Posttraumatic Stress Disorder-Associated Cognitive Deficits on the Repeatable Battery for the Assessment of Neuropsychological Status in a Veteran Population

Nathan Hantke; Maheen M Adamson; Art Noda; Laura C Lazzeroni; Sherry A Beaudreau; Maya Yutsis; J Kaci Fairchild; Lisa M Kinoshita; Jennifer Kong; Tong Sheng; Dana Waltzman; John Wesson Ashford; Jerome A Yesavage

doi:10.12788/fp.0083

Posttraumatic Stress Disorder-Associated Cognitive Deficits on the Repeatable Battery for the Assessment of Neuropsychological Status in a Veteran Population

Fed Pract. 2021 Jan;38(1):28-34. doi: 10.12788/fp.0083.

Affiliation

¹ is a Clinical Neuropsychologist in the Mental Health and Clinical Neuroscience Division at the US Department of Veterans Affairs (VA) Portland Health Care System in Oregon. is a Postdoctoral Fellow, is a Clinical Director, is the Director, and is the Executive Director; all at the War Related Illness and Injury Study Center; is a Clinical Neuropsychologist at the VA Memory Clinic; is a Program Analyst in Polytrauma System of Care; is an Investigator in the Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC): is an Associate Director, is the Director; all at the MIRECC; is a Clincial Research Senior Scientific Director in the Rehabilitation Service, all at the VA Palo Alto Health Care System in California. is a Research Data Analyst, J. Kaci Fairchild, Sherry Beaudreau, John Ashford, Jerome Yesavage, and are Professors, Dana Waltzman is a Postdoctoral Fellow, all in the Stanford Department of Psychiatry and Behavioral Sciences; is a Clinical Neuropsychologist and Clinical Assistant Professor (affiliated) in the Stanford Neuroscience Institute, and Maheen Adamson is a Clinical Associate Professor in the Department of Neurosurgery, all at Stanford University School of Medicine in California. Nathan Hantke is an Assistant Professor in the Department of Neurology at Oregon Health and Science University in Portland.

Abstract

Background: Posttraumatic stress disorder (PTSD) is a frequent problem of veterans receiving care and is often associated with cognitive deficits. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a well-validated cognitive screening measure often used in the US Department of Veterans Affairs (VA), particularly in neurorehabilitation settings. However, the influence of PTSD on RBANS performance is unclear, particularly within a heterogeneous VA outpatient population in which PTSD and traumatic brain injury (TBI) may not be the primary focus of care.

Methods: Participants included 153 veterans with complex deployment-related health problems, including a diagnosis of PTSD (n = 98) and a history of TBI (n = 92). All veterans completed a targeted cognitive battery that included the Wechsler Test of Adult Reading, the Wechsler Adults Intelligence Scale, measure assessing processing speed, attention, and cognitive flexibility, and RBANS.

Results: A diagnosis of PTSD was associated with worse performance on the Story Recall subtest of the RBANS, but not on any other cognitive measures. A diagnosis of mild TBI, or co-occurring PTSD and TBI did not predict cognitive performance on any measures.

Conclusions: The RBANS best captured cognitive deficits associated with PTSD compared with a history of mild TBI or co-occurring mild TBI and PTSD. These findings may provide insight into the interpretation and attribution of cognitive deficits in the veteran population.

Grants and funding

P30 AG059307/AG/NIA NIH HHS/United States