Neurocognitive Correlates of Successful Treatment of PTSD in Female Veterans.
The influence of psychotherapy on neurocognition in post-traumatic stress disorder (PTSD) has not been examined methodically. This is despite evidence that pre-treatment learning and memory has been associated with treatment success and that executive function theories emphasize weak executive functions (especially inhibition/switching) are associated with PTSD.



To determine (1) if higher pre-treatment learning/memory, inhibition/switching, or both predict treatment success; and (2) if treatment success is associated with specific improvement in inhibition/switching and not learning/memory or working memory, another aspect of executive function.



Pre-treatment neurocognition and neurocognitive changes (inhibition/switching, learning/memory, working memory) were examined in female veterans with PTSD. They were evaluated before and after 16-weeks of group psychotherapy for PTSD that included three counterbalanced modules (cognitive restructuring therapy, exposure therapy, skills training) with fidelity checks for therapist adherence.



Only pre-treatment learning/memory predicted better treatment outcome. Treatment success was associated with improvement in inhibition/switching only, even after controlling for mild traumatic brain injury, and changes in depressive symptoms, working memory, and learning/memory.



Our finding that learning/memory predicted treatment success is consistent with previous studies. We extended these studies by showing that the effect was restricted to learning/memory, which is contrary to the executive function theory of PTSD. In contrast, the fact that only inhibition/switching significantly improved with better treatment success is consistent with its potential importance in maintaining PTSD symptoms. Future research should determine whether inhibition/switching abilities are a risk for development and maintenance of PTSD or whether such abilities have a broader reciprocal relationship with PTSD symptom change. (JINS, 2016, 22, 643-651).
1University of New Mexico School of Medicine and The New Mexico Veterans Affairs Healthcare System,Albuquerque,New Mexico.
Kathleen Y
KY
Haaland
1University of New Mexico School of Medicine and The New Mexico Veterans Affairs Healthcare System,Albuquerque,New Mexico.
Joseph R
JR
Sadek
2New Mexico Veterans Affairs Healthcare System and The Biomedical Research Institute of New Mexico,Albuquerque,New Mexico.
Jenna E
JE
Keller
3New Mexico Veterans Affairs Healthcare System,Albuquerque, New Mexico and The VISN 17 Center of Excellence,Waco, Texas.
Diane T
DT
Castillo
D000293:Adolescent; D000328:Adult; D000368:Aged; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D007858:Learning / Q000502:physiology*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology* / Q000628:therapy*; D014728:Veterans; D055815:Young Adult
Executive functioning; Female; Neuropsychology; PTSD; Psychotherapy; Trauma; Veterans