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Figure 1 | Alzheimer's Research & Therapy

Figure 1

From: Considerations for animal models of blast-related traumatic brain injury and chronic traumatic encephalopathy

Figure 1

Conceptual models for blast-related neuropsychiatric disorders. Traumatic brain injury (TBI) is presumed to be a requisite antecedent to post-concussive syndrome (PCS), chronic traumatic encephalopathy (CTE), and post-traumatic headache (PTH). Post-traumatic stress disorder (PTSD) is characterized as an independent clinical entity in Models 1 and 2, but not in Model 3. Suicide-related ideation and behaviors (SUI) subsumes a constellation of psychiatric attributes (for example, self-directed violence, suicidal ideation and intent, attempted suicide, completed suicide) that may segregate as independent clinical entities. Note that these conceptual models do not distinguish mediating (causal) and confounding (noncausal) interactions. In Model 1, the clinical entities are maximally independent. In Model 2, the clinical entities incompletely overlap. In Model 3, the clinical entities are maximally interdependent. Modulating factors (age, sex, trauma history, genotype), comorbidities (for example, frontal lobe syndrome, major affective disorders, substance use disorders), and situational factors (for example, psychosocial stress, affect flooding, firearm availability) may complicate diagnostic differentiation and clinical management. Given the diagnostic uncertainty and clinical complexity of blast TBI-related neuropsychiatric conditions, a one-size-fits-all management strategy for each clinical disorder is unlikely to be effective.

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