Attention and memory performances were studied in Persian Gulf War veterans with and without posttraumatic stress disorder (PTSD) diagnoses. Veterans diagnosed with PTSD showed relative performance deficiencies on tasks of sustained attention, mental manipulation, initial acquisition of information, and retroactive interference. Their performances were also characterized by errors of commission and intrusion. The tendency toward response disinhibition and intrusion on cognitive tasks was correlated positively with reexperiencing symptoms and negatively with avoidance-numbing symptoms. These cognitive deficit patterns are consistent with models of PTSD that emphasize the role of hyperarousal and implicate dysfunction of frontal-subcortical systems. Results suggest that intrusion of traumatic memories in PTSD may not be limited to trauma-related cognitions but instead reflects a more general pattern of disinhibition.

Attention, learning, memory, and estimated intellectual potential were examined in 26 Vietnam veterans diagnosed with posttraumatic stress disorder (PTSD) and in 21 Vietnam veterans without mental disorders. Results revealed PTSD-associated cognitive deficits on tasks of sustained attention, working memory, initial learning, and estimated premorbid intelligence but not on measures of focus of attention, shift of attention, or memory savings. Cognitive task performances adjusted for estimated native intelligence remained negatively correlated with PTSD severity. An intellectual measure adjusted for cognitive task performances was negatively correlated with PTSD severity, even after the authors statistically controlled the level of combat exposure. Results suggested that although intellectual resources may constitute a vulnerability–protective factor for PTSD development, PTSD was associated with cognitive impairment independent of intellectual functioning.

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Dysphagia with aspiration is prevalent in acute stroke; however, noninvasive clinical screening assessments to identify patients at risk of developing aspiration are limited. This study was undertaken to determine whether risk factors detected in the clinical examination approximated the videofluoroscopic swallow study (VSS) in identification of dysphagia severity. Six clinical features—dysphonia, dysarthria, abnormal volitional cough, abnormal gag reflex, cough after swallow, and voice change after swallow—were assessed by means of an oropharyngeal evaluation and a clinical swallowing examination. Clinical assessments and VSS were completed on consecutive stroke patients ( n =59) within 5 days of hospital admission. The VSS was scored on a scale of 0 to 4 (0=normal, 1=mild, 2=moderate, 3=moderate-severe, 4=severe dysphagia). Results showed that the presence of at least 2 of the 6 clinical features consistently distinguished patients with moderate to severe dysphagia from patients with mild dysphagia/normal swallowing. These data demonstrate that this clinical dysphagia screening tool can provide objective criteria for the need for VSS in acute stroke patients.

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