Association of Time Since Deployment, Combat Intensity, and Posttraumatic Stress Symptoms With Neuropsychological Outcomes Following Iraq War Deployment

Marx, Brian P.; Brailey, Kevin; Proctor, Susan P.; MacDonald, Helen Z.; Graefe, Anna C.; Amoroso, Paul J.; Heeren, Timothy; Vasterling, Jennifer J.

doi:10.1001/archgenpsychiatry.2009.109

Cited by 90 publications

(55 citation statements)

References 61 publications

(65 reference statements)

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“…In another longitudinal sample of predominantly male, war-deployed soldiers, higher PTSD symptom levels were associated with worse attention one year after returning from deployment, over and above pre-deployment attention. [19] Furthermore, initial research in predominantly male samples of treatment-seeking older veterans has found that PTSD is associated with an approximately two-fold increased risk of incident dementia. [20–22] Notably, associations of PTSD with cognitive function have been largely independent of depression.…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic stress disorder symptoms and cognitive function in a large cohort of middle-aged women

et al. 2017

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Background Posttraumatic stress disorder (PTSD) has been linked to cognitive decline, but research in women is generally lacking. We examined whether trauma and elevated PTSD symptoms were associated with worse cognitive function in middle-aged civilian women. A secondary objective was to investigate the possible role of depression in the relation of PTSD symptoms to cognitive function. Methods The sample comprised 14,029 middle-aged women in the Nurses’ Health Study II. Lifetime trauma exposure, lifetime PTSD symptoms, and past-week depressive symptoms were measured in 2008. Cognitive function was measured in 2014–2016 using the Cogstate Brief Battery, a self-administered online cognitive battery that assesses psychomotor speed, attention, learning, and working memory. We used linear regression models to estimate mean differences in cognition across PTSD symptom levels. Results Compared to no trauma, elevated PTSD symptoms consistent with probable PTSD (i.e., 4+ symptoms on a screening questionnaire) were associated with worse performance on psychomotor speed/attention (b=−0.08 standard units, p=.001) and learning/working memory (b=−0.09, p<.001) composites, after adjusting for socio-demographics. Although attenuated, associations remained significant when adjusted for depressive symptoms and other cognitive risk factors. We found the strongest associations among women with comorbid probable PTSD and depression. Conclusions PTSD symptoms were negatively related to measures of psychomotor speed/attention and learning/working memory in middle-aged women. Our study adds to a growing literature that suggests that mental disorders are associated with worse cognitive function over the life course.

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Section: Introductionmentioning

confidence: 99%

Posttraumatic stress disorder symptoms and cognitive function in a large cohort of middle-aged women

et al. 2017

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“…PTSD co-occurs with SUD among roughly 40 % of civilians and veterans [2, 5, 6]. Individuals with co-occurring SUD and PTSD incur heightened risk for other psychiatric problems (e.g., depression, anxiety), suicidality, neuropsychological impairment, increased morbidity and mortality, unemployment, and social impairment [2, 5, 7, 8]. This complex comorbidity also places a tremendous economic burden on the healthcare system, as it results in poorer treatment outcomes, longer duration of substance use, and more treatment episodes [9–12].…”

Section: Introductionmentioning

confidence: 99%

Concurrent Treatment of Substance Use and PTSD

Flanagan

Korte

Killeen

et al. 2016

Curr Psychiatry Rep

109

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Substance use disorders (SUD) and posttraumatic stress disorder (PTSD) are chronic, debilitating conditions that frequently co-occur. Individuals with co-occurring SUD and PTSD suffer a more complicated course of treatment and less favorable treatment outcomes compared to individuals with either disorder alone. The development of effective psychosocial and pharmacological interventions for co-occurring SUD and PTSD is an active and critically important area of investigation. Several integrated psychosocial treatments for co-occurring SUD and PTSD have demonstrated promising outcomes. While recent studies examining medications to treat co-occurring SUD and PTSD have yielded encouraging findings, there remain substantial gaps in the evidence base regarding the treatment of co-occurring SUD and PTSD. This review will summarize the findings from clinical trials targeting a reduction in SUD and PTSD symptoms simultaneously. These results may improve our knowledge base and subsequently enhance our ability to develop effective interventions for this complex comorbid condition.

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“…Examples include children with attention-deficit hyperactivity disorder (Bolfer et al, 2010; Chamberlain et al, 2011; Gualtieri & Johnson, 2006; Polderman, van Dongen, & Boomsma, 2011) or depression (Brooks, Iverson, Sherman, & Roberge, 2010); adults with psychiatric illnesses, such as depression or bipolar disorder (Iverson, Brooks, Langenecker, & Young, 2011; Sweeney, Kmiec, & Kupfer, 2000); and adolescents and young adults who sustain sport-related concussions (Bleiberg, Garmoe, Halpern, Reeves, & Nadler, 1997; Bleiberg et al, 2004; Broglio, Ferrara, Macciocchi, Baumbartner, & Elliott, 2007; Cernich, Reeves, Sun, & Bleiberg, 2007; Collie, Makdissi, Maruff, Bennell, & McCrory, 2006; Collins, Lovell, Iverson, Ide, & Maroon, 2006; Gualtieri & Johnson, 2008; Iverson, Brooks, Collins, & Lovell, 2006; Iverson, Brooks, Lovell, & Collins, 2006; Peterson, Stull, Collins, & Wang, 2009; Van Kampen, Lovell, Pardini, Collins, & Fu, 2006). CNADs have also been applied to adult epilepsy (Moore, McAuley, Long, & Bornstein, 2002), cardiovascular surgery (Raymond, Hinton-Bayre, Radel, Ray, & Marsh, 2006), neurocognitive problems encountered by active duty military service members and veterans (Anger et al, 1999; Marx et al, 2009; McLay, Spira, & Reeves, 2010; Retzlaff, Callister, & King, 1999; Vasterling et al, 2006), and mild cognitive impairment in older adults (Doniger et al, 2006; Dwolatzky et al, 2004; Gualtieri & Johnson, 2005; Tornatore, Hill, Laboff, & McGann, 2005; Wild, Howieson, Webbe, Seelye, & Kaye, 2008) or dementia (Doniger et al, 2005; Dorion et al, 2002; Wouters, de Koning et al, 2009; Wouters, Zwinderman, van Gool, Schmand, & Lindeboom, 2009). Computerized tests, sometimes administered as part of a predominantly examiner-administered battery, are also used to identify poor effort within the context of a comprehensive neuropsychological evaluation (Green, Rohling, Lees-Haley, & Allen, 2001; Slick et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Computerized Neuropsychological Assessment Devices: Joint Position Paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology

Bauer

Iverson

Cernich

et al. 2012

The Clinical Neuropsychologist

182

199

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This joint position paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology sets forth our position on appropriate standards and conventions for computerized neuropsychological assessment devices (CNADs). In this paper, we first define CNADs and distinguish them from examiner-administered neuropsychological instruments. We then set forth position statements on eight key issues relevant to the development and use of CNADs in the healthcare setting. These statements address (a) device marketing and performance claims made by developers of CNADs; (b) issues involved in appropriate end-users for administration and interpretation of CNADs; (c) technical (hardware/software/firmware) issues; (d) privacy, data security, identity verification, and testing environment; (e) psychometric development issues, especially reliability and validity; (f) cultural, experiential, and disability factors affecting examinee interaction with CNADs; (g) use of computerized testing and reporting services; and (h) the need for checks on response validity and effort in the CNAD environment. This paper is intended to provide guidance for test developers and users of CNADs that will promote accurate and appropriate use of computerized tests in a way that maximizes clinical utility and minimizes risks of misuse. The positions taken in this paper are put forth with an eye toward balancing the need to make validated CNADs accessible to otherwise underserved patients with the need to ensure that such tests are developed and utilized competently, appropriately, and with due concern for patient welfare and quality of care.

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Association of Time Since Deployment, Combat Intensity, and Posttraumatic Stress Symptoms With Neuropsychological Outcomes Following Iraq War Deployment

Cited by 90 publications

References 61 publications

Posttraumatic stress disorder symptoms and cognitive function in a large cohort of middle-aged women

Posttraumatic stress disorder symptoms and cognitive function in a large cohort of middle-aged women

Concurrent Treatment of Substance Use and PTSD

Computerized Neuropsychological Assessment Devices: Joint Position Paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology

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