Neurocognitive Correlates of Successful Treatment of PTSD in Female Veterans

Abstract

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).

Dissociation between working memory performance and proactive interference control in post-traumatic stress disorder

“…Is there any evidence of a dissociation between verbal and visual WM, especially in relation to symptom severity? Closer examination of this issue – including at the level of individual differences – could be informative in studies of treatment response to different psychotherapies (e.g., Haaland et al, 2016). The largest meta-analysis to date yielded a medium effect size ( d =−0.50) for the combined construct of attention/working memory but did not differentiate between verbal and visual WM (Scott et al, 2015).…”

Gender Differences in Outcomes after Traumatic Brain Injury among Service Members and Veterans

“…In a pre‐post trial design, Haaland et al reported that mTBI history had no association with response to PTSD treatment among women veterans ( n = 42 females; 45% with mTBI history) . A small RCT ( n = 21; 33% female) reported a reduction in TBI and subclinical PTSD symptoms with Emotional Freedom Technique therapy; however, there were no significant associations with gender …”

Neurocognitive functioning over the course of trauma‐focused psychotherapy for PTSD: Changes in verbal memory and executive functioning

“…There was no proof of differences during psychotherapy between patients who were and who were not taking serotonergic antidepressants. The significant improvements and effect sizes in our study are in line with a previous study, which found small‐ to medium‐sized improvements on indices of verbal learning/memory and inhibition/switching after group trauma‐focused psychotherapy and skills training in female veterans with PTSD (Haaland et al ., ). The results of the current study partly agree with a small study which found improvements in some aspects of executive functioning and not in others after a variety of psychotherapeutic treatments for PTSD (Walter et al ., ).…”

“…The degree of change in PTSD symptoms over treatment was correlated with the degree of change in neuropsychological performance in the expected direction, but none of these relationships reached statistical significance. Relationships between neuropsychological changes and symptom change over treatment have rarely been studied in previous reports; one study found that improvements in inhibition/switching were related to treatment outcome, but improvements in verbal learning/memory were not (Haaland et al ., ). Taken together, these studies show that neuropsychological changes are not consistently related to the degree of change in PTSD symptoms, and neurocognitive alterations in PTSD may probably best be defined as both state‐related and trait markers.…”

“…A replication study failed to find a difference between paroxetine and placebo (Fani et al ., ). In female veterans with PTSD who underwent trauma‐focused psychotherapy and skills training in a group, significant improvements were found post‐treatment in verbal learning/memory and inhibition/switching, but only change in inhibition switching proved to be related to treatment success (Haaland, Sadek, Keller, & Castillo, ). Furthermore, one small study has found improvements in some aspects of executive functioning after various forms of trauma‐focused psychotherapy (Walter, Palmieri, & Gunstad, ).…”