Abstract
This study examined the performance of veterans and active duty personnel who served in Operation Enduring Freedom and/or Operation Iraqi Freedom (OEF/OIF) on a basic associative learning task. Eighty-eight individuals participated in this study. All received a comprehensive clinical evaluation to determine the presence and severity of posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). The eyeblink conditioning task was composed of randomly intermixed delay and trace conditioned stimulus (CS) and unconditioned stimulus (US) pairs (acquisition) followed by a series of CS only trials (extinction). Results revealed that those with a clinical diagnosis of PTSD or a diagnosis of PTSD with comorbid mTBI acquired delay and trace conditioned responses (CRs) to levels and at rates similar to a deployed control group, thus suggesting intact basic associative learning. Differential extinction impairment was observed in the two clinical groups. Acquisition of CRs for both delay and trace conditioning, as well as extinction of trace CRs, was associated with alcoholic behavior across all participants. These findings help characterize the learning and memory function of individuals with PTSD and mTBI from OEF/OIF and raise the alarming possibility that the use of alcohol in this group may lead to more significant cognitive dysfunction.
Highlights
Emerging evidence suggests that there is a significant overlap in the clinical symptoms associated with posttraumatic stress disorder (PTSD) and mild traumatic brain injury, conditions that co-occur with great frequency in veterans of Operation Enduring Freedom and Operation
The data for the relatively small mild traumatic brain injury (mTBI) group is presented for comparison purposes only; all data analysis was conducted for the sample size of 81 and for three groups: Deployed Controls, PTSD Only, and Comorbid
Gender distribution was found to be significantly different between groups, X2(2) = 7.3; the PTSD Only group had a higher number of females than the other groups
Summary
Emerging evidence suggests that there is a significant overlap in the clinical symptoms associated with posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI), conditions that co-occur with great frequency in veterans of Operation Enduring Freedom and OperationIraqi Freedom (OEF/OIF). Veterans and active duty service members of OEF/OIF have been exposed to unprecedented risk factors for the co-morbid occurrence of PTSD and mTBI—the so-called signature injuries of these wars. Both of these “invisible wounds” [3] leaves service members vulnerable to what can become considerable associated cognitive and behavioral problems [4,5], notably memory and attention dysfunction [5,6], depression [7,8], substance abuse [9,10], anxiety and suicide [11,12]. The risk factor most commonly connected with both of these two signature injuries is exposure(s) to blast munitions
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