Blast concussion and posttraumatic stress as predictors of postcombat neuropsychological functioning in OEF/OIF/OND veterans.

Autor:	Nelson NW; Graduate School of Professional Psychology., Disner SG; Minneapolis VA Medical Center., Anderson CR; Minneapolis VA Medical Center., Doane BM; Minneapolis VA Medical Center., McGuire K; Minneapolis VA Medical Center., Lamberty GJ; Minneapolis VA Medical Center., Hoelzle J; Department of Psychology., Sponheim SR; Minneapolis VA Medical Center.
Jazyk:	angličtina
Zdroj:	Neuropsychology [Neuropsychology] 2020 Jan; Vol. 34 (1), pp. 116-126. Date of Electronic Publication: 2019 Sep 23.
DOI:	10.1037/neu0000594
Abstrakt:	Objectives: Many combat veterans exhibit cognitive limitations of uncertain origin. In this study, we examined factors that predict cognitive functioning by considering effects of blast-related concussion (BRC), non-blast-related concussion (NBRC), and posttraumatic stress disorder (PTSD) symptoms. Analyses specifically tested whether (a) BRC and NBRC were distinct in their prediction of cognitive performance; (b) a dose-response relationship existed between recurrent concussion (BRC and NBRC) and cognitive impairment; and (c) PTSD symptoms mediated the relationship between BRC and cognitive performance. Method: Two hundred eighty veterans with combat zone deployment histories completed semistructured clinical interviews to define BRC and NBRC histories, current and past mental health disorders, and dimensional ratings of PTSD symptomatology. Participants were also administered a number of neuropsychological measures to appraise cognitive functioning. Results: A structural equation model (SEM) suggested that BRC and NBRC were not distinct in their prediction of cognitive performance, and there was no evidence that recurrent concussion (blast or nonblast) was directly associated with cognitive performance. BRC was significantly associated with PTSD symptoms ( r = .24), PTSD symptoms were significantly associated with cognitive performance in the SEM ( r = -.27), and PTSD symptoms significantly mediated the link between BRC and cognitive performance ( p = .03). Conclusions: These results suggest that concussion history fails to directly contribute to cognitive performance, regardless of mechanism (blast or nonblast) and recurrence. BRC is nonetheless unique in its contribution to PTSD and PTSD-related cognitive deficits. Results support interventions specific to PTSD management in the interest of promoting neuropsychological functioning among war veterans. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Databáze:	MEDLINE
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