An examination of the relationship between posttraumatic stress disorder symptom severity and cognitive test performance in a veteran sample

Objective: This study examined the relationship between Posttraumatic Stress Disorder (PTSD) symptom severity and cognitive test performance in veterans, hypothesizing that PTSD Checklist for DSM-5 (PCL-5) scores would be correlated with test performance on commonly used neuropsychological measures. Method: Clinically-referred veterans without a neurocognitive disorder who passed the Test of Memory Malingering (TOMM), completed the PCL-5, and completed Weschler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Digit Span or Coding, Weschler Memory Scale-Fourth Edition (WMS-IV) Logical Memory (LMI/LMII), letter fluency (FAS), or Trail Making Test (Parts A and B) were included. The sample included 38 veterans (81.6% male); mean age = 58.79 (SD = 14.71; range 22–80) and mean education level = 13.97 years (SD = 2.42, range 6–20). Primary diagnoses included PTSD (47.4%), depression (21.1%), and no diagnosis (23.7%). Pearson, Spearman, and partial correlations were calculated. Results: Moderate negative correlations were found between PCL-5 and FAS raw scores (r = −0.41, p = 0.014; 95%CI [−0.654,-0.089]) and LMI raw scores (r = −0.453, p = 0.02; 95%CI [−0.715,-0.080]). After controlling for age and education, moderate negative correlations remained for FAS (r = −0.46, p = 0.004) and LMI (r = −0.43, p = 0.018) and a weak, non-significant correlation with LMII (r = −0.297, p = 0.079). Conclusions: In veterans with valid cognitive test performance and no neurocognitive disorder, PTSD symptom severity negatively correlated with FAS and WMS-IV LM performance. This suggests PTSD symptoms may influence performance on phonemic fluency and story recall task. Assessing and addressing PTSD symptoms may result in more accurate diagnoses and improved cognitive functioning. Understanding the PTSD-cognition relationship can inform interventions and support strategies to enhance veterans’ quality of life.

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