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创伤后应激障碍和轻度创伤性脑损伤退伍军人的反应抑制受损。

Impaired response inhibition in veterans with post-traumatic stress disorder and mild traumatic brain injury.

机构信息

Research Service, Veterans Affairs Northern California Health Care System, Martinez, California, USA.

出版信息

J Int Neuropsychol Soc. 2012 Sep;18(5):917-26. doi: 10.1017/S1355617712000458. Epub 2012 May 18.

Abstract

Combat veterans with post-traumatic stress disorder (PTSD) can show impairments in executive control and increases in impulsivity. The current study examined the effects of PTSD on motor response inhibition, a key cognitive control function. A Go/NoGo task was administered to veterans with a diagnosis of PTSD based on semi-structured clinical interview using DSM-IV criteria (n = 40) and age-matched control veterans (n = 33). Participants also completed questionnaires to assess self-reported levels of PTSD and depressive symptoms. Performance measures from the patients (error rates and reaction times) were compared to those from controls. PTSD patients showed a significant deficit in response inhibition, committing more errors on NoGo trials than controls. Higher levels of PTSD and depressive symptoms were associated with higher error rates. Of the three symptom clusters, re-experiencing was the strongest predictor of performance. Because the co-morbidity of mild traumatic brain injury (mTBI) and PTSD was high in this population, secondary analyses compared veterans with PTSD+mTBI (n = 30) to veterans with PTSD only (n = 10). Although preliminary, results indicated the two patient groups did not differ on any measure (p > .88). Since cognitive impairments could hinder the effectiveness of standard PTSD therapies, incorporating treatments that strengthen executive functions might be considered in the future. (JINS, 2012, 18, 1-10).

摘要

患有创伤后应激障碍(PTSD)的战斗老兵可能表现出执行控制方面的障碍和冲动性增加。本研究考察了 PTSD 对运动反应抑制的影响,运动反应抑制是一种关键的认知控制功能。使用 DSM-IV 标准进行半结构化临床访谈对 PTSD 诊断的退伍军人(n = 40)和年龄匹配的对照组退伍军人(n = 33)进行了 Go/NoGo 任务。参与者还完成了评估 PTSD 和抑郁症状自我报告水平的问卷。将患者(错误率和反应时间)的表现测量值与对照组进行比较。PTSD 患者在反应抑制方面存在明显缺陷,在 NoGo 试验中犯的错误比对照组多。较高的 PTSD 和抑郁症状水平与较高的错误率相关。在三个症状群中,再体验是表现的最强预测因素。由于该人群中轻度创伤性脑损伤(mTBI)和 PTSD 的共病率较高,因此进行了次要分析,将 PTSD+mTBI(n = 30)的退伍军人与仅 PTSD(n = 10)的退伍军人进行了比较。尽管初步结果表明两组患者在任何指标上均无差异(p >.88)。由于认知障碍可能会阻碍标准 PTSD 疗法的有效性,因此未来可能会考虑采用增强执行功能的治疗方法。(JINS,2012,18,1-10)。

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