings together leading experts in PTSD and mTBI to explore the nature, consequences, and management of these interacting conditions. Presenting cutting-edge research and clinical practices, the book meets a growing need among mental health practitioners in both civilian and military contexts. The volume focuses on the complexities of caring for patients with comorbid PTSD and mTBI, whether caused by war-zone experiences, motor vehicle accidents, domestic violence or other interpersonal assaults, or sports concussions. Contributors examine the biological and psychosocial mechanisms underlying both disorders as well as potential ways they may affect each other. Commonly associated problems that may further complicate recovery--chronic pain and substance abuse--are also discussed in detail. Reviewing empirically based best practices in assessment and treatment, chapters offer recommendations for tailoring interventions to different patients' needs. Important topics include how to deal with dilemmas in evaluation and what treatment strategies work best for addressing overlapping symptoms. The book also considers ways to improve the structure and cost-effectiveness of providing care in this challenging area. Throughout, scientific controversies and unanswered questions are highlighted and promising directions for future research identified. Synthesizing knowledge from multiple disciplines, this is an essential reference for mental health practitioners and trauma specialists--including neuropsychologists, clinical psychologists, psychiatrists, and social workers--as well as graduate students and trainees.

Jennifer J. Vasterling, PhD, is Chief of Psychology at the VA Boston Healthcare System. She is also a clinical neuropsychologist, an active researcher in the VA National Center for PTSD, and Professor of Psychiatry at Boston University School of Medicine. Dr. Vasterling is a recipient of the Award for Outstanding Contributions to the Science of Trauma Psychology from the American Psychological Association (Division 56, Division of Trauma Psychology). She is an authority on the neuropsychological features of PTSD and is known for her work examining the cognitive and emotional changes that accompany war-zone deployment.

Richard A. Bryant, PhD, is Scientia Professor of Psychology at the University of New South Wales. He is also an Australian Research Council Laureate Fellow and Director of the Traumatic Stress Clinic at Westmead Hospital in Sydney. Dr. Bryant is a recipient of honors including the Distinguished Contribution to Psychological Science Award from the Australian Psychological Society and the Robert S. Laufer Award for Outstanding Scientific Achievement from the International Society for Traumatic Stress Studies (ISTSS). His work focuses on the intersection of PTSD and traumatic brain injury, the assessment and treatment of acute trauma reactions, and the cognitive and biological mechanisms underpinning traumatic stress. Terence M. Keane, PhD, is Director and Associate Chief of Staff for Research and Development at the VA National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System. He is also Assistant Dean for Research and Professor and Vice-Chairman of Psychiatry at Boston University School of Medicine. Dr. Keane is a recipient of the Lifetime Achievement Award from the ISTSS, among numerous other awards. He developed many of the most widely used PTSD assessment measures and is an authority on the cognitive-behavioral treatment of PTSD.

I. Introduction 1. Understanding the Interface of Traumatic Stress and Mild Traumatic Brain Injury: Background and Conceptual Framework, Jennifer J. Vasterling, Richard A. Bryant, and Terence M. KeaneII. Clinical Presentations and Mechanisms 2. Understanding Mild Traumatic Brain Injury: Neuropathology and Neuroimaging, Erin D. Bigler and William L. Maxwell 3. A Biopsychosocial Conceptualization of Poor Outcome from Mild Traumatic Brain Injury, Grant L. Iverson 4. Understanding Posttraumatic Stress Disorder: Implications for Comorbid Posttraumatic Stress Disorder and Mild Traumatic Brain Injury, Jasmeet Pannu Hayes and Mark W. Gilbertson 5. Effects of Traumatic Brain Injury-Associated Neurocognitive Alterations on Posttraumatic Stress Disorder, Mieke Verfaellie, Melissa M. Amick, and Jennifer J. VasterlingIII. Commonly Associated Conditions 6. Chronic Pain, John D. Otis, Catherine B. Fortier, and Terence M. Keane 7. Substance Use Disorder, Lisa M. Najavits, Jennifer Highley, Sara L. Dolan, and Frank A. FeeIV. Clinical Management 8. Assessment, Erin W. Ulloa, Brian P. Marx, Rodney D. Vanderploeg, and Jennifer J. Vasterling 9. Assessment in Contexts That Threaten Response Validity, Jon D. Elhai, Jerry J. Sweet, Leslie M. Guidotti Breting, and Danny Kaloupek 10. Treatment of Mild Traumatic Brain Injury, Jennie Ponsford 11. Treatment of Posttraumatic Stress Disorder Following Mild Traumatic Brain Injury, Richard A. Bryant and Brett T. Litz 12. Implications for Service Delivery in the Military, Richard A. Bryant, Carl A. Castro, and Grant L. Iverson 13. Estimating the Costs of Care, Ann Hendricks, Maxine Krengel, Katherine M. Iverson, Rachel Kimerling, Carlos Tun, Jomana Amara, and Henry L. LewV. Conclusions 14. Understanding the Interface of Traumatic Stress and Mild Traumatic Brain Injury: Future Directions in Science and Clinical Practice, Jennifer J. Vasterling, Richard A. Bryant, and Terence M. Keane