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Neurocognitive Correlates of Successful Treatment of PTSD in Female Veterans

Published online by Cambridge University Press:  06 June 2016

Kathleen Y. Haaland ,
Joseph R. Sadek ,
Jenna E. Keller  and
Diane T. Castillo
Kathleen Y. Haaland*
Affiliation:
University of New Mexico School of Medicine and The New Mexico Veterans Affairs Healthcare System, Albuquerque, New Mexico
Joseph R. Sadek
Affiliation:
University of New Mexico School of Medicine and The New Mexico Veterans Affairs Healthcare System, Albuquerque, New Mexico
Jenna E. Keller
Affiliation:
New Mexico Veterans Affairs Healthcare System and The Biomedical Research Institute of New Mexico, Albuquerque, New Mexico
Diane T. Castillo
Affiliation:
New Mexico Veterans Affairs Healthcare System, Albuquerque, New Mexico and The VISN 17 Center of Excellence, Waco, Texas
*
Correspondence and reprint requests to: Kathleen Y. Haaland, Department of Psychiatry & Behavioral Sciences, University of New Mexico, Albuquerque, New Mexico 87131. E-mail: khaaland@unm.edu
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Abstract

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. (JINS, 2016, 22, 643–651)

Keywords

NeuropsychologyExecutive functioningPsychotherapyFemaleTraumaPTSDVeterans
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 22 , Issue 6 , July 2016 , pp. 643 - 651
Copyright
Copyright © The International Neuropsychological Society 2016. This is a work of the U.S. Government and is not subject to copyright protection in the United States. 

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