Schöndorf Zoe-Sofia, Terhoeven Valentin, Jaehn Anna, Roesch-Ely Daniela, Friederich Hans-Christoph, Nikendei Christoph, Kindermann David
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany.
DZPG (German Centre for Mental Health - Partner Site Heidelberg/Mannheim/Ulm), Heidelberg, Germany.
Front Psychiatry. 2025 Jan 15;15:1433614. doi: 10.3389/fpsyt.2024.1433614. eCollection 2024.
Previous research has indicated cognitive impairments in patients with post-traumatic stress disorder (PTSD), specifically in attention, memory, and executive functioning. However, there is limited knowledge about the cognitive profile of individuals with complex PTSD (cPTSD), a new diagnosis in ICD-11. Moreover, predictors of cognitive impairment remain unclear. The present study aims to enhance understanding of cognitive functioning and its predictors in cPTSD compared with non-complex PTSD (ncPTSD).
= 64 participants ( = 34 cPTSD, = 30 ncPTSD) completed psychometric questionnaires and the neuropsychological test set Cognitive Basic Assessment (COGBAT) assessing a general cognitive index, attention, visual memory, and executive functioning. First, the test results of both groups were compared to the COGBAT norm sample. Secondly, group differences in cognitive domains were analyzed using student -tests with independent samples (cPTSD vs. ncPTSD). Thirdly, bivariate and multivariate regressions examined influencing factors of cognitive impairment.
Both groups showed cognitive impairments in comparison to the COGBAT norm group. Significant differences between cPTSD and ncPTSD were found in visual memory ( = .003) and selective attention ( = .004). In multivariate regression, type of PTSD and age were found to significantly impact visual memory, while type of PTSD, age, and psychotropic medication showed significant effects on selective attention.
Given higher symptom severity and cognitive deficits in cPTSD, more intensive and diverse interventions should be considered in comprehensive treatment plans, for instance, cognitive training.
先前的研究表明，创伤后应激障碍（PTSD）患者存在认知障碍，尤其是在注意力、记忆和执行功能方面。然而，对于复杂PTSD（cPTSD）患者的认知概况了解有限，cPTSD是《国际疾病分类第11版》中的一种新诊断。此外，认知障碍的预测因素仍不明确。本研究旨在增强对cPTSD与非复杂PTSD（ncPTSD）相比的认知功能及其预测因素的理解。
64名参与者（34名cPTSD患者，30名ncPTSD患者）完成了心理测量问卷和神经心理测试集认知基本评估（COGBAT），该测试评估了一般认知指数、注意力、视觉记忆和执行功能。首先，将两组的测试结果与COGBAT常模样本进行比较。其次，使用独立样本的学生t检验分析认知领域的组间差异（cPTSD与ncPTSD）。第三，进行双变量和多变量回归分析认知障碍的影响因素。
与COGBAT常模组相比，两组均表现出认知障碍。在视觉记忆（P = 0. = 003）和选择性注意力（P = 0. = 004）方面，cPTSD和ncPTSD之间存在显著差异。在多变量回归中，发现PTSD类型和年龄对视觉记忆有显著影响，而PTSD类型、年龄和精神药物对选择性注意力有显著影响。
鉴于cPTSD患者症状严重程度较高且存在认知缺陷，在综合治疗计划中应考虑更强化和多样化的干预措施，例如认知训练。
