title: Relations Between Cognitive Functioning and Alcohol Use, Craving, and Post-Traumatic Stress: An Examination Among Trauma-Exposed Military Veterans With Alcohol Use Disorder.
abstract: Cognitive dysfunction is commonly observed among individuals with alcohol use disorder (AUD) and trauma exposure and is, in turn, associated with worse clinical outcomes. Accordingly, disruptions in cognitive functioning may be conceptualized as a trans-disease phenomenon representing a potential high-yield target for intervention. Less is known though about how different cognitive functions covary with alcohol use, craving, and post-traumatic stress symptom severity among trauma-exposed individuals with AUD. Sixty-eight male and female trauma-exposed military veterans with AUD, entering treatment trials to reduce alcohol use, completed measures assessing alcohol use and craving, post-traumatic stress symptom severity, and cognitive functioning. In multivariate models, after controlling for post-traumatic stress symptom severity, poorer learning and memory was associated with higher alcohol consumption and higher risk taking/impulsivity was associated with stronger preoccupations with alcohol and compulsions to drink. Alcohol consumption and craving, but not performance on cognitive tests, were positively associated with post-traumatic stress symptom severity. Findings suggest that interventions to strengthen cognitive functioning might be used as a preparatory step to augment treatments for AUD. Clinicians are encouraged to consider a standard assessment of cognitive functioning, in addition to post-traumatic stress symptom severity, in treatment planning and delivery for this vulnerable and high-risk population.
authors.affiliation: National Center for Post-Traumatic Stress Disorder, Center for Innovation to Implementation, Palo Alto Veterans Affairs Health Care System, 795 Willow Road, Menlo Park, CA 94025.
authors.forename: Adrienne J
authors.initials: AJ
authors.lastname: Heinz
authors.affiliation: San Francisco Veteran Affairs Medical Center 4150 Clement Street, San Francisco, CA 94121.
authors.forename: David L
authors.initials: DL
authors.lastname: Pennington
authors.affiliation: National Center for Post-Traumatic Stress Disorder, Center for Innovation to Implementation, Palo Alto Veterans Affairs Health Care System, 795 Willow Road, Menlo Park, CA 94025.
authors.forename: Nicole
authors.initials: N
authors.lastname: Cohen
authors.affiliation: Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304.
authors.forename: Brandi
authors.initials: B
authors.lastname: Schmeling
authors.affiliation: San Francisco Veteran Affairs Medical Center 4150 Clement Street, San Francisco, CA 94121.
authors.forename: Brooke A
authors.initials: BA
authors.lastname: Lasher
authors.affiliation: San Francisco Veteran Affairs Medical Center 4150 Clement Street, San Francisco, CA 94121.
authors.forename: Emily
authors.initials: E
authors.lastname: Schrodek
authors.affiliation: San Francisco Veteran Affairs Medical Center 4150 Clement Street, San Francisco, CA 94121.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Batki
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000523:psychology; D002140:California; D003071:Cognition / Q000502:physiology*; D066249:Craving / Q000502:physiology*; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D008568:Memory; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000523:psychology; D014728:Veterans / Q000523:psychology*