Correlations Between Cognitive Functions and Clinical Symptoms in Adolescents With Complex Post-traumatic Stress Disorder

Abstract

Introduction: Complex post-traumatic stress disorder (C-PTSD) is characterized by the typical symptoms of PTSD, in addition to affective dysregulation, negative self-concept, and disturbances in interpersonal relationships. Children and adolescents with C-PTSD have been reported to have deficits in emotional and cognitive functions. We hypothesized that the following are associated with the severity of C-PTSD symptoms: (1) adolescents with C-PTSD who show deficits in emotional perception and cognitive functions, including executive function and attention; and (2) deficits in neurocognitive functions.Methods: Information on 69 adolescents with PTSD, aged 10–19 years, was gathered from seven shelters. All participants were assessed using complete clinical scales, including the C-PTSD Interview and Depression, Anxiety, and Stress Scales, and neurocognitive function tests, including the emotional perception, mental rotation, and modified Tower of London tests.Results: Adolescents with C-PTSD were more likely to have a history of sexual assault, dissociation, and self-harm than those with PTSD. The total and subscale scores of the C-PTSD Interview Scale in adolescents with C-PTSD were higher than that in adolescents with PTSD. In addition, neurocognitive functions, including emotional perception, attention, and working memory, were correlated with the severity of C-PTSD symptoms.Discussion: Adolescents with C-PTSD experienced more serious clinical symptoms and showed more deficits in neurocognitive functions than adolescents with PTSD. Clinicians should pay careful attention toward the emotional and neurocognitive functions when assessing and treating patients with C-PTSD.

The Relationship Between Dissociation and Complex Post-Traumatic Stress Disorder: A Scoping Review

“…In terms of symptom assessments, most studies used the Dissociative Experiences Scale (DES) (Carlson et al, 1993) or its subscale (i.e., DES-Taxon; DES-T) (Waller & Ross, 1997) to assess dissociation ( n = 13) (Dorahy et al, 2013; Dorrepaal et al, 2012; Ford et al, 2015; Ford et al, 2017; Hyland et al, 2018; Longo et al, 2019; Peles et al, 2012, 2014; Powell, 1996; Sachsse et al, 2006; Tian et al, 2020; Van Dijke et al, 2015; Zucker et al, 2006). Most studies used the International Trauma Questionnaire (ITQ) (Cloitre et al, 2018) ( n = 11) or the Structured Interview for Disorders of Extreme Stress (SIDES) (Pelcovitz et al, 1997) ( n = 6) to assess CPTSD symptoms; only nine studies used other methods (e.g., clinical assessment, the Stress Reactions Checklist for Disorders of Extreme Stress, the C-PTSD Interview Scale) to assess CPTSD symptoms (Dorahy et al, 2013; Ford et al, 2015, 2017; Haselgruber et al, 2020; Longo et al, 2019; Powell, 1996; Powers et al, 2017; Sachsse et al, 2006; Shin et al, 2021). As long as the study explained how dissociation and CPTSD were specifically assessed (e.g., which measure was used, or how clinical assessment was conducted), it was regarded as meeting the second inclusion criterion.…”

“…All studies were published during 2006-2021, except for the thesis identified from ProQuest (Powell, 1996). Most studies used adult samples (n = 23), and only three studies recruited children as participants (Haselgruber et al, 2020(Haselgruber et al, , 2021Shin et al, 2021). Participants were from different countries/regions, including the United States (n = 5), the United Kingdom (n = 4), the Netherlands (n = 3), Austria (n = 2), Canada (n = 2), Ireland (n = 2), South Korea (n = 2), and one in each of the additional countries-Australia, China, Denmark, Germany, Israel, and Italy.…”

“…Participants were from different countries/regions, including the United States (n = 5), the United Kingdom (n = 4), the Netherlands (n = 3), Austria (n = 2), Canada (n = 2), Ireland (n = 2), South Korea (n = 2), and one in each of the additional countries-Australia, China, Denmark, Germany, Israel, and Italy. In terms of study settings, most studies recruited participants from clinical settings or treatment-seeking people (n = 18); three studies recruited participants in shelters or foster care settings (Haselgruber et al, 2020(Haselgruber et al, , 2021Shin et al, 2021); three used nonclinical samples reporting at least one traumatic event or childhood adversity (Bürgin et al, 2021;Choi et al, 2021;Tian et al, 2020); one used an online sample (Frewen et al, 2019); and the remaining study used a nationally representative sample (Jowett et al, 2021).…”

Transtorno de estresse pós-traumático (TEPT) em crianças e adolescentes: impactos e tratamentos

“…Alguns estudos mostraram que adolescentes com TEPT-complexo têm uma taxa maior de história de agressão sexual, dissociação e automutilação do que adolescentes com TEPT (Shin et al, 2021).…”

Complex PTSD symptom clusters and executive function in UK Armed Forces veterans: a cross-sectional study

“…Given emotion dysregulation is a DSO symptom of CPTSD, exploring associations between CPTSD and EFs could inform understanding of the disorder and how existing PTSD interventions could be tailored to improve treatment response in veterans seeking treatment for CPTSD. In a study using an adolescent sample, deficits in EFs were associated with greater CPTSD severity [ 36 ]. However, less is known about the relationship between CPTSD and EFs in veteran populations.…”