This is where the NTSB report most directly addresses the issue: "...the loss of the left trim tab’s downward force on the elevator resulted in a concurrent sudden upward deflection of the elevator, a sudden and forceful aft movement of the control stick, the pitch-up of the airplane, and the rapid increase in G."
At this point, the trim tab was still attached, but its link assembly had broken.
In addition, the report notes "two major modifications to the elevators each made the airplane more sensitive in pitch control: the substantially increased elevator counterweights (about twice that of a stock P-51D) that overbalanced the elevators and the substantially decreased elevator inertia weight (less than half that of stock)."