Although impairment in cognitive functioning is theoretically linked to the presence of post-traumatic stress disorder (PTSD), the actual impact of this disorder on neuropsychological performance remains largely unknown. While a modest amount of empirical attention has been directed toward examining the neuropsychological correlates of PTSD, several methodological problems, most notably small sample sizes and the resulting lack of power, have greatly restricted generalizability of findings. The present study examined the neuropsychological performance pattern of Vietnam veterans with PTSD (n = 241) as compared to those with generalized anxiety disorder (n = 241) and no history of psychiatric diagnosis (n = 241). A one-way MANOVA revealed no significant differences among the groups on any of the dependent measures of cognitive functioning, including the Wechsler Adult Intelligence Scale-Revised Block Design subtest, the California Verbal Learning Test, the Rey-Osterrieth Complex Figure Drawing Test, and the Paced Auditory Serial Addition Test. The results are reconciled as they relate to previous research examining the theoretical constructs of PTSD, clinical applications, and directions for future research.
The literature regarding executive functioning in schizophrenia was examined to determine effect size differences between schizophrenic, normal control, and psychiatric groups. Effect sizes (n = 176) from 71 studies were cumulated across measures including the Wisconsin Card Sorting Test (WCST), Halstead Category Test (HCT), verbal/design fluency, Trail Making B (TMB), and the Stroop Color-Word Test. Schizophrenic groups were impaired relative to controls (delta = -1.45). Schizophrenic groups also performed 0.40 standard deviations lower than psychiatric groups. Within the schizophrenic versus normal control comparisons, the effect size based on complex measures, such as the WCST/HCT (delta = -1.42), was similar to that based on less complex measures, such as TMB and the Stroop (delta = -1.58). Chlorpromazine equivalents and illness duration were not significantly correlated with effect sizes (p > 0.05). Effect sizes and number of hospitalizations (p < 0.05) were related. Effect sizes and Brief Psychiatric Rating Scale (BPRS) were not significantly correlated. Negative and positive symptoms were significantly correlated (p < 0.05). The results as they apply to research and clinical practice are discussed.
This review examines the literature on neuropsychological differences between paranoid and nonparanoid schizophrenia subjects. Thirty-two studies related to intellectual functioning, attention, memory, language, visual-spatial, and motor functions are discussed. Subjects with paranoid schizophrenia did not demonstrate higher intellectual functioning than those with nonparanoid schizophrenia, and both groups performed similarly on tests of verbal ability and visual-spatial functions. Several studies suggest that the paranoid subtype is associated with higher performance on tests of executive functions, attention, memory, and motor skills. However, the findings are inconsistent. Methodological issues in the literature are examined, including varying degrees of participants' chronicity and severity of illness among studies, criteria for diagnostic group membership, medication effects, reliability and validity of the neuropsychological measures, and statistical power.
Background: Two large independent studies funded by the US government have assessed the impact of the Vietnam War on the prevalence of PTSD in US veterans. The National Vietnam Veterans Readjustment Study (NVVRS) estimated the current PTSD prevalence to be 15.2% while the Vietnam Experience Study (VES) estimated the prevalence to be 2.2%. We compared alternative criteria for estimating the prevalence of PTSD using the NVVRS and VES public use data sets collected more than 10 years after the United States withdrew troops from Vietnam.
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