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退伍军人中创伤后应激障碍相关认知缺陷的可重复性神经心理状态评估量表研究

Posttraumatic Stress Disorder-Associated Cognitive Deficits on the Repeatable Battery for the Assessment of Neuropsychological Status in a Veteran Population.

作者信息

Hantke Nathan, Adamson Maheen M, Noda Art, Lazzeroni Laura C, Beaudreau Sherry A, Yutsis Maya, Fairchild J Kaci, Kinoshita Lisa M, Kong Jennifer, Sheng Tong, Waltzman Dana, Ashford John Wesson, Yesavage Jerome A

机构信息

is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland.

出版信息

Fed Pract. 2021 Jan;38(1):28-34. doi: 10.12788/fp.0083.

Abstract

BACKGROUND

Posttraumatic stress disorder (PTSD) is a frequent problem of veterans receiving care and is often associated with cognitive deficits. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a well-validated cognitive screening measure often used in the US Department of Veterans Affairs (VA), particularly in neurorehabilitation settings. However, the influence of PTSD on RBANS performance is unclear, particularly within a heterogeneous VA outpatient population in which PTSD and traumatic brain injury (TBI) may not be the primary focus of care.

METHODS

Participants included 153 veterans with complex deployment-related health problems, including a diagnosis of PTSD (n = 98) and a history of TBI (n = 92). All veterans completed a targeted cognitive battery that included the Wechsler Test of Adult Reading, the Wechsler Adults Intelligence Scale, measure assessing processing speed, attention, and cognitive flexibility, and RBANS.

RESULTS

A diagnosis of PTSD was associated with worse performance on the Story Recall subtest of the RBANS, but not on any other cognitive measures. A diagnosis of mild TBI, or co-occurring PTSD and TBI did not predict cognitive performance on any measures.

CONCLUSIONS

The RBANS best captured cognitive deficits associated with PTSD compared with a history of mild TBI or co-occurring mild TBI and PTSD. These findings may provide insight into the interpretation and attribution of cognitive deficits in the veteran population.

摘要

背景

创伤后应激障碍(PTSD)是接受治疗的退伍军人中常见的问题,且常与认知缺陷相关。可重复性神经心理状态评估量表(RBANS)是一种经过充分验证的认知筛查工具,在美国退伍军人事务部(VA)经常使用,尤其是在神经康复环境中。然而,PTSD对RBANS表现的影响尚不清楚,特别是在一个异质性的VA门诊患者群体中,其中PTSD和创伤性脑损伤(TBI)可能不是主要的关注焦点。

方法

参与者包括153名患有与部署相关的复杂健康问题的退伍军人,包括PTSD诊断(n = 98)和TBI病史(n = 92)。所有退伍军人都完成了一个针对性的认知测试组合,包括韦氏成人阅读测验、韦氏成人智力量表、评估处理速度、注意力和认知灵活性的测量以及RBANS。

结果

PTSD诊断与RBANS的故事回忆子测验表现较差相关,但与任何其他认知测量无关。轻度TBI诊断或同时存在的PTSD和TBI并不能预测任何测量指标的认知表现。

结论

与轻度TBI病史或同时存在的轻度TBI和PTSD相比,RBANS最能体现与PTSD相关的认知缺陷。这些发现可能为退伍军人人群中认知缺陷的解释和归因提供见解。

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