Neurocognitive Correlates of Successful Treatment of PTSD in Female Veterans.

Autor:	Haaland KY; 1University of New Mexico School of Medicine and The New Mexico Veterans Affairs Healthcare System,Albuquerque,New Mexico., Sadek JR; 1University of New Mexico School of Medicine and The New Mexico Veterans Affairs Healthcare System,Albuquerque,New Mexico., Keller JE; 2New Mexico Veterans Affairs Healthcare System and The Biomedical Research Institute of New Mexico,Albuquerque,New Mexico., Castillo DT; 3New Mexico Veterans Affairs Healthcare System,Albuquerque, New Mexico and The VISN 17 Center of Excellence,Waco, Texas.
Jazyk:	angličtina
Zdroj:	Journal of the International Neuropsychological Society : JINS [J Int Neuropsychol Soc] 2016 Jul; Vol. 22 (6), pp. 643-51. Date of Electronic Publication: 2016 Jun 06.
DOI:	10.1017/S1355617716000424
Abstrakt:	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).
Databáze:	MEDLINE
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