title: Neuropsychological Functioning in Veterans with Posttraumatic Stress Disorder: Associations with Performance Validity, Comorbidities, and Functional Outcomes.
abstract: OBJECTIVE
  Numerous studies have shown that individuals with posttraumatic stress disorder (PTSD) display reduced performances on neuropsychological tests, although most prior research has not adequately accounted for comorbidities or performance validity concerns that are common in this population and could partially account for the observed neurocognitive findings. Moreover, few studies have examined the functional implications of neuropsychological results in PTSD.
  
  
  METHODS
  We examined neuropsychological functioning in 44 veterans with PTSD and 40 veteran trauma comparison (TC) participants with combat exposure and no PTSD.
  
  
  RESULTS
  After excluding four veterans with PTSD for performance validity concerns, multivariate analyses of variance by neurocognitive domain revealed significantly worse performance by the PTSD group in the domains of speed of information processing (p=.035) and executive functions (p=.017), but no group differences in attention/working memory, verbal/language functioning, visuoconstruction, or episodic memory. Group differences by PTSD status were still present after covarying for depression, a history of head injuries, and substance use disorders. Executive functioning performance was associated with poorer self-reported occupational functioning and physical health-related quality of life, while speed of information processing performance was associated with poorer physical health-related quality of life.
  
  
  CONCLUSIONS
  These results are generally consistent with a fronto-limbic conceptualization of PTSD-associated neuropsychological dysfunction and show that cognitive functioning may be associated with critical functional outcomes. Taken together, results suggest that consideration of neurocognitive functioning may enhance the clinical management of individuals with PTSD.
authors.affiliation: 1National Center for PTSD,Clinical Neurosciences Division,West Haven,Connecticut.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Wrocklage
authors.affiliation: 1National Center for PTSD,Clinical Neurosciences Division,West Haven,Connecticut.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Schweinsburg
authors.affiliation: 1National Center for PTSD,Clinical Neurosciences Division,West Haven,Connecticut.
authors.forename: John H
authors.initials: JH
authors.lastname: Krystal
authors.affiliation: 1National Center for PTSD,Clinical Neurosciences Division,West Haven,Connecticut.
authors.forename: Marcia
authors.initials: M
authors.lastname: Trejo
authors.affiliation: 1National Center for PTSD,Clinical Neurosciences Division,West Haven,Connecticut.
authors.forename: Alicia
authors.initials: A
authors.lastname: Roy
authors.affiliation: 1National Center for PTSD,Clinical Neurosciences Division,West Haven,Connecticut.
authors.forename: Valerie
authors.initials: V
authors.lastname: Weisser
authors.affiliation: 6Department of Psychiatry,Perelman School of Medicine,University of Pennsylvania,Philadelphia,Pennsylvania.
authors.forename: Tyler M
authors.initials: TM
authors.lastname: Moore
authors.affiliation: 1National Center for PTSD,Clinical Neurosciences Division,West Haven,Connecticut.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Southwick
authors.affiliation: 6Department of Psychiatry,Perelman School of Medicine,University of Pennsylvania,Philadelphia,Pennsylvania.
authors.forename: J Cobb
authors.initials: JC
authors.lastname: Scott
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001288:Attention / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D009483:Neuropsychological Tests; D011788:Quality of Life / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology; D015599:Trauma Severity Indices; D014728:Veterans; D055815:Young Adult
keywords: Cognitive abilities; Executive functions; Memory; Neuropsychology; Occupational functioning; Posttraumatic stress disorder; Quality of life