Neurocognitive Correlates of Successful Treatment of PTSD in Female Veterans

被引:43
作者
Haaland, Kathleen Y. [1 ,2 ]
Sadek, Joseph R. [1 ,2 ]
Keller, Jenna E. [2 ,3 ]
Castillo, Diane T. [2 ,4 ]
机构
[1] Univ New Mexico, Sch Med, Albuquerque, NM 87131 USA
[2] New Mexico Vet Affairs Healthcare Syst, Albuquerque, NM USA
[3] Biomed Res Inst New Mexico, Albuquerque, NM USA
[4] VISN 17 Ctr Excellence, Waco, TX USA
关键词
Neuropsychology; Executive functioning; Psychotherapy; Female; Trauma; PTSD; Veterans; POSTTRAUMATIC-STRESS-DISORDER; MEMORY MALINGERING TOMM; EXECUTIVE FUNCTION; NEUROPSYCHOLOGICAL PERFORMANCE; MODIFICATION PROGRAM; INHIBITORY CONTROL; VERBAL MEMORY; ATTENTION; DEFICITS; NETWORKS;
D O I
10.1017/S1355617716000424
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: 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. Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.
引用
收藏
页码:643 / 651
页数:9
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