Vulnerability to Neuropsychiatric Symptoms after Traumatic Brain Injury, Chronic Stress, and Aging

Presented by:
Dr. John Williamson, Ph.D., ABPP-CN
Associate Professor of Psychiatry, Neuroscience, & Clinical and Health Psychology
Center for OCD & Anxiety-Related Disorders, UF
Center for Cognitive Aging and Memory, UF
Lead, Cognitive Function Initiative
Brain Rehabilitation Research Center, North FL/South GA VAMC

Faculty Disclosure:

Dr. Williamson has disclosed that he has no relevant financial relationships. No one else in a position to control content has any financial relationships to disclose.

Conflict of interest information for the CME Advisory Committee members can be found on the following website: All relevant financial relationships have been mitigated.

Release Date: November 5, 2022
Expiration Date:  November 4, 2025

Target Audience: All physicians

Learning Objectives:

As a result of participation in this activity, participants should be able to:

  1. Identify potential sources of persistent neurobehavioral disruption resulting from traumatic brain injury.
  2. Determine possible role of heterogeneity of white matter injury in presentation of disorders such as PTSD.
  3. Describe role of chronic stress in brain aging in the context of neuropsychiatric symptoms.


Requirements for successful completion: Certificates are awarded upon successful completion (80% proficiency) of the post-test.

Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Resource(s) for further study:

  1. Posttraumatic Stress Disorder Subsequent to Apparent Mild Traumatic Brain Injury. Rieke, et al. Cognitive and Behavioral Neurology: March 2021:34(1);26-37. Doi:10.1097/WNN.0000000000000264.
  2. VA/DoD Concussion-Mild Traumatic Brain Injury Clinical Practice Guideline
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  4. Vasterling JJ, Aslan M, Lee LO, Proctor SP, Ko J, Jacob S, Concato J. Longitudinal Associations among Posttraumatic Stress Disorder Symptoms, Traumatic Brain Injury, and Neurocognitive Functioning in Army Soldiers Deployed to the Iraq War. JINS 2017.
  5. Stein MB, Kessler RC, Heeringa SG, et al. Prospective Longitudinal Evaluation of the Effect of Deployment-Acquired Traumatic Brain Injury on Posttraumatic Stress and Related Disorders: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). American Journal of Psychiatry 2015.
  6. Sorg SF, Schiehser DM, Bondi MW, et al. White Matter Microstructural Compromise is Associated with Cognition but not Posttraumatic Stress Disorder Symptoms in Military Veterans with Traumatic Brain Injury. J Head Trauma Rehabil. 2016; 31(5):297-308. PubMed ID: 26360008.
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  8. Bottari SA, Lamb DG, Murphy AJ, et al. Hyperarousal symptoms and decreased right hemispheric frontolimbic white matter integrity predict poorer sleep quality in combat-exposed veterans. Brain Inj. 2021 Jul 3;35(8):922-933. Doi: 10.1080/02699052.2021.1927186. Epub 2021 May 29. PMID: 34053386
  9. Schneider BL, Ghoddoussi F, Charlton JL, et al. Increased Cortical Gamma-Aminobutyric Acid Precedes Incomplete Extinction of Conditioned Fear and Increased Hippocampal Excitatory Tone in a Mouse Model of Mild Traumatic Brain Injury. Journal of Neurotrauma 2016; 33(17):1614-1624. Doi: 10.1089/neu.2015.4190
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  21. Reardon et al. An analysis of post-traumatic stress symptoms in United States Air Force drone operators. Journal of Anxiety Disorders 2014;28(5):480-487.
  22. McMillan KA, Asmundson G, et al. Comorbid PTSD and Social Anxiety Disorder: Associations with Quality of Life and Suicide Attempts. Journal of Nervous and Mental Disease 2017;205(9):732-737. doi: 10.1097/NMD.0000000000000704
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  35. Hannum G, et al. Genome-wide Methylation Profiles Reveal Quantitative Views of Human Aging Rates. Molecular Cell 2013;49(2):359-367.
  36. Shah AJ, et al. Posttraumatic Stress Disorder and Impaired Autonomic Modulation in Male Twins. Biological Psychiatry 2013;73(11):1103-1110.

If you have any questions please feel free to contact Nancy Boyd at (352) 594-4298 or at