Posttraumatic Psychological Symptoms are Associated with Reduced Inhibitory Control, not General Executive Dysfunction

Abstract

Although there is mounting evidence that greater PTSD symptoms are associated with reduced executive functioning, it is not fully understood whether this association is more global or specific to certain executive function subdomains, such as inhibitory control. We investigated the generality of the association between PTSD symptoms and executive function by administering a broad battery of sensitive executive functioning tasks to a cohort of returning Operation Enduring Freedom/Operation Iraqi Freedom Veterans with varying PTSD symptoms. Only tasks related to inhibitory control explained significant variance in PTSD symptoms as well as symptoms of depression, while measures of working memory, measures of switching, and measures simultaneously assessing multiple executive function subdomains did not. Notably, the two inhibitory control measures that showed the highest correlation with PTSD and depressive symptoms, measures of response inhibition and distractor suppression, explained independent variance. These findings suggest that greater posttraumatic psychological symptoms are not associated with a general decline in executive functioning but rather are more specifically related to stopping automatic responses and resisting internal and external distractions.

Dissociation between working memory performance and proactive interference control in post-traumatic stress disorder

“…Previous studies in Iraq and Afghanistan Veterans with PTSD revealed impaired performance on tasks that require the inhibition of inappropriate motor responses (Swick et al, 2012; DeGutis et al, 2015). This replicable response inhibition deficit has been seen in other PTSD populations (Vasterling et al, 1998; Falconer et al, 2008a; Wu et al, 2010) and stands in contrast to the present results.…”

Sustained Attention Across the Life Span in a Sample of 10,000

“…To separate the contribution of strategic changes and ability factors, we have also successfully utilized signal detection analyses of gradCPT (Esterman, Reagan, Liu, Turner, & DeGutis, 2014). Finally, several recent studies suggest that the gradCPT is ecologically valid in that a variant of the gradCPT correlates with real-world attentional problems (Rosenberg, et al, 2013) and performance on the original version is impaired in patient populations with traditionally poor sustained attention (Auerbach, et al, 2014; DeGutis, et al, in press). Together, this suggests the gradCPT is a powerful tool to capture changes in sustained attention ability throughout the lifespan.…”

Executive functioning and diabetes: The role of anxious arousal and inflammation

“…As a result, this measure was chosen as a covariate to determine if broad cognitive skills explain hypothesized associations. This is important given that anxiety symptoms associated with post-traumatic stress have been found to be specific to inhibition as opposed to general executive dysfunction (DeGutis et al, 2015). …”

“…Inhibition is the ability to refrain from responding or attending to tempting/distracting information, objects, thoughts, or activities. Indeed, those who have low inhibition are more likely to attend to anxious thoughts, and have greater difficulty shifting their attention away from such thoughts, than those with high inhibition (DeGutis et al, 2015; Joormann & Gotlib, 2010; Schmeichel & Tang, 2015). Others have argued that better inhibition is associated with less anxiety via the ability to flexibly and adaptively respond to one’s environment using optimal coping strategies (e.g., Martel, Nokolas, & Nigg, 2007).…”

“…As low inhibition is associated with high anxious arousal at the medium effect size level ( r = .38; DeGutis et al, 2015), low inhibition may also be associated with high inflammation; however, it is unclear if inhibition is associated with inflammation in the general population as the literature has primarily been focused on the natural decline of cognitive skills and increase in inflammation near the end of human life (Magaki, Mueller, Dickson, & Kirsch, 2007; Simen, Bordner, Martin, Moy, & Barry, 2011). Furthermore, inhibition is typically combined with other cognitive abilities in statistical analyses, limiting the ability to understand the unique effects of inhibition (Marsland et al, 2015).…”