title: Assessment and diagnosis of mild traumatic brain injury, posttraumatic stress disorder, and other polytrauma conditions: burden of adversity hypothesis.
abstract: OBJECTIVE
  Military personnel returning from Iraq and Afghanistan have been exposed to physical and emotional trauma. Challenges related to assessment and intervention for those with posttraumatic stress disorder (PTSD) and/or history of mild traumatic brain injury (TBI) with sequelae are discussed, with an emphasis on complicating factors if conditions are co-occurring. Existing literature regarding cumulative disadvantage is offered as a means of increasing understanding regarding the complex symptom patterns reported by those with a history of mild TBI with enduring symptoms and PTSD.
  
  
  CONCLUSIONS
  The importance of early screening for both conditions is highlighted. In addition, the authors suggest that current best practices include treating symptoms regardless of etiology to decrease military personnel and veteran burden of adversity.
authors.affiliation: VA VISN 19 Mental Illness Research, Education, and Clinical Center.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Brenner
authors.affiliation: James A. Haley VA Medical Center.
authors.forename: Rodney D
authors.initials: RD
authors.lastname: Vanderploeg
authors.affiliation: Department of Deployment Health and Headquarters.
authors.forename: Heidi
authors.initials: H
authors.lastname: Terrio
mesh_terms: D055826:Afghan Campaign 2001-; D001753:Blast Injuries / Q000175:diagnosis / Q000523:psychology; D001930:Brain Injuries / Q000175:diagnosis* / Q000523:psychology*; D005107:Explosions; D006801:Humans; D054542:Iraq War, 2003-2011; D009104:Multiple Trauma / Q000175:diagnosis* / Q000523:psychology*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology