The effects of psychological interventions on neurocognitive functioning in posttraumatic stress disorder: a systematic review

Abstract

Background: Posttraumatic stress disorder (PTSD) is a serious mental disorder, which is associated with emotional and cognitive functioning problems. Psychological interventions, such as trauma-focused cognitive behavioural therapy (tf-CBT) and eye movement desensitization and reprocessing (EMDR) are effective in reducing PTSD symptoms. Despite evidence showing that PTSD is associated with neurocognitive deficits, there is no systematic overview available on neurocognitive outcomes following treatment for PTSD. The current systematic review examined whether psychological treatments for PTSD improve neurocognitive functioning outcomes related to memory, attention, information processing, and executive functioning. Method: A literature search in PubMed, PsycINFO, PTSDpubs, and Cochrane Library was performed up to March 7, 2022, in collaboration with a medical information specialist. Eligible PTSD treatment studies examining neurocognitive outcomes (memory, attention, information processing and executive function) in patients with a DSM-IV or ICD diagnosis of PTSD were included. Results: Of the 3023 titles and abstracts identified, 9 articles met inclusion criteria, of which 5 randomized controlled trials (RCTs) and 4 non-randomized studies. Treatments included were cognitive behavioural therapy (CBT), cognitive processing therapy (CPT), brief eclectic psychotherapy (BEP), eye movement desensitization and reprocessing (EMDR), virtual reality graded exposure therapy (VR-GET), and resilience-oriented treatment (ROT). Conclusions: This systematic review showed that psychological treatments for PTSD do not affect most neurocognitive functions, with exception of the memory outcomes. Future research, high-quality studies are needed to provide evidence of the effect of psychological treatment in improving neurocognitive functioning in PTSD. HIGHLIGHTS This systematic review investigated the effects of psychological treatments on neurocognitive functioning in adults with PTSD. This review showed that most studies were very heterogeneous in design, method, and analysis. This review supports the evidence for psychological treatments for PTSD on improving memory outcomes.

The sexually divergent cFos activation map of fear extinction

“…Exposure therapy, a behavior treatment that aims to weaken the associations between stressful events and related cues by repeated exposure to the environment, is a widely used method for treating PTSD. However, the biological mechanism underlying exposure therapy is still not fully understood [ [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] ]. Therefore, research progress on fear memory and its extinction is essential for improving the understanding and treatment of PTSD [ 2 , 3 , [7] , [8] , [9] , [10] , [11] , [12] ].…”

A First Exploration: Can Eye Movement Desensitization and Reprocessing Improve Cognition in Older Adults With Posttraumatic Stress Disorder?

“…45 A systematic review supported a beneficial but mixed effect of TFT on memory rather than any other measures of neurocognitive functioning. 46 The influence of TFT used is not investigated yet. Especially EMDR is understudied in older adults but has potential especially when cognitive functioning is suboptimal because EMDR is less cognitive based than for example CBT.…”

“…48 EMDR is a first-line effective TFT for treatment of PTSD 49 and was slightly more effective on improving verbal memory compared to brief eclectic psychotherapy. 41,46 In conclusion, limited research has considered cognitive changes following TFT with mixed findings and no such studies were applied in older adults. The purpose of current study was to examine the outcome of EMDR treatment in older adults with PTSD in improving cognitive performance, especially verbal learning memory and executive function (interference, working memory) as measured by Rey Auditory Verbal Learning Test (RAVLT; (Rey, 1958)) and Stroop Colour-Word Test (SCWT).…”

“…A systematic review supported a beneficial but mixed effect of TFT on memory rather than any other measures of neurocognitive functioning. 46…”

“…48 EMDR is a first-line effective TFT for treatment of PTSD 49 and was slightly more effective on improving verbal memory compared to brief eclectic psychotherapy. 41,46…”