Military Traumatic Brain Injury Initiative - MTBI2

Getting treatment for posttraumatic stress (PTS) isn't always easy- & staying in treatment can be just as difficult.

Common therapies for PTS, like Prolonged Exposure Therapy & Cognitive Processing Therapy, can have dropout rates as high as 55%. This means many patients aren’t in treatment long enough to experience long-term benefits.

According to our teammate Dr. Michael Roy, these high dropout rates send a very clear message: scientists & clinicians need to continue developing new PTS therapies to offer patients more treatment options.

In his recent study, Dr. Roy found that Reconsolidation of Traumatic Memories (RTM) could be "an especially promising alternative."

RTM uses a structured protocol in which patients replay their trauma as a "movie." After "replaying" their trauma with emotional distance, patients work with trained experts to put this memory in the past where it belongs, helping to ensure it doesn’t cause as many symptoms in the present.

Some patients find RTM to be less painful & intense than traditional trauma-focused therapies.

More research is needed on RTM & other potential PTS therapies, but Dr. Roy believes this approach has great potential to help service members.

"The next step is training therapists in RTM at U.S. Department of War & Veterans Health Administration (VHA) - U.S. Department of Veterans Affairs so a large, multi-center trial can be done” he said.

📸: Marine Corps Lance Cpl. Jacob Claudell

Sustaining a traumatic brain injury (TBI) doesn't guarantee you'll also experience posttraumatic stress ( ), but it *does* significantly increase the risk.

A 2020 review found that approx. 48% of military personnel developed PTS after a TBI — which is nearly 3x higher than civilians.

There are a few risk factors that can explain the prevalence of PTS among both civilians & military personnel who experienced a TBI, including:

🧠 psychosocial & environmental factors (e.g. social support, years of education, marital status & age)

🧠 military-specific factors (e.g. combat-related trauma, history of deployment & service lasting over 4 years)

🧠 TBI-related factors (e.g. sustaining multiple TBIs, severity of injury & environment where injury was sustained)

🧠 psychological & cognitive factors (e.g. mood fluctuations, difficulty regulating behavior & lower distress tolerance)

🧠 genetics

While there isn't enough evidence to determine whether certain occupations increase risk of PTSD, military service is a risk factor for both developing PTS & symptom severity.

Unfortunately, the relationship between PTSD & TBI is particularly strong for military personnel. Military experience increases risk for brain injuries of all severities as well as increasing the risk of lifetime TBIs.

In many cases, the situations that cause injury are traumatic.

Read the Traumatic Brain Injury Center of Excellence's 15-Year Longitudinal Study's full research review to learn more about PTSD & TBI in the military: https://www.health.mil/Reference-Center/Publications/2026/01/20/TBICoE-Research-Review-Mild-TBI-and-PTSD

📸: Air Force Airman 1st Class Xavier Romero

Service members who sustain traumatic brain injuries (TBIs) can also experience posttraumatic stress (PTS), & this combination often makes recovery more challenging.

During a 15-year Longitudinal Study, the Traumatic Brain Injury Center of Excellence found that nearly half of service members & vets who experienced a TBI also reported symptoms of PTS.

Military personnel with TBI & PTS were 9-22 times more likely to experience poor neurobehavioral outcomes, including fatigue, depression, anger, & cognitive complaints. Those who experienced poor sleep & low resilience were 11-19 times more likely to have poor long-term outcomes & quality of life.

A healthy or unhealthy family environment was the strongest predictor of good/poor outcomes for military personnel with TBI and PTS.

Understanding the ways PTS can impact military personnel helps researchers & clinicians discover more effective treatments & recovery options.

You can learn more about the risk factors for poor long-term outcomes after TBI here: https://www.health.mil/Reference-Center/Fact-Sheets/2026/02/18/15-Year-Studies-Risk-Factor-Fact-Sheet

✏️ Pop Quiz! ✏️

How many Veterans Days are there in the U.S.? The answer may surprise you ...

— which is celebrated today, 12JUN — commemorates the signing of the 1948 Women’s Armed Services Integration Act, which allowed women to have a military career.

Since then, women have joined the military at an ever-increasing rate. Per a 2024 U.S. Department of War demographics report, women made up 17.9% of active-duty service members & 22.4% of select reserve personnel.

The U.S. Navy & United States Air Force have the largest percentage of female service members.

Despite making up a significant portion of active-duty military personnel, women are vastly underrepresented in military medical research.

Women's Veterans Day is a reminder that female service members deserve to be represented & celebrated as much as their male counterparts.

📸: Navy

Thank women the next time you put on protective gear on.

Women have always been a vital part of U.S. military medicine & have created innovations that have greatly improved combat casualty care & strengthened survivability.

In 1964, Stephanie Kwolek developed Kevlar — an incredibly strong & heat-resistant fiber — that formed the basis of military soft armor.

Later, in the 1990s, U.S. Navy Marlene DeMaio (CAPT, Ret.) & her team developed the Interceptor Multi-Threat Body Armor System to improve body protection for service members. This innovative system used ceramic plates alongside the Kevlar to help prevent penetrative injuries & reduce internal trauma, which drastically improved service members’ combat survival rates.

And the impact of women in military medicine doesn’t stop there.

Clara Barton, a nurse during the American Civil War who was known as the “Angel of the Battlefield,” went on to found the American Red Cross.

Without women, military medicine would not be the revolutionary field it is today.

Their innovations, inventions, and leadership have helped protect generations of military personnel — and their impact deserves to be recognized throughout our Nation’s history.

📸: Cpl. Karis Mattingly; Stephanie Kowlek Courtesy of Science History Institute

Protecting the brain is our GOOOAL!

Per the CDC, soccer ranks among the 10 youth sports with the highest risk of concussion (girls' soccer ranks 2nd & boys' soccer ranks 9th).

A 2020 study found that the concussion rate has increased as the sport grows more popular in the U.S.

While heading the ball can lead to injury — especially in young players, because they have lower body mass compared to collegiate or adult athletes — collisions with other players was the most common cause of concussions.

In many cases, those collisions can happen when players are attempting to head the ball.

While more research is needed to find the most effective methods to prevent injury, in 2025 U.S. Soccer banned headers for players under the age of 13 & kept 11–13-year-olds to just 30 min of header practice per week. Players aged 14 & older have no restrictions.

To make it to the , players need to keep their head in the game — and hopefully, both they & the next generations of players can also protect it in the meantime.

Learn more about soccer concussions: https://pmc.ncbi.nlm.nih.gov/articles/PMC10060082/

📸: U.S. Marine Corps photo by Lance Cpl. Jacob Claudell

Dizzy? Anxious? Having trouble sleeping? You may be experiencing posttraumatic headaches ... or posttraumatic stress.

Per a 2020 study, nearly 30% of patients who experienced persistent posttraumatic headaches ( ) also reported symptoms of .

Symptoms of both PTH and PTSD have been found to compound one another & make each feel more intense.

The two diagnoses also share several overlapping symptoms including:
🧠 Fatigue
🧠 Dizziness
🧠 Insomnia
🧠 Anxiety
🧠 Difficulties with cognitive function

Unfortunately, there is no 1 treatment that can eliminate both PTH & PTSD. Both conditions require some trial & error to find the most effective plan. But a multi-disciplinary approach — involving both therapy & meds —helps manage symptoms.

Learn more about the overlap between PTH & PTSD here: https://pmc.ncbi.nlm.nih.gov/articles/PMC7313050/

📸: Mark C. Olsen, New Jersey National Guard

Military personnel are more likely to experience a than civilians & have a higher risk of experiencing posttraumatic headaches ( ).

In a 2022 study of service members & veterans who experienced a concussion, 75% reported experiencing headaches after injury.

Nearly 50% of military personnel who experienced a concussion also reported experiencing 15 or more headache days per month, with those service members & veterans experiencing a "throbbing" pain that lasted between 4-24 hours at a time.

Debilitating, lengthy headaches can make it difficult to pay attention, concentrate on details & endure loud noises or bright lights, all of which service members often encounter during work.

The more we understand PTH, the closer we get to developing better treatments & solutions that will help service members return to duty, headache free.

📸: Army Sgt. Addison Shinn

Turn off the lights & pass the ibuprofen — it's time to talk about headaches & migraines.

Posttraumatic headaches (PTH) are 1 of the most common & persistent symptoms of , often developing within 7 days of a brain injury. Migraines are the most common type of PTH.

Contrary to popular belief, patients who sustain a mild TBI (aka, a concussion) have higher incidences, longer durations & higher intensities of PTH than patients with moderate or severe TBIs.

And service members are at high risk of experiencing PTH.

75 to 77% of patients who experience PTH reported tension-style headaches, but migraines are most common among patients who experience blast-related concussions. What’s more, patients with PTH also commonly experience symptoms of depression, anxiety & insomnia.

Migraines & tension headaches can be debilitating. Adding in these additional TBI symptoms can make even the most basic tasks seem impossible.

Learning more about PTH can help us figure out how to support service members who may be dealing with these headaches.

You can learn more about PTH & potential treatments here: https://pmc.ncbi.nlm.nih.gov/articles/PMC10342432/

Military caregivers often report feeling a lack of emotional, financial & even social support.

But with so many responsibilities on their plate, it can be hard to find help — so we compiled a list of resources & supports.

In addition to branch-specific resources for military caregivers, we wanted to highlight a variety of programs & support systems focused on caregiver mental health care. You can find links to all the websites in the comments.

Please note — this list is just a starting point.

It is not exhaustive & it does not include every single caregiver mental health support program that exists. We are also not endorsing any of these resources.

But caregivers deserve the same kind of care & dedication that they show to our military personnel & veterans. They matter beyond just the care that they provide. They deserve the same kind of support & assistance as everyone else.

➡️ Swipe to find our list of resources & let us know if there are any other great centers helping military caregivers in our comments!