Neurocognitive Intraindividual Variability in Veterans with Mild Traumatic Brain Injury History and Posttraumatic Stress Disorder.

IF 2.1 4区 心理学 Q2 PSYCHOLOGY Archives of Clinical Neuropsychology Pub Date : 2024-10-28 DOI:10.1093/arclin/acae098
Holly K Rau, David P Sheppard, Justin E Karr, Rebecca C Hendrickson, Abigail Schindler, Elaine R Peskind, Kathleen F Pagulayan
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Abstract

Objective: Veterans with a history of blast-related mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) may be at risk for greater cognitive concerns and worse functional outcomes compared to those with either condition in isolation. However, traditional neuropsychological assessment approaches have yielded equivocal results in these populations. The present study examined an alternative method for detecting subtle cognitive inefficiencies: neurocognitive intraindividual variability (IIV), a measure of within-person performance consistency.

Method: Participants were 79 male Veterans with a history of blast-related mTBI and current PTSD (mTBI/PTSD group; n = 54) or neither diagnosis (controls; n = 25). Mean T-scores and IIV scores were calculated from neuropsychological measures of attention and speed of information processing (A/SoP) as well as executive functioning (EF).

Results: Global IIV was significantly higher in the mTBI/PTSD group compared to controls (p = .047, Cohen's d = 0.49). At the domain level, larger effect sizes were observed for EF IIV (Cohen's d = 0.46) compared to A/SoP IIV (d = 0.32), although neither were statistically significant. Within the mTBI/PTSD group, higher Global IIV was associated with worse self-reported executive dysfunction, psychological quality of life, and cognitive post-concussive symptoms; at the domain level, these clinical outcomes were generally associated with greater A/SoP IIV (but not EF IIV).

Conclusion: Findings extend previous investigations of neurocognitive IIV in individuals with a history of mTBI across PTSD status. Among Veterans with a history of mTBI and comorbid PTSD, neurocognitive variability may be a better indicator of self-reported cognitive inefficiencies and Veteran experience of daily cognitive functioning than mean neuropsychological performances.

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有轻度脑外伤史和创伤后应激障碍的退伍军人的神经认知个体差异。
目的:有爆炸相关轻度创伤性脑损伤(mTBI)和创伤后应激障碍(PTSD)病史的退伍军人与单独患有其中一种疾病的退伍军人相比,可能会面临更大的认知问题和更糟糕的功能障碍。然而,传统的神经心理学评估方法在这些人群中得出的结果并不明确。本研究采用了另一种方法来检测微妙的认知缺陷:神经认知个体内变异性(IIV),这是一种衡量个体内表现一致性的方法:参与者为 79 名男性退伍军人,他们都有与爆炸相关的 mTBI 和创伤后应激障碍病史(mTBI/PTSD 组;n = 54),或没有任何诊断(对照组;n = 25)。根据注意力和信息处理速度(A/SoP)以及执行功能(EF)的神经心理学测量结果计算出平均 T 分数和 IIV 分数:结果:与对照组相比,mTBI/PTSD 组的总体 IIV 明显更高(p = .047,Cohen's d = 0.49)。在领域层面,EF IIV(Cohen's d = 0.46)的效应大小大于 A/SoP IIV(d = 0.32),但二者均无统计学意义。在 mTBI/PTSD 组中,较高的全局 IIV 与较差的自我报告执行功能障碍、心理生活质量和认知震荡后症状相关;在领域水平上,这些临床结果通常与较高的 A/SoP IIV 相关(但与 EF IIV 无关):研究结果扩展了以往对创伤后应激障碍状态下有 mTBI 病史者神经认知 IIV 的研究。在有创伤后应激障碍的 mTBI 退伍军人中,与平均神经心理学表现相比,神经认知变异性可能是自我报告认知效率低下和退伍军人日常认知功能体验的更好指标。
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来源期刊
CiteScore
4.60
自引率
7.70%
发文量
358
审稿时长
6-12 weeks
期刊介绍: The journal publishes original contributions dealing with psychological aspects of the etiology, diagnosis, and treatment of disorders arising out of dysfunction of the central nervous system. Archives of Clinical Neuropsychology will also consider manuscripts involving the established principles of the profession of neuropsychology: (a) delivery and evaluation of services, (b) ethical and legal issues, and (c) approaches to education and training. Preference will be given to empirical reports and key reviews. Brief research reports, case studies, and commentaries on published articles (not exceeding two printed pages) will also be considered. At the discretion of the editor, rebuttals to commentaries may be invited. Occasional papers of a theoretical nature will be considered.
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