Abstract

This study examined whether reduced performance on two neuropsychological tasks, cognitive flexibility and working memory, were associated with higher levels of trauma centrality. A growing body of research has shown that trauma centrality, the extent to which a person believes a potentially traumatic event has become central to their self-identity and life story, is associated with post-traumatic stress disorder (PTSD). Furthermore, PTSD is often associated with alterations in neuropsychological functioning. The relationship between neuropsychological processes and trauma centrality, however, has yet to be explored. OEF/OIF combat veterans (N = 41) completed the Post-traumatic Diagnostic Scale (PDS), the Beck Depression Inventory-II (BDI-II), the Centrality of Event Scale (CES), and on-line measures of cognitive flexibility and working memory assessed via WebNeuro. Bivariate Pearson correlations showed that CES scores were positively correlated with PDS and BDI scores, and negatively correlated with cognitive flexibility and working memory. Linear regressions revealed that working memory significantly predicted CES when controlling for depression and PTSD severity while cognitive flexibility approached significance when controlling for these same variables. This study employed a cross-sectional design, precluding causality. The small sample size, entirely male sample, and use of an online neuropsychological assessment warrant follow-up research. Although numerous studies have found an association between CES and PTSD, this is the first to suggest that neuropsychological processes underlie the construct of trauma centrality. Given the importance of maladaptive cognitive processes underlying the pathogenesis of PTSD, these data suggest that future studies aimed at examining the link between neuropsychological processes and maladaptive cognitive processes, such as trauma centrality, may help to characterize and treat PTSD.

Highlights

  • The way in which a person remembers and interprets the impact of a traumatic event appears to play an important role in the pathogenesis of post-traumatic stress disorder (PTSD) (Horowitz, 1997; Foa et al, 1999; Conway and Pleydell-Pearce, 2000; Ehlers and Clark, 2000; Dalgleish et al, 2003; Bryant and Guthrie, 2007)

  • Among the veterans exposed to traumatic events, there were significant differences between veterans with PTSD and veterans without PTSD in BDI, Post-traumatic Diagnostic Scale (PDS), and Centrality of Event Scale (CES) scores

  • This study establishes a link between neuropsychological functioning and trauma centrality

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Summary

Introduction

The way in which a person remembers and interprets the impact of a traumatic event appears to play an important role in the pathogenesis of post-traumatic stress disorder (PTSD) (Horowitz, 1997; Foa et al, 1999; Conway and Pleydell-Pearce, 2000; Ehlers and Clark, 2000; Dalgleish et al, 2003; Bryant and Guthrie, 2007). Numerous studies have shown that higher scores on the CES are positively correlated with greater PTSD symptom severity in both clinical and non-clinical populations including college students (Berntsen and Rubin, 2006, 2007; Robinaugh and McNally, 2010), combat veterans (Brown et al, 2010), and adults with a history of childhood sexual abuse (Robinaugh and McNally, 2011). The relationship between trauma centrality and PTSD symptom severity has been shown to be significant even after controlling for stress, anxiety, depression, dissociation, negative perspective, and emotional intensity (Berntsen and Rubin, 2007; Schuettler and Boals, 2011). Most research examining trauma centrality has been crosssectional, a recent prospective study found that trauma centrality longitudinally predicted PTSD symptoms (Boals and Ruggero, 2015). The relationship between trauma centrality and PTSD symptomatology is well-established, the extent to which neuropsychological processes underlie trauma centrality has yet to be examined

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