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The role of intraindividual cognitive variability in posttraumatic stress syndromes and cognitive aging: a literature search and proposed research agenda

Published online by Cambridge University Press:  16 March 2020

Lauren A. Rutter Open the ORCID record for Lauren A. Rutter [Opens in a new window] ,
Ipsit V. Vahia ,
Eliza Passell ,
Brent P. Forester  and
Laura Germine
Lauren A. Rutter*
Affiliation:
Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, USA
Ipsit V. Vahia
Affiliation:
Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA
Eliza Passell
Affiliation:
Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
Brent P. Forester
Affiliation:
Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, USA
Laura Germine
Affiliation:
Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
*
Correspondence should be addressed to: Lauren A. Rutter, Department of Psychological and Brain Sciences, Indiana University Bloomington, 1101 E. 10th St., Bloomington, IN 47405, USA. Email: larutter@iu.edu.
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Abstract

Objectives:

Cognitive impairments are directly related to severity of symptoms and are a primary cause for functional impairment. Intraindividual cognitive variability likely plays a role in both risk and resiliency from symptoms. In fact, such cognitive variability may be an earlier marker of cognitive decline and emergent psychiatric symptoms than traditional psychiatric or behavioral symptoms. Here, our objectives were to survey the literature linking intraindividual cognitive variability, trauma, and dementia and to suggest a potential research agenda.

Design:

A wide body of literature suggests that exposure to major stressors is associated with poorer cognitive performance, with intraindividual cognitive variability in particular linked to the development of posttraumatic stress disorder (PTSD) in the aftermath of severe trauma.

Measurements:

In this narrative review, we survey the empirical studies to date that evaluate the connection between intraindividual cognitive variability, PTSD, and pathological aging including dementia.

Results:

The literature suggests that reaction time (RT) variability within an individual may predict future cognitive impairment, including premature cognitive aging, and is significantly associated with PTSD symptoms.

Conclusions:

Based on our findings, we argue that intraindividual RT variability may serve as a common pathological indicator for trauma-related dementia risk and should be investigated in future studies.

Keywords

cognitive impairmentcognitive assessmentposttraumatic stress disorder (PTSD)agingrisk factors
Type
Review Article
Information
International Psychogeriatrics , Volume 33 , Special Issue 7: Issue Theme: Cognitive Aging: Subjective and Objective , July 2021 , pp. 677 - 687
Copyright
© International Psychogeriatric Association 2020

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References

Aupperle, R. L., Melrose, A. J., Stein, M. B. and Paulus, M. P. (2012). Executive function and PTSD: disengaging from trauma. Neuropharmacology, 62(2), 686–694. doi: 10.1016/j.neuropharm.2011.02.008.CrossRefGoogle ScholarPubMed
Bäckman, L., Jones, S., Berger, A., Laukka, E. J. and Small, B. J. (2005). Cognitive impairment in preclinical Alzheimer’s disease: a meta-analysis. Neuropsychology, 19(4), 520–531. doi: 10.1037/0894-4105.19.4.520.CrossRefGoogle ScholarPubMed
Bielak, A. M., Hultsch, D. F., Strauss, E., MacDonald, S. S. and Hunter, M. A. (2010). Intraindividual variability in reaction time predicts cognitive outcomes 5 years later. Neuropsychology, 24(6), 731–741. doi: 10.1037/a0019802.CrossRefGoogle ScholarPubMed
Bielecki, M., Popiel, A., Zawadzki, B. and Sedek, G. (2017). Age as moderator of emotional stroop task performance in Posttraumatic Stress Disorder (PTSD). Frontiers in Psychology, 8, 1614. doi: 10.3389/fpsyg.2017.01614.CrossRefGoogle Scholar
Block, S. R. and Liberzon, I. (2016). Attentional processes in posttraumatic stress disorder and the associated changes in neural functioning. Experimental Neurology, 284, 153–167.CrossRefGoogle ScholarPubMed
Bomyea, J., Amir, N. and Lang, A. J. (2012). The relationship between cognitive control and posttraumatic stress symptoms. Journal of Behavior Therapy and Experimental Psychiatry, 43(2), 844–848. doi: 10.1016/j.jbtep.2011.12.001.CrossRefGoogle ScholarPubMed
Bunce, D., MacDonald, S. S. and Hultsch, D. F. (2004). Inconsistency in serial choice decision and motor reaction times dissociate in younger and older adults. Brain and Cognition, 56(3), 320–327. doi: 10.1016/j.bandc.2004.08.006.CrossRefGoogle ScholarPubMed
Brady, K. T., Killeen, T. K., Brewerton, T. and Lucerini, S. (2000). Comorbidity of psychiatric disorders and posttraumatic stress disorder. The Journal of Clinical Psychiatry, 61(Suppl7), 22–32.Google ScholarPubMed
Chuah, Y. L., Venkatraman, V., Dinges, D. F. and Chee, M. L. (2006). The neural basis of interindividual variability in inhibitory efficiency after sleep deprivation. The Journal of Neuroscience, 26(27), 7156–7162. doi: 10.1523/JNEUROSCI.0906-06.2006.CrossRefGoogle ScholarPubMed
Christensen, H. (2001). What cognitive changes can be expected with normal ageing? Australian and New Zealand Journal of Psychiatry, 35, 768–775. doi: 10.1046/j.1440-1614.2001.00966.x.CrossRefGoogle ScholarPubMed
Coghill, D. R., Seth, S. and Matthews, K. (2014). A comprehensive assessment of memory, delay aversion, timing, inhibition, decision making and variability in attention deficit hyperactivity disorder: advancing beyond the three-pathway models. Psychological Medicine, 44(9), 1989–2001. doi: 10.1017/S0033291713002547.CrossRefGoogle ScholarPubMed
Ehlers, A. and Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319–345. doi: 10.1016/S0005-7967(99)00123-0.CrossRefGoogle ScholarPubMed
Elwood, L. S., Hahn, K. S., Olatunji, B. O. and Williams, N. L. (2009). Cognitive vulnerabilities to the development of PTSD: A review of four vulnerabilities and the proposal of an integrative vulnerability model. Clinical Psychology Review, 29(1), 87–100. doi: 10.1016/j.cpr.2008.10.002.CrossRefGoogle ScholarPubMed
Fjell, A. M., Westlye, L. T., Amlien, I. K. and Walhovd, K. B. (2011). Reduced white matter integrity is related to cognitive instability. The Journal of Neuroscience, 31(49), 18060–18072. doi: 10.1523/JNEUROSCI.4735-11.2011.CrossRefGoogle ScholarPubMed
Fortenbaugh, F. C. et al., (2017). Interpersonal early‐life trauma alters amygdala connectivity and sustained attention performance. Brain and Behavior, 7(5), 1–16, doi: 10.1002/brb3.684.CrossRefGoogle ScholarPubMed
Golier, J. A., Harvey, P. D., Legge, J. and Yehuda, R. (2006). Memory Performance in Older Trauma Survivors: Implications for the Longitudinal Course of PTSD. In: Yehuda, R. and Yehuda, R. (Eds.), Psychobiology of Posttraumatic Stress Disorders: A Decade of Progress (pp. 54–66). Malden, MA: Blackwell Publishing.Google Scholar
Grober, E., Hall, C. B., Lipton, R. B., Zonderman, A. B., Resnick, S. M. and Kawas, C. (2008). Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer’s disease. Journal of the International Neuropsychological Society, 14(2), 266–278. doi: 10.1017/S1355617708080302.CrossRefGoogle ScholarPubMed
Hultsch, D. F., MacDonald, S. S. and Dixon, R. A. (2002). Variability in reaction time performance of younger and older adults. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 57(2), P101–P115. doi: 10.1093/geronb/57.2.P101.CrossRefGoogle ScholarPubMed
Hultsch, D. F., MacDonald, S. S., Hunter, M. A., Levy-Bencheton, J. and Strauss, E. (2000). Intraindividual variability in cognitive performance in older adults: comparison of adults with mild dementia, adults with arthritis, and healthy adults. Neuropsychology, 14(4), 588–598. doi: 10.1037/0894-4105.14.4.588.CrossRefGoogle ScholarPubMed
Hurd, M. D., Martorell, P., Delavande, A., Mullen, K. J. and Langa, K. M. (2013). Monetary costs of dementia in the United States. The New England Journal of Medicine, 368, 1326–1334. doi: 10.1056/NEJMsa1204629.CrossRefGoogle ScholarPubMed
Kaiser, S., Roth, A., Rentrop, M., Friederich, H., Bender, S. and Weisbrod, M. (2008). Intra-individual reaction time variability in schizophrenia, depression and borderline personality disorder. Brain and Cognition, 66(1), 73–82. doi: 10.1016/j.bandc.2007.05.007.CrossRefGoogle ScholarPubMed
Kälin, A. M. et al. (2014). Intraindividual variability across cognitive tasks as a potential marker for prodromal Alzheimer’s disease. Frontiers in Aging Neuroscience, 6, 147. doi: 10.3389/fnagi.2014.00147.CrossRefGoogle ScholarPubMed
Lapp, L. K., Agbokou, C. and Ferreri, F. (2011). PTSD in the elderly: the interaction between trauma and aging. International Psychogeriatrics, 23(6), 858–868. doi: 10.1017/S1041610211000366.CrossRefGoogle ScholarPubMed
Li, S. and Lindenberger, U. (1999). Cross-level unification: a computational exploration of the link between deterioration of neurotransmitter systems and dedifferentiation of cognitive abilities in old age. In: Nilsson, L., Markowitsch, H.J., Nilsson, L. and Markowitsch, H.J. (Eds.), Cognitive Neuroscience of Memory (pp. 103–146). Ashland, OH: Hogrefe & Huber Publishers.Google Scholar
Lohr, J. B. et al., (2015). Is post-traumatic stress disorder associated with premature senescence? A review of the literature. The American Journal of Geriatric Psychiatry, 23(7), 709–725. doi: 10.1016/j.jagp.2015.04.001.CrossRefGoogle ScholarPubMed
Lövdén, M., Li, S., Shing, Y. L. and Lindenberger, U. (2007). Within-person trial-to-trial variability precedes and predicts cognitive decline in old and very old age: longitudinal data from the Berlin Aging Study. Neuropsychologia, 45(12), 2827–2838. doi: 10.1016/j.neuropsychologia.2007.05.005.CrossRefGoogle ScholarPubMed
Lu, H., Chan, S. S. and Lam, L. C. (2016). Associations between Intra-Individual Variability of reaction time and cognitive function in cognitively normal senior adults: still beyond good or bad? Geriatrics, 1, 13. doi: 10.3390/geriatrics1020013.CrossRefGoogle ScholarPubMed
Lupien, S. J., Maheu, F., Tu, M., Fiocco, A. and Schramek, T. E. (2007). The effects of stress and stress hormones on human cognition: implications for the field of brain and cognition. Brain and Cognition, 65(3), 209–237. doi: 10.1016/j.bandc.2007.02.007.CrossRefGoogle ScholarPubMed
MacDonald, S. S., Hultsch, D. F. and Dixon, R. A. (2003). Performance variability is related to change in cognition: evidence from the Victoria longitudinal study. Psychology and Aging, 18(3), 510–523. doi: 10.1037/0882-7974.18.3.510.CrossRefGoogle ScholarPubMed
MacDonald, S. S., Karlsson, S., Fratiglioni, L. and Bäckman, L. (2011). Trajectories of cognitive decline following dementia onset: what accounts for variation in progression? Dementia and Geriatric Cognitive Disorders, 31(3), 202–209. doi: 10.1159/000325666.CrossRefGoogle Scholar
MacDonald, S. S., Li, S. and Bäckman, L. (2009). Neural underpinnings of within-person variability in cognitive functioning. Psychology and Aging, 24(4), 792–808. doi: 10.1037/a0017798.CrossRefGoogle ScholarPubMed
Merritt, V. C. et al. (2018). Repetitive mild traumatic brain injury in military veterans is associated with increased neuropsychological intra-individual variability. Neuropsychologia, 119, 340–348. doi: 10.1016/j.neuropsychologia.2018.08.026.CrossRefGoogle ScholarPubMed
Mittal, D., Torres, R., Abashidze, A. and Jimerson, N. (2001). Worsening of post-traumatic stress disorder symptoms with cognitive decline: case series. Journal of Geriatric Psychiatry and Neurology, 14(1), 17–20. doi: 10.1177/089198870101400105.CrossRefGoogle ScholarPubMed
Ode, S., Robinson, M. D. and Hanson, D. M. (2011). Cognitive-emotional dysfunction among noisy minds: predictions from individual differences in reaction time variability. Cognition and Emotion, 25(2), 307–327. doi: 10.1080/02699931.2010.494387.CrossRefGoogle ScholarPubMed
Polak, A. R., Witteveen, A. B., Reitsma, J. B. and Olff, M. (2012). The role of executive function in posttraumatic stress disorder: a systematic review. Journal of Affective Disorders, 141(1), 11–21. doi: 10.1016/j.jad.2012.01.001.CrossRefGoogle ScholarPubMed
Rubin, E. H. et al. (1998). A prospective study of cognitive function and onset of dementia in cognitively healthy elders. Archives Neurology, 55, 395–401.CrossRefGoogle ScholarPubMed
Salthouse, T. A. (2007). Implications of within-person variability in cognitive and neuropsychological functioning for the interpretation of change. Neuropsychology, 21(4), 401–411. doi: 10.1037/0894-4105.21.4.401.CrossRefGoogle ScholarPubMed
Schmidt, U. et al. (2015). Searching for non-genetic molecular and imaging PTSD risk and resilience markers: Systematic review of literature and design of the German Armed Forces PTSD biomarker study. Psychoneuroendocrinology, 51, 444–458. doi: 10.1016/j.psyneuen.2014.08.020.CrossRefGoogle ScholarPubMed
Smallwood, J., O’Connor, R. C., Sudbery, M. V. and Obonsawin, M. (2007). Mind-wandering and dysphoria. Cognition and Emotion, 21(4), 816–842. doi: 10.1080/02699930600911531.CrossRefGoogle Scholar
Schuitevoerder, S. et al. (2013). A meta-analysis of cognitive functioning in older adults with PTSD. Journal of Anxiety Disorders, 27(6), 550–558. doi: 10.1016/j.janxdis.2013.01.0.CrossRefGoogle ScholarPubMed
Spencer, A. E. et al. (2016). Examining the association between posttraumatic stress disorder and attention deficit/hyperactivity disorder: a systematic review and meta-analysis. The Journal of Clinical Psychiatry, 77(1), 72–83. doi: 10.4088/JCP.14r09479.CrossRefGoogle ScholarPubMed
Stawski, R. S., MacDonald, S. S., Brewster, P. W. H., Munoz, E., Cerino, E. S. and Halliday, D. W. R. (2019). A comprehensive comparison of quantifications of intraindividual variability in response times: a measurement burst approach. The Journals of Gerontology: Series B, 74(3), 397–408. doi: 10.1093/geronb/gbx115.CrossRefGoogle ScholarPubMed
Strauss, E., MacDonald, S. S., Hunter, M., Moll, A. and Hultsch, D. F. (2002). Intraindividual variability in cognitive performance in three groups of older adults: cross-domain links to physical status and self-perceived affect and beliefs. Journal of the International Neuropsychological Society, 8(7), 893–906. doi: 10.1017/S1355617702870035.CrossRefGoogle ScholarPubMed
Stuss, D. T. (2017). Individual differences in cognitive neuropsychology. Personality and Individual Differences, 188, 4–6. doi: 10.1016/j.paid.2016.10.037.CrossRefGoogle Scholar
Swick, D., Honzel, N., Larsen, J. and Ashley, V. (2013). Increased response variability as a marker of executive dysfunction in veterans with post-traumatic stress disorder. Neuropsychologia, 51(14), 3033–3040. doi: 10.1016/j.neuropsychologia.2013.10.008.CrossRefGoogle ScholarPubMed
Thomas, M. L. et al. (2016). Paradoxical trend for improvement in mental health with aging: a community-based study of 1,546 adults aged 21-100 years. Journal of Clinical Psychiatry, 77(8), e1019–25. doi: 10.4088/JCP.16m10671.CrossRefGoogle ScholarPubMed
Thompson, W. K. et al. (2013). Characterizing trajectories of cognitive functioning in older adults with schizophrenia: does method matter? Schizophrenia Research, 143(1), 90–96. doi: 10.1016/j.schres.2012.10.033.CrossRefGoogle ScholarPubMed
Troyer, A. K., Vandermorris, S. and Murphy, K. J. (2016). Intraindividual variability in performance on associative memory tasks is elevated in amnestic mild cognitive impairment. Neuropsychologia, 90, 110–116. doi: 10.1016/j.neuropsychologia.2016.06.011.CrossRefGoogle ScholarPubMed
Vahia, I. V., Thompson, W. K., Depp, C. A., Allison, M. and Jeste, D. V. (2012). Developing a dimensional model for successful cognitive and emotional aging. International Psychogeriatrics, 24(4), 515–523. doi: 10.1017/S1041610211002055.CrossRefGoogle ScholarPubMed
van den Bosch, R. J., Rombouts, R. P. and van Asma, M. O. (1996). What determines continuous performance task performance? Schizophrenia Bulletin, 22(4), 643–651. doi: 10.1093/schbul/22.4.643.CrossRefGoogle ScholarPubMed
Vasterling, J. J. and Brailey, K. (2005). Neuropsychological findings in adults with PTSD. In: Vasterling, J.J., Brewin, C.R., Vasterling, J.J. and Brewin, C.R. (Eds.), Neuropsychology of PTSD: Biological, Cognitive, and Clinical Perspectives (pp. 178–207). New York: Guilford Press.Google Scholar
Vasterling, J. J., Brailey, K., Proctor, S. P., Kane, R., Heeren, T. and Franz, M. (2012). Neuropsychological outcomes of mild traumatic brain injury, post-traumatic stress disorder and depression in Iraq-deployed US Army soldiers. The British Journal of Psychiatry, 201(3), 186–192. doi: 10.1192/bjp.bp.111.096461.CrossRefGoogle ScholarPubMed
Vasterling, J. J. et al. (2006). The neurocognition deployment health study: a prospective Cohort study of army soldiers. Military Medicine, 171(3), 253–260. doi: 10.7205/MILMED.171.3.253.CrossRefGoogle ScholarPubMed
Vasterling, J. J., Verfaellie, M. and Sullivan, K. D. (2009). Mild traumatic brain injury and posttraumatic stress disorder in returning veterans: perspectives from cognitive neuroscience. Clinical Psychology Review, 29(8), 674–684. doi: 10.1016/j.cpr.2009.08.004.CrossRefGoogle ScholarPubMed
Vaughan, L. et al. (2013). Intraindividual variability in domain-specific cognition and risk of mild cognitive impairment and dementia. Current Gerontology and Geriatrics Research, 2013, 495793. doi: 10.1155/2013/495793.CrossRefGoogle ScholarPubMed
Vaurio, R. G., Simmonds, D. J. and Mostofsky, S. H. (2009). Increased intra-individual reaction time variability in attention-deficit/hyperactivity disorder across response inhibition tasks with different cognitive demands. Neuropsychologia, 47, 2389–2396. http://dx.doi.org/10.1016/j.neuropsychologia.2009.01.022.CrossRefGoogle ScholarPubMed
Vinogradov, S., Poole, J. H., Willis-Shore, J., Ober, B. A. and Shenaut, G. K. (1998). Slower and more variable reaction times in schizophrenia: what do they signify? Schizophrenia Research, 32(3), 183–190. doi: 10.1016/S0920-9964(98)00043-7.CrossRefGoogle ScholarPubMed
Weintraub, D. and Ruskin, P. E. (1999). Posttraumatic stress disorder in the elderly: a review. Harvard Review Psychiatry, 7(3), 144–152.CrossRefGoogle ScholarPubMed
Williams, B. R., Hultsch, D. F., Strauss, E. H., Hunter, M. A. and Tannock, R. (2005). Inconsistency in reaction time across the lifespan. Neuropsychology, 19, 88–96. doi: 10.1037/0894-4105.19.1.88.CrossRefGoogle Scholar
Yaffe, K. et al., (2010). Posttraumatic stress disorder and risk of dementia among US veterans. Archives of General Psychiatry, 67(6), 608–613. doi: 10.1001/archgenpsychiatry.2010.61.CrossRefGoogle ScholarPubMed