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Published on Nov 20, 2011
According to research published in Neurology®, the medical journal of the American Academy of Neurology, the development of aggressive behavior after brain injury is linked to injury location and gene expression. The article,Prefrontal cortex lesions and MAO-A modulate aggression in penetrating traumatic brain injury," is authored by a group headed by Jordan Grafman, PhD, director of traumatic brain injury research at Kessler Foundation. This is a follow-up study to the Vietnam Veterans Head Injury Project, which monitors long-term sequelae in more than 200 veterans with penetrating brain injury. Aggressive behavior develops in some individuals after traumatic brain injury--the signature wound of the wars in Iraq and Afghanistan. "Aggressive behavior not only hinders rehabilitation and recovery after brain injury, it's devastating to families. http://kesslerfoundation.org/media/di... Head injury has become known as the "signature injury" of the Iraq war. The Website of the Defense and Veterans Brain Injury Center (DVBIC), a congressionally funded research and outreach agency, cites a brain injury rate of 62% among troops returning from combat duty in Iraq. Blast-related TBI, an effect of the over-pressurized shock wave that ripples out from an explosion, is a particular concern in the current conflicts. In the Walter Reed study, about half the soldiers reported having been exposed to at least one blast; 60% of these blast victims sustained a brain injury. A study published by Army researchers January 31 in The New England Journal of Medicineii found that nearly 90% of troops had been exposed to two or more blasts from improvised explosive devices. http://www.dana.org/media/detail.aspx... Blast injury to the human brain may cause the whole spectrum of TBI from mild TBI to severe brain injury with brain swelling, intracranial haemorrhage and penetrating injury. The circumstances of the blast exposure and premorbid personality will determine the mix of psychological and physical injury. It cannot be concluded that bomb blast causes PTSD and depression by psychogenic means alone. The emotional shock of the blast and the circumstances surrounding it may be enough in some cases to explain the PTSD and depression. However, there is emerging evidence that parts of the brain injured in blast TBI are concerned with regulation of emotions and judgement and this organic component of brain injury may contribute to the onset of PTSD and depression. There is still reluctance by military personnel to self-report mental health problems. Mental health professionals must continue to address this problem and reduce the stigma attached to mental health. This might occur by increased efforts to liaise with commanders who should be well briefed and supportive of mental health strategies. It is important that personnel understand that seeking treatment is confidential and that seeking help is a sign of interest in getting better, not a weakness and that treatment will minimize stress related conditions. There also needs to be a continued emphasis on the de-stigmatization of psychological conditions in military personnel returning from deployment.