Elevated rates of memory impairment in military service-members and veterans with posttraumatic stress disorder.
Elevated rates of memory impairment in military service-members and veterans with posttraumatic stress disorder.
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患有创伤后应激障碍的军人和退伍军人的记忆障碍率升高。
DOI：
10.1080/13803395.2016.1264575
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发表时间：
2017
影响因子：
2.2
通讯作者：
McGlinchey,ReginaE
中科院分区：
文献类型：
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作者：
Stricker,NikkiH;Lippa,SaraM;Green,DeborahL;McGlynn,SusanM;Grande,LauraJ;Milberg,WilliamP;McGlinchey,ReginaE
简介：研究创伤后应激障碍（PTSD）的神经认知影响的研究通常会发现各种认知领域的“缺陷”。然而，PTSD患者的认知障碍率仍不清楚，因为研究主要集中在零假设检验（NHT）和推断障碍模式，而不是凭经验确定该样本中的认知障碍率。方法：本研究使用领域特异性方法检查了非寻求治疗的持久自由行动/伊拉克自由行动/新黎明行动服务成员和退伍军人与（n= 92）和（n= 79）PTSD和无药物滥用/依赖谁通过了性能有效性措施，并在年龄，教育，估计智商和种族匹配。卡方分析用于比较各组认知障碍的发生率，基于使用三个截止值（-1，-1.5和-2SD）的标准评分。NHT也被用来比较performance across groups.Results：PTSD患者的记忆障碍率（-1-SDcutoff）高于对照组，但注意力、处理速度和执行功能的障碍率相同; NHT无显著差异。任何领域的损伤在PTSD中也更普遍（-1-，-1.5-和-2-SD临界值）。没有差异被发现在NHT或损伤率与PTSD与（n= 34）和没有（n= 58）depression.Conclusions：PTSD患者更有可能满足标准的记忆障碍，并显示在任何领域比对照组的损害。与单独患有PTSD的患者相比，患有PTSD和共病抑郁症的患者在任何认知领域都不太可能受损，或者在单个认知任务上得分较低。临床医生注意到PTSD患者的认知障碍，如果缺陷仅限于记忆，则在将这种障碍归因于另一种病因之前应谨慎行事。
Introduction: Studies investigating the neurocognitive effects of posttraumatic stress disorder (PTSD) routinely find “deficits” in various cognitive domains. However, the rate of cognitive impairment in individuals with PTSD remains unclear, as studies have focused on null hypothesis testing (NHT) and inferring patterns of impairment rather than empirically determining the rate of cognitive impairment in this sample.Method: This study examined rates of cognitive impairment using a domain-specific approach in non-treatment-seeking Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn service members and veterans with (n= 92) and without (n= 79) PTSD and without substance abuse/dependence who passed a performance validity measure and were matched on age, education, estimated IQ, and ethnicity. Chi-square analyses were used to compare the rate of cognitive impairment across groups based on normative scores using three cutoffs (−1, −1.5, and −2SDs). NHT was also used to compare performances across groups.Results: Individuals with PTSD showed higher rates of impairment in memory (−1-SDcutoff) than controls, but equivalent rates of impairment in attention, processing speed, and executive functioning; no significant differences were found on NHT. Impairment in any domain was also more prevalent in PTSD (−1-, −1.5-, and −2-SDcutoffs). No differences were found on NHT or rates of impairment in individuals with PTSD with (n= 34) and without (n= 58) depression.Conclusions: Patients with PTSD were more likely to meet criteria for memory impairment and to show impairment in any domain than controls. Patients with PTSD and comorbid depression were no more likely to be impaired in any cognitive domain or to have lower scores on individual cognitive tasks than patients with PTSD alone. Clinicians noting cognitive impairment in individuals with PTSD should exercise caution before ascribing that impairment to another etiology if deficits are limited to memory.