Using network models to explore the associations between posttraumatic stress disorder symptoms and subjective cognitive functioning

Abstract

Several studies have identified relationships between posttraumatic stress disorder (PTSD) and cognitive functioning. Here, we aimed to elucidate the nature of this relationship by investigating cross-sectional associations between subjective cognitive functioning (SCF) and 1) the PTSD sum score, 2) symptom domains, and 3) individual symptoms. We also investigated temporal stability by testing whether results replicated over a 3-year period. We estimated partial correlation networks of DSM-5 PTSD symptoms (at baseline) and SCF (at baseline and follow-up, respectively), using data from the National Health and Resilience in Veterans Study (NHRVS; N = 1484; Mdn = 65 years). The PTSD sum score was negatively associated with SCF. SCF was consistently negatively associated with the PTSD symptom domains ‘marked alterations in arousal and reactivity’ and ‘negative alterations in cognitions and mood’, and showed robust relations with the specific symptoms ‘having difficulty concentrating’ and ‘trouble experiencing positive feelings’. Results largely replicated at the 3-year follow-up, suggesting that some PTSD symptoms both temporally precede and are statistically associated with the development or maintenance of reduced SCF. We discuss the importance of examining links between specific PTSD domains and symptoms with SCF—relations obfuscated by focusing on PTSD diagnoses or sum scores—as well as investigating mechanisms underlying these relations.Registration Number: 37069 (https://aspredicted.org/n5sw7.pdf)