Tate Larissa L, Paxton Willing Maegan M, French Louis M, Law Wendy A, Bennion Layne D, Sullivan Katherine W, Riggs David S
Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
National Intrepid Center of Excellence/Walter Reed National Military Medical Center, Bethesda, Maryland.
Mil Psychol. 2020 Dec 17;33(1):23-28. doi: 10.1080/08995605.2020.1842037. eCollection 2021.
TBI and PTSD occur in a significant number of service members and can each result in considerable distress and cognitive challenges. Past research has established the impact of mild TBI (mTBI) and PTSD on cognitive performance; however, findings regarding the effects of mTBI and PTSD on cognitive performance are inconsistent. The present study examined the potentially synergistic effects of mTBI and PTSD symptoms on cognitive performance in a sample of 180 treatment-seeking active duty service members. As part of a larger clinical study, participants completed several self-report measures and an objective cognitive assessment via computer-based testing. Compared to norms, service members with mTBI-only, PTSD-symptoms-only, and comorbid TBI and PTSD performed significantly worse on cognitive tests, and there was a significant effect of group on cognitive performance, even when controlling for performance validity. Notably, individuals experiencing both mTBI and PTSD performed worse than those with either condition alone; service members with mTBI-only and those with PTSD symptoms-only did not differ. Findings further illustrate the complexity of the relationship between these two conditions, indicating comorbid mTBI and PTSD may represent a unique challenge to cognitive performance. Additional research is needed to clarify their combined impact on post-injury functioning.
大量现役军人患有创伤性脑损伤(TBI)和创伤后应激障碍(PTSD),这两种疾病都会导致相当大的痛苦和认知挑战。过去的研究已经证实了轻度创伤性脑损伤(mTBI)和创伤后应激障碍对认知能力的影响;然而,关于mTBI和创伤后应激障碍对认知能力影响的研究结果并不一致。本研究调查了180名寻求治疗的现役军人样本中,mTBI和创伤后应激障碍症状对认知能力的潜在协同作用。作为一项更大规模临床研究的一部分,参与者完成了几项自我报告测量,并通过计算机测试进行了客观的认知评估。与常模相比,仅患有mTBI、仅患有创伤后应激障碍症状以及同时患有TBI和创伤后应激障碍的军人在认知测试中的表现明显更差,即使在控制了表现效度的情况下,组间对认知能力也有显著影响。值得注意的是,同时患有mTBI和创伤后应激障碍的个体比仅患有其中一种疾病的个体表现更差;仅患有mTBI的军人和仅患有创伤后应激障碍症状的军人之间没有差异。研究结果进一步说明了这两种疾病之间关系的复杂性,表明mTBI和创伤后应激障碍共病可能对认知能力构成独特挑战。需要更多的研究来阐明它们对伤后功能的综合影响。