Deficits in short-term memory in posttraumatic stress disorder

Bremner, J. Douglas; Tm, Scott; Rc, Delaney; Sm, Southwick; Jw, Mason; Dr, Johnson; Rb, Innis; McCarthy, Gregory; Ds, Charney

doi:10.1176/ajp.150.7.1015

Cited by 376 publications

(49 citation statements)

References 45 publications

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“…Since most studies that have examined correlations between the severity of PTSD symptoms and neurocognitive performance have found significant associations (Bremner et al, 1993, 2004; Cohen et al, 2013; Gilbertson et al, 2001; Lindauer et al, 2006; Olff et al, 2014; Twamley et al, 2009; Vasterling et al, 2002, 1998), we performed post hoc analyses to examine whether PTSD symptom severity might contribute to the magnitude of effect size estimates within specific cognitive domains. In general, although results have been variable, measures of immediate verbal memory, speed of information processing, sustained attention, and working memory appeared to have the most consistent correlations with PTSD symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…These results helped generate appealing hypotheses to investigate in studies of PTSD in humans (e.g., Bremner, Randall, Scott, Bronen, et al, 1995; Sapolsky, 2000), and initial investigations of neurocognitive functioning in PTSD primarily focused on episodic memory effects that were ostensibly mediated by the hippocampus. Although some studies reported robust effects of PTSD on memory functioning, including associations between reductions in hippocampal volume and episodic memory difficulties (Bremner et al, 1993; Bremner, Randall, Scott, Bronen, et al, 1995; Tischler et al, 2006; Vythilingam et al, 2005), a number of studies have failed to replicate these findings (Bremner et al, 1997; Lindauer, Olff, van Meijel, Carlier, & Gersons, 2006; Neylan et al, 2004; Stein, Koverola, Hanna, Torchia, & McClarty, 1997; Woodward, Kaloupek, et al, 2009), which raises questions about applying a hippocampal conceptualization to memory deficits in PTSD (Woodward, Kaloupek, et al, 2009). …”

Section: Neurocognitive Functioning In Ptsdmentioning

confidence: 99%

“…Moreover, a substantial literature has amassed over the past 25 years showing performance deficits on neuropsychological measures of attention, working memory, episodic memory, speed of information processing, and executive functioning in individuals with PTSD (e.g., Aupperle, Melrose, Stein, & Paulus, 2012; Bremner et al, 1993; Dalton, Pederson, & Ryan, 1989; Uddo, Vasterling, Brailey, & Sutker, 1993; Vasterling & Brewin, 2005; Yehuda, Golier, Tischler, Stavitsky, & Harvey, 2005). For example, Vasterling and colleagues (2002) found significant deficits in sustained attention, working memory, and immediate verbal memory in Vietnam veterans with PTSD, even after adjusting for premorbid intellectual functioning and substance abuse.…”

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confidence: 99%

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A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder.

Scott¹,

Matt²,

Wrocklage³

et al. 2015

Psychological Bulletin

424

363

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Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data from 60 studies totaling 4,108 participants, including 1,779with PTSD, 1,446 trauma-exposed comparison participants, and 895 healthy comparison participants without trauma exposure. Effect size estimates were calculated using a mixed-effects meta-analysis for nine cognitive domains: attention/working memory, executive functions, verbal learning, verbal memory, visual learning, visual memory, language, speed of information processing, and visuospatial abilities. Analyses revealed significant neurocognitive effects associated with PTSD, although these ranged widely in magnitude, with the largest effect sizes in verbal learning (d =−.62), speed of information processing (d =−.59), attention/working memory (d =−.50), and verbal memory (d =−.46). Effect size estimates were significantly larger in treatment-seeking than community samples and in studies that did not exclude participants with attention-deficit hyperactivity disorder, and effect sizes were affected by between-group IQ discrepancies and the gender composition of the PTSD groups. Our findings indicate that consideration of neuropsychological functioning in attention, verbal memory, and speed of information processing may have important implications for the effective clinical management of persons with PTSD. Results are further discussed in the context of cognitive models of PTSD and the limitations of this literature.

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Section: Discussionmentioning

confidence: 99%

Section: Neurocognitive Functioning In Ptsdmentioning

confidence: 99%

mentioning

confidence: 99%

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A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder.

Scott¹,

Matt²,

Wrocklage³

et al. 2015

Psychological Bulletin

424

363

View full text Add to dashboard Cite

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“…Therefore, the cognitive problems in PTSD subjects that might interfere with language learning in refugees may have been underestimated. However, numerous studies have shown that PTSD is associated with cognitive problems [5]. Especially, explicit memory is impaired in PTSD [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Language Acquisition in Relation to Cumulative Posttraumatic Stress Disorder Symptom Load over Time in a Sample of Resettled Refugees

Söndergaard¹,

Theorell²

2004

Psychother Psychosom

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Objective: To study the effects of symptoms of posttraumatic stress disorder (PTSD), depression and dissociation as well as cumulative symptom load on language learning during the introduction phase in resettled refugees. Method: Participants were resettled refugees of Iraqi origin. They were assessed by means of a structured interview for PTSD at baseline as well as self-rating questionnaires. Language acquisition was studied by means of register data from the school system. Five levels of language proficiency were recorded. Self-reported symptom scores for PTSD, depression and dissociation (Impact of Events Scale-22, Hopkins Symptom Checklist-25, Dissociative Experiences Scale) were measured at four time points during 9 months immediately after resettlement. In 49 participants in a longitudinal study, data regarding progress in language studies were accessible. Results: The results of the study indicate that the speed of language acquisition – the number of levels taken during the study, adjusted to hours of school presence – is related to the cumulative PTSD symptom load over time (Events Scale-22), but is not related neither to the symptom load of depression and dissociation, nor to the number of previous school years. Conclusion: The study shows that the symptom load of PTSD during the follow-up period is significantly inversely related to the speed of language acquisition in refugees. This implies that treatment as well as preventive measures against worsening of PTSD symptoms are important in order to minimise harmful post-migration stress for the facilitation of integration.

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“…In general, individuals with PTSD have been shown to exhibit specific patterns of information processing, including attentional biases for trauma-relevant cues (Bryant and Harvey, 1997; Dalgleish et al, 2003; Fani et al, 2012; Wald et al, 2013), and impairments in sustained attention, declarative and working memory as compared to individuals without PTSD (Bremner et al, 1993, 2004; Uddo et al, 1993; Yehuda et al, 1995; Vasterling et al, 1998, 2002; Gilbertson et al, 2001; Stein et al, 2002a; Koso and Hansen, 2006; Samuelson et al, 2006; Schweizer and Dalgleish, 2011; Dretsch et al, 2012). These phenomena may be relevant to particular patterns of neural response and structure that are characteristic of individuals with PTSD, including smaller hippocampal volumes (Bremner et al, 1995; Kitayama et al, 2005; Karl et al, 2006) and exaggerated amygdala response (Rauch et al, 2000; Armony et al, 2005; Shin et al, 2005; Bryant et al, 2008a,b).…”

Section: Neuroimaging Geneticsmentioning

confidence: 99%

Genetic approaches to understanding post-traumatic stress disorder

Almli¹,

Fani²,

Smith³

et al. 2013

Int. J. Neuropsychopharm.

103

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Post-traumatic stress disorder (PTSD) is increasingly recognized as both a disorder of enormous mental health and societal burden, but also as an anxiety disorder that may be particularly understandable from a scientific perspective. Specifically, PTSD can be conceptualized as a disorder of fear and stress dysregulation, and the neural circuitry underlying these pathways in both animals and humans are becoming increasingly well understood. Furthermore, PTSD is the only disorder in psychiatry in which the initiating factor, the trauma exposure, can be identified. Thus, the pathophysiology of the fear and stress response underlying PTSD can be examined and potentially interrupted. Twin studies have shown that the development of PTSD following a trauma is heritable, and that genetic risk factors may account for up to 30–40% of this heritability. A current goal is to understand the gene pathways that are associated with PTSD, and how those genes act on the fear/stress circuitry to mediate risk vs. resilience for PTSD. This review will examine gene pathways that have recently been analysed, primarily through candidate gene studies (including neuroimaging studies of candidate genes), in addition to genome-wide associations and the epigenetic regulation of PTSD. Future and on-going studies are utilizing larger and collaborative cohorts to identify novel gene candidates through genome-wide association and other powerful genomic approaches. Identification of PTSD biological pathways strengthens the hope of progress in the mechanistic understanding of a model psychiatric disorder and allows for the development of targeted treatments and interventions.

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Deficits in short-term memory in posttraumatic stress disorder

Abstract: Patients with PTSD may have deficits in short-term memory. Counseling and rehabilitation that address these deficits may be of value for PTSD patients.

Cited by 376 publications

References 45 publications

A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder.

A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder.

Language Acquisition in Relation to Cumulative Posttraumatic Stress Disorder Symptom Load over Time in a Sample of Resettled Refugees

Genetic approaches to understanding post-traumatic stress disorder

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