title: An exploratory study of the association of acute posttraumatic stress, depression, and pain to cognitive functioning in mild traumatic brain injury.
abstract: OBJECTIVE
  Few studies have examined whether psychological distress and pain affect cognitive functioning in the acute to subacute phase (up to 30 days postinjury) following mild traumatic brain injury (mTBI). The current study explored whether acute posttraumatic stress, depression, and pain were associated with performance on a task of selective and sustained attention completed under conditions of increasing cognitive demands (standard, auditory distraction, and dual-task), and on tests of working memory, memory, processing speed, reaction time (RT), and verbal fluency.
  
  
  METHODS
  At a mean of 2.87 days (SD = 2.32) postinjury, 50 adult mTBI participants, consecutive admissions to a Level 1 trauma hospital, completed neuropsychological tests and self-report measures of acute posttraumatic stress, depression, and pain. A series of canonical correlation analyses was used to explore the relationships of a common set of psychological variables to various sets of neuropsychological variables.
  
  
  RESULTS
  Significant results were found on the task of selective and sustained attention. Strong relationships were found between psychological variables and speed (r(c) = .56, p = .02) and psychological variables and accuracy (r(c) = .68, p = .002). Pain and acute posttraumatic stress were associated with higher speed scores (reflecting more correctly marked targets) under standard conditions. Acute posttraumatic stress was associated with lower accuracy scores across all task conditions. Moderate but nonsignificant associations were found between psychological variables and most cognitive tasks.
  
  
  CONCLUSIONS
  Acute posttraumatic stress and pain show strong associations with selective and sustained attention following mTBI.
authors.affiliation: Department of Psychology.
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Massey
authors.affiliation: Department of Psychology.
authors.forename: Susanne
authors.initials: S
authors.lastname: Meares
authors.affiliation: Department of Psychology.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Batchelor
authors.affiliation: School of Psychology, University of New South Wales.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bryant
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology; D001924:Brain Concussion / Q000523:psychology; D001930:Brain Injuries / Q000150:complications / Q000523:psychology*; D003071:Cognition; D003863:Depression / Q000209:etiology / Q000523:psychology*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010146:Pain / Q000209:etiology / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance; D011930:Reaction Time; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000523:psychology*; D014193:Trauma Centers; D014705:Verbal Behavior; D055815:Young Adult