Stricker Nikki H, Keller Jenna E, Castillo Diane T, Haaland Kathleen Y
Psychology Service, VA Boston Healthcare System, Boston, Massachusetts, USA; Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.
J Trauma Stress. 2015 Apr;28(2):102-9. doi: 10.1002/jts.22000. Epub 2015 Apr 2.
Neurocognitive problems are common with posttraumatic stress disorder (PTSD) and are important to understand because of their association with the success of PTSD treatment and its potential neural correlates. To our knowledge, this is the first neurocognitive study in an all-female U.S. veteran sample, some of whom had PTSD. We examined neurocognitive performance and assessed whether learning deficits, common in PTSD, were associated with executive functioning. Veterans with PTSD (n = 56) and without (n = 53) were evaluated for psychiatric and neurocognitive status. The PTSD group had a lower estimated IQ (d = 0.53) and performed more poorly on all neurocognitive domains (d range = 0.57-0.88), except verbal retention (d = 0.04). A subset of the 2 groups that were matched on IQ and demographics similarly demonstrated poorer performance for the PTSD group on all neurocognitive domains (d range = 0.52-0.79), except verbal retention (d = 0.15). Within the PTSD group, executive functioning accounted for significant variance in verbal learning over and above IQ and processing speed (ΔR(2) = .06), as well as depression (ΔR(2) = .07) and PTSD severity (ΔR(2) = .06). This study demonstrated that female veterans with PTSD performed more poorly than females without PTSD on several neurocognitive domains, including verbal learning, processing speed, and executive functioning. Replication of these results using a control group of veterans with more similar trauma exposure, history of mild traumatic brain injury, and psychiatric comorbidities would solidify these findings.
神经认知问题在创伤后应激障碍（PTSD）中很常见，由于它们与PTSD治疗的成功及其潜在的神经关联有关，因此了解这些问题很重要。据我们所知，这是第一项针对全女性美国退伍军人样本的神经认知研究，其中一些人患有PTSD。我们检查了神经认知表现，并评估了PTSD中常见的学习缺陷是否与执行功能相关。对患有PTSD（n = 56）和未患有PTSD（n = 53）的退伍军人进行了精神和神经认知状态评估。PTSD组的估计智商较低（d = 0.53），并且在所有神经认知领域的表现都更差（d范围 = 0.57 - 0.88），除了言语记忆（d = 0.04）。在智商和人口统计学上匹配的两组子集同样显示，PTSD组在所有神经认知领域的表现更差（d范围 = 0.52 - 0.79），除了言语记忆（d = 0.15）。在PTSD组中，执行功能在言语学习方面的方差显著高于智商和处理速度（ΔR(2) = 0.06），以及抑郁（ΔR(2) = 0.07）和PTSD严重程度（ΔR(2) = 0.06）。这项研究表明，患有PTSD的女性退伍军人在几个神经认知领域的表现比未患有PTSD的女性更差，包括言语学习、处理速度和执行功能。使用创伤暴露、轻度创伤性脑损伤病史和精神共病更相似的退伍军人对照组来重复这些结果将巩固这些发现。
