Impaired Response Inhibition in Veterans with Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury

Swick, Diane; Honzel, Nikki; Larsen, Jary; Ashley, Victoria; Justus, Timothy

doi:10.1017/s1355617712000458

Cited by 112 publications

(95 citation statements)

References 69 publications

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“…Accordingly, treating BDI scores as a covariate to parcel out the effects of depression is not recommended (Miller and Chapman, 2001). As in our previous studies (Swick et al, 2012, we saw a very high correlation between the self-reported symptoms of PTSD and depression in this population (rho=.90, p<.0001).…”

Section: Error-related Negativity and Depressionsupporting

confidence: 88%

“…Performance on two different versions of the arrow flanker task was unaffected by PTSD. This contrasts with the deficits shown by these same patients in tasks tapping emotional interference control , response inhibition (Swick et al, 2012), response consistency , and dual task performance (Honzel et al, 2014). Taken together, the behavioral results support the general notion of separable executive control functions (Miyake et al, 2000;Stuss, 2011).…”

Section: Discussionmentioning

confidence: 45%

“…Our previous results indicated this group is impaired on a number of cognitive control tasks, showing more errors of commission in a Go/NoGo task (Swick et al, 2012), more variable RTs , greater interference in an emotional Stroop task using traumarelated words , and decreases in working memory performance and ERPs in a dual-task condition (Honzel et al, 2014). More pronounced deficits in these tasks were associated with greater PTSD symptom severity.…”

Section: Introductionmentioning

confidence: 92%

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Intact error monitoring in combat Veterans with post-traumatic stress disorder

Swick

Honzel

Turken

2015

Psychiatry Research: Neuroimaging

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The error-related negativity (ERN) is a neuroelectric signature of performance monitoring during speeded response time tasks. Previous studies indicate that individuals with anxiety disorders show ERN enhancements that correlate with the degree of clinical symptomology. Less is known about the error monitoring system in post-traumatic stress disorder (PTSD). PTSD is characterized by impairments in the regulation of fear and other emotional responses, as well as deficits in maintaining cognitive control. Here, combat Veterans with PTSD were compared to control Veterans in two different versions of the flanker task (n=13 or 14 per group). Replicating and extending previous findings, PTSD patients showed an intact ERN in both experiments. In addition, task performance and error compensation behavior were intact. Finally, ERN amplitude showed no relationship with self-reported PTSD, depression, or post-concussive symptoms. These results suggest that error monitoring represents a relative strength in PTSD that can dissociate from cognitive control functions that are impaired, such as response inhibition and sustained attention. A healthy awareness of errors in external actions could be leveraged to improve interoceptive awareness of emotional state. The results could have positive implications for PTSD treatments that rely on self-monitoring abilities, such as neurofeedback and mindfulness training.

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Section: Error-related Negativity and Depressionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 45%

Section: Introductionmentioning

confidence: 92%

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Intact error monitoring in combat Veterans with post-traumatic stress disorder

Swick

Honzel

Turken

2015

Psychiatry Research: Neuroimaging

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“…These findings are consistent with other neurocognitive studies in men and women with PTSD which report poorer verbal learning as well as weaker processing speed (Samuelson et al, 2006;Aupperle et al, 2012a) and executive functions including set switching, response inhibition, or attention/working memory (Gilbertson et al, 2006;Swick et al, 2012;Jenkins et al, 2000;Leskin et al, 2007;Vasterling et al, 2002;Parslow & Jorm, 2007;Stein et al, 2002).…”

Section: Discussionsupporting

confidence: 88%

“…For example, male veterans with PTSD demonstrated impaired inhibition on a memory test, while there was no evidence of impaired retention of information initially learned . More recent studies have also reported weaknesses in response inhibition (Leskin & White, 2007;Swick, Honzel, Larsen, Ashley, & Justus, 2012) as well as other aspects of executive functioning including set switching (Stein, Kennedy, & Twamley, 2002;Leskin et al, 2007;Gilbertson et al, 2006) and working memory (Jenkins, Langlais, Delis, & Cohen, 2000;Vasterling et al, 2002). However, no study has assessed if executive dysfunction accounts for poor verbal learning, which is one aim of this study.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Cognitive, Exposure, and Skills Group Manualized Treatments in OIF/OEF Female Veterans

Castillo¹

2014

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Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. REPORT DATE (DD-MM-YYYY)2. REPORT TYPE (From -To) Final DATES COVERED PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER Biomedical Research Institute of New MexicoAlbuquerque, NM 87108 SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR'S ACRONYM(S) U.S. Army Medical Research and Materiel CommandFort Detrick, Maryland 21702- SPONSOR/MONITOR'S REPORT 5012 NUMBER(S) DISTRIBUTION / AVAILABILITY STATEMENTApproved for public release; distribution unlimited. SUPPLEMENTARY NOTES ABSTRACTThe purpose of the study was to evaluate and establish the effectiveness of three treatments for PTSD -exposure, cognitive, and skills (assertiveness/relaxation) therapies-provided in a structured group format in a sample of OEF/OIF female Veterans. The results supported the primary aim of the study, where the manualized group treatment protocol significantly lowered PTSD symptoms (decrease of 24 points on the CAPS) after the 16-week treatment, a finding maintained 3 and 6 months after treatment. The effect size of the change was comparable to treatments delivered in an individual format. Additionally, the treatment improved the participant's life functioning, mental and physical as measured by the SF36 and quality of life, as measured by the QOLI. The subset of participants assessed for neurocognitive functioning and compared to a normal sample showed significantly lower IQ, but still in the normal range, and poorer executive functioning, similar to male combat Veterans with PTSD. The study's findings support the application of cognitive, exposure, and skills therapies delivered in small groups of 3 members, add methodologically sound findings to the paucity of group literature, and for the first time, establish a structure for the delivery of exposure treatment in a group. SUBJECT TERMS INTRODUCTIONThe purpose of the study is to evaluate and establish the effectiveness of three behavioral treatments for PTSD--exposure, cognitive, and skills (assertiveness/relaxation) therapies--provided in a group format. The efficacies of both exposure and cognitive therapies have been...

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Atomoxetine in comorbid ADHD/PTSD: A randomized, placebo controlled, pilot, and feasibility study

Wang

Zuschlag

Myers

et al. 2022

Depression and Anxiety

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Background PTSD and ADHD often occur comorbidly. Research indicates that the cognitive deficits in PTSD may be related to the same disturbance of fronto‐temporal systems as observed in ADHD, and ADHD has been shown to impact PTSD treatment outcomes. The presented study evaluated the safety and efficacy of atomoxetine in Veterans with comorbid ADHD/PTSD. Methods A double blind, randomized, placebo controlled, cross‐over pilot and feasibility study was conducted. Atomoxetine was examined as an adjunctive treatment over this 10 weeks, two phase, crossover study which compared treatment with atomoxetine 80 mg daily to placebo daily. The primary outcome was improvement in ADHD symptoms as measured by the Conners' Adult ADHD Rating Scales‐Self‐Report: Short Version (CAARS‐S:S), the Barkley Adult ADHD Rating Scale‐IV (BAARS‐IV), and the Adult ADHD Quality of Life‐29 (AAQoL‐29). Secondary outcomes included the Clinician Administered PTSD Scale (CAPS), Medical Outcomes Study 36‐Item Short‐Form Health Survey (SF‐36), and the response inhibition task Go/NoGo (GNG). Results Atomoxetine treated patients had greater reductions in ADHD symptoms as defined by total scores on the CAARS‐S:S (F(1, 29) = 6.37, p = .017); both the BAARS‐IV (F(1, 26) = 3.16, p = .087); and GNG overall errors test (F(1, 29) = 3.88, p = .06), reached a trend level of significance. No significant differences were noted in quality of life assessments, GNG latency periods, or CAPS scores. Atomoxetine was well‐tolerated with no serious adverse events observed. Conclusions In Veterans with ADHD comorbid with PTSD, atomoxetine demonstrated modest efficacy for ADHD symptoms; quality of life measures and PTSD symptoms were not affected.

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Impaired Response Inhibition in Veterans with Post-Traumatic Stress Disorder and Mild Traumatic Brain Injury

Cited by 112 publications

References 69 publications

Intact error monitoring in combat Veterans with post-traumatic stress disorder

Intact error monitoring in combat Veterans with post-traumatic stress disorder

Effectiveness of Cognitive, Exposure, and Skills Group Manualized Treatments in OIF/OEF Female Veterans

Atomoxetine in comorbid ADHD/PTSD: A randomized, placebo controlled, pilot, and feasibility study

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