Understanding the Neuropsychological Consequences of Deployment Stress: A Public Health Framework

Abstract

Complaints of neuropsychological dysfunction have emerged among subsets of military personnel after almost every major deployment involving western nations in recent history. Although deployments have been characterized by a range of neural risk factors, psychological stress is common to most prolonged deployments. This review uses a public health framework to address associations between deployment-related stress and neuropsychological performance. Specifically, the review covers mechanisms by which deployment-related psychological stress may affect neuropsychological functioning, considers the advantages and disadvantages of approaching the question from a public health perspective, and discusses how epidemiological research may sort out questions regarding course, cause, and effect.

What’s easier: Doing what you want, or being told what to do? Cued versus voluntary language and task switching.

“…However, if anything, bottom-upper bilinguals tended to switch more often in the voluntary condition than top-downer bilinguals. Additional work is needed to determine how habitual switching frequency may or may not lead to more efficient switching (Rodríguez-Fornells, Krämer, Lorenzo-Seva, Festman, & Münte, 2012; Soveri, Rodríguez-Fornells, & Laine, 2011), and whether or not such efficiency can transfer across tasks and domains (e.g., see Prior & Gollan, 2011; 2013). Naturally occurring switches may improve switching ability in general (leading to smaller cued switch costs) only when practiced switches are costly top-down switches.…”

The cognitive neuropsychological phenotype of carriers of the FMR1 premutation

“…It has been argued that targeted, domain-specific measures may more sensitively identify subtle neurocognitive deficits than gross neuropsychological tests [67]. Indeed, more targeted measures have identified enhanced psychomotor ability [68,69], motor programming deficits [70], increased balance and memory problems [70,71], and age- and CGG-dependent changes in the attentional demands of postural control [72]. Collectively, these findings point to early at-risk phenotypic features suggesting cerebellar dysfunction in a subgroup of female premutation carriers; however, prospective longitudinal studies will be needed to determine who will eventually develop cognitive impairment and neurodegenerative decline.…”

Kindergarten classroom functioning of extremely preterm/extremely low birth weight children

“…Children in both groups were administered tests of cognitive abilities and academic achievement by examiners not informed of the child’s birth status while parents were interviewed and completed child behavior ratings [10,23,24]. Following assessment of both the NBW child and NBW classmate, research assistants who had not tested the children they were observing and were not informed of their birth status conducted the classroom observations of both children.…”

“…Our primary aims were to determine if and how the performance of kindergarten EPT/ELBW children differed from that of their NBW peers and identify individual characteristics related to more problematic classroom functioning within the EPT/ELBW group. Based on the cognitive, learning, and behavior problems of EPT/ELBW children at school entry [10,23,24], we hypothesized that they would require more teacher attention, display more off-task behavior, and exhibit less academic engagement in the classroom than their NBW classmates. Previous research suggests that the academic deficits in children with extreme prematurity, although variable, are related to multiple individual characteristics, including higher neonatal medical risk, early childhood neurodevelopmental impairment, low scores on tests of global cognitive ability and executive function, and behavior problems [6,24-29].…”