Parslow Ruth A, Jorm Anthony F
University of Melbourne, Orygen Research Centre, Locked Bag 10, Melbourne, Victoria 3052, Australia.
Am J Psychiatry. 2007 Mar;164(3):509-15. doi: 10.1176/ajp.2007.164.3.509.
The authors sought to assess whether neurocognitive deficits in people with the posttraumatic stress disorder (PTSD) symptoms of reexperiencing and arousal are a consequence of these symptoms or represent a preexisting vulnerability factor for developing these symptoms after exposure to a traumatic event.
A random sample of 2,097 young adults who participated in a longitudinal epidemiological study in 1999 and 2000 were reinterviewed in 2003 and 2004 after a major natural disaster (a widespread fire) had occurred in the region. At both interviews, participants completed a number of neurocognitive tests covering immediate and delayed word recall, digit span, coding speed, and vocabulary. Five pre- and posttrauma neurocognitive measures for 1,599 participants who were exposed to the fire were examined to assess the extent to which development of the PTSD symptoms of reexperiencing and arousal was associated with change in neurocognitive skills. Analyses adjusted for a number of potential confounding factors.
Higher levels of fire-related reexperiencing and arousal symptoms were associated with less improvement in word recall ability at the second interview. However, levels of these symptoms were more consistently associated with having poorer pretrauma scores on all five neurocognitive measures available for this study.
The presence of the PTSD symptoms of reexperiencing and arousal may result in a relative decline in some measures of verbal memory over time. The more robust finding from this study is that poorer performance on some neurocognitive tests may be a vulnerability factor for developing symptoms of PTSD, not only an outcome of PTSD symptoms.
作者试图评估创伤后应激障碍（PTSD）中重现和觉醒症状患者的神经认知缺陷是这些症状的结果，还是代表了在经历创伤事件后出现这些症状的预先存在的易感性因素。
对2097名年轻成年人进行随机抽样，他们在1999年和2000年参与了一项纵向流行病学研究，并于2003年和2004年在该地区发生重大自然灾害（一场大面积火灾）后接受了再次访谈。在两次访谈中，参与者都完成了多项神经认知测试，包括即时和延迟单词回忆、数字广度、编码速度和词汇量。对1599名遭受火灾的参与者的五项创伤前和创伤后神经认知指标进行了检查，以评估重现和觉醒的PTSD症状的发展与神经认知技能变化之间的关联程度。分析对一些潜在的混杂因素进行了调整。
在第二次访谈中，与火灾相关的更高水平的重现和觉醒症状与单词回忆能力的改善较少有关。然而，这些症状的水平更一致地与在本研究可用的所有五项神经认知指标上创伤前得分较低有关。
重现和觉醒的PTSD症状的存在可能会导致随着时间的推移某些言语记忆指标相对下降。这项研究更有力的发现是，在一些神经认知测试中表现较差可能是发展PTSD症状的一个易感性因素，而不仅仅是PTSD症状的一个结果。
