Academic journal article Cognitive, Affective and Behavioral Neuroscience

Trauma Exposure Is Associated with Increased Context-Dependent Adjustments of Cognitive Control in Patients with Posttraumatic Stress Disorder and Healthy Controls

Academic journal article Cognitive, Affective and Behavioral Neuroscience

Trauma Exposure Is Associated with Increased Context-Dependent Adjustments of Cognitive Control in Patients with Posttraumatic Stress Disorder and Healthy Controls

Article excerpt

Published online: 3 June 2014

(C> Psychonomic Society, Inc. 2014

Abstract Recent evidence has suggested that posttraumatic stress disorder (PTSD) is associated with alterations in prefrontal-cortex-dependent cognitive processes (e.g., work- ing memory, cognitive control). However, it remains unclear whether these cognitive dysfunctions are related to PTSD symptomatology or trauma exposure. Furthermore, regarding cognitive control, research has only focused on the integrity of selected control functions, but not their dynamic regulation in response to changing environmental demands. Therefore, the present study investigated dynamic variations in interference control, in addition to overall interference susceptibility and working memory (WM) performance in matched groups of 24 PTSD patients and 26 traumatized and 30 nontraumatized healthy controls. The Simon task was used to measure overall interference susceptibility and the flexible adjustment of cog- nitive control, on the basis of the occurrence of response conflicts (conflict adaptation effect). WM performance was assessed with the forward and backward digit span tasks. Since we have previously shown that trauma exposure per se is associated with reduced hair cortisol concentrations (HCC), we further explored whether PTSD/trauma-related cognitive alterations are related to HCC in proximal 3 -cm hair segments. The results revealed that PTSD patients and traumatized controls showed significantly more pronounced conflict adaptation effects than nontraumatized controls. Moreover, the conflict adaptation effect was positively related to the number of lifetime traumatic events and the frequency of traumatization. The groups did not differ in overall interfer- ence susceptibility or WM performance. Exploratory analyses revealed no association between HCC and the observed cog- nitive differences. These results suggest that context-driven control adjustments constitute a sensitive correlate of trauma exposure, irrespective of PTSD.

Keywords Posttraumatic stress disorder * Trauma * Cognitive control * Conflict adaptation * Working memory * Hair cortisol

Posttraumatic stress disorder (PTSD) emerges as a possible clinical outcome from exposure to one or more traumatic events and involves cognitive impairments, including the involuntary recollection of the traumatic event, the inability to recall important aspects of the trauma, and concentration difficulties (American Psychiatric Association, 2000). Previous research has frequently examined neuropsychologi- cal alterations associated with PTSD, with a particular focus on hippocampal-dependent memory impairments. Another important aspect of cognitive functioning relates to prefrontal cortex (pFC) dependent processes that are crucially involved in the intentional manipulation of traumatic memories (Depue, Curran, & Banich, 2007). The pFC represents the main neural correlate of working memory (WM), as well as of the cognitive-control processes crucial for goal-directed behavior and adaptive responding to challenging and novel conditions (Miller & Cohen, 2001).

Indeed, PTSD patients are assumed to exhibit structural and functional changes of the pFC (reviewed in Pitman et al., 2012) and impaired pFC-dependent functions (reviewed in Aupperle, Melrose, Stein, & Paulus, 2012; Polak, Witteveen, Reitsma, & Olff, 2012). More specifically, the majority of studies have detected poorer WM performance in PTSD pa- tients in comparison to traumatized controls (e.g., Jelinek et al., 2008; Koso & Hansen, 2006; Vasterling et al., 2002) or both traumatized and nontraumatized controls (Jenkins, Langlais, Delis, & Cohen, 2000; Lagarde, Doyon, & Brunet, 2010). Although these findings suggest that WM deficits are related to PTSD, there is also evidence for a general impair- ment in trauma-expo sed groups, irrespective of PTSD (e.g., El-Hage, Gaillard, Isingrini, & Beizung, 2006). However, a number of studies have also failed to find differences between such groups (e. …

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