Department of Psychiatry, University Hospital, Zurich, Switzerland.
J Affect Disord. 2010 Oct;126(1-2):287-92. doi: 10.1016/j.jad.2010.03.006. Epub 2010 Apr 24.
Cognitive theories of anxiety disorders postulate an increased attentional bias to environmental cues associated with threat that underlies the exaggerated fear response. The role of trauma, which may represent strong competitive advantage for attention, remains unclear. We investigated the influence of trauma exposure and the presence of anxiety/stress disorders on the impact of emotional distractors on cognitive performance.
Fourteen trauma-exposed subjects with PTSD, 12 trauma-exposed subjects with anxiety disorders other than PTSD, 12 trauma-exposed healthy subjects and 19 non-trauma-exposed healthy controls participated in this study. The impact of emotion on cognition was determined by the Affective Stroop task that measures the effect of irrelevant emotional distractors on the speed of operant responding.
The speed of cognitive performance was significantly reduced in the presence of negative distractors versus neutral or positive distractors in subjects with PTSD, while there was no significant influence of the distractor type on performance in the other diagnostic groups (diagnosis-by-distractor type interaction, p<0.001). While negative distractors induced the same levels of anxiety and depersonalization in subjects with PTSD and subjects with other anxiety disorders, distractor-induced depersonalization was associated with slowing of cognitive performance in PTSD (p=0.02) but not in other groups.
Different types of anxiety disorders in the non-PTSD group might reduce the selectivity of the results; some subjects received medication possibly impacting on their cognitive functioning.
The cognitive impairments in the presence of negative distractors specifically found in PTSD call for research into novel psychotherapeutic approaches, e.g. attentional training, for PTSD.
焦虑障碍的认知理论假设，对与威胁相关的环境线索的注意力偏向增加，这是夸大的恐惧反应的基础。创伤的作用，它可能代表着注意力的强大竞争优势，仍然不清楚。我们研究了创伤暴露和焦虑/压力障碍的存在对情绪干扰因素对认知表现的影响。
14 名创伤后应激障碍的创伤暴露受试者、12 名创伤后应激障碍以外的焦虑障碍的创伤暴露受试者、12 名创伤暴露的健康受试者和 19 名非创伤暴露的健康对照者参加了这项研究。情绪对认知的影响是通过情感 Stroop 任务来确定的，该任务测量无关情绪干扰因素对操作性反应速度的影响。
在 PTSD 受试者中，与中性或正性干扰相比，负性干扰显著降低了认知表现的速度，而在其他诊断组中，干扰类型对表现没有显著影响（诊断-干扰类型交互作用，p<0.001）。虽然负性干扰在 PTSD 受试者和其他焦虑障碍受试者中引起了相同程度的焦虑和人格解体，但干扰引起的人格解体与 PTSD 中认知表现的减慢有关（p=0.02），而在其他组中则没有。
非 PTSD 组中不同类型的焦虑障碍可能会降低结果的选择性；一些受试者接受了可能影响他们认知功能的药物治疗。
在 PTSD 中特定发现的负性干扰下的认知障碍需要研究新的心理治疗方法，例如注意力训练，用于 PTSD。
