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创伤后应激障碍和轻度创伤性脑损伤中的客观神经认知缺陷:除了症状相似之外还有什么?

Objective neuropsychological deficits in post-traumatic stress disorder and mild traumatic brain injury: what remains beyond symptom similarity?

机构信息

Department of Psychology, Université du Québec à Montréal, Quebec, H2X 3P2, Canada.

Institut Universitaire en Santé Mental de Montréal, Montreal, Quebec, H1N 3M5, Canada.

出版信息

Behav Sci (Basel). 2014 Dec 1;4(4):471-86. doi: 10.3390/bs4040471.

Abstract

This exploratory study intends to characterize the neuropsychological profile in persons with post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) using objective measures of cognitive performance. A neuropsychological battery of tests for attention, memory and executive functions was administered to four groups: PTSD (n = 25), mTBI (n = 19), subjects with two formal diagnoses: Post-traumatic Stress Disorder and Mild Traumatic Brain Injury (mTBI/PTSD) (n = 6) and controls (n = 25). Confounding variables, such as medical, developmental or neurological antecedents, were controlled and measures of co-morbid conditions, such as depression and anxiety, were considered. The PTSD and mTBI/PTSD groups reported more anxiety and depressive symptoms. They also presented more cognitive deficits than the mTBI group. Since the two PTSD groups differ in severity of PTSD symptoms but not in severity of depression and anxiety symptoms, the PTSD condition could not be considered as the unique factor affecting the results. The findings underline the importance of controlling for confounding medical and psychological co-morbidities in the evaluation and treatment of PTSD populations, especially when a concomitant mTBI is also suspected.

摘要

本探索性研究旨在使用认知表现的客观测量来描述创伤后应激障碍 (PTSD) 和轻度创伤性脑损伤 (mTBI) 患者的神经心理学特征。对四个组进行了注意力、记忆和执行功能的神经心理学测试:创伤后应激障碍组 (n = 25)、轻度创伤性脑损伤组 (n = 19)、同时患有创伤后应激障碍和轻度创伤性脑损伤的患者 (n = 6) 和对照组 (n = 25)。控制了混杂变量,如医学、发育或神经学的前期病症,还考虑了共病状况的衡量标准,如抑郁和焦虑。PTSD 和 mTBI/PTSD 组报告了更多的焦虑和抑郁症状。与 mTBI 组相比,他们也表现出更多的认知缺陷。由于两个 PTSD 组在 PTSD 症状的严重程度上有所不同,但在抑郁和焦虑症状的严重程度上没有差异,因此不能认为 PTSD 状况是影响结果的唯一因素。研究结果强调了在评估和治疗 PTSD 人群时控制混杂的医学和心理共病的重要性,特别是当怀疑同时患有 mTBI 时。

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