Clinical Utility of Neuropsychological Services in Treatment Outcomes and Symptom Change in U.S. Veterans with Posttraumatic Stress Disorder and Subjective Neurocognitive Impairment

Download or read book Clinical Utility of Neuropsychological Services in Treatment Outcomes and Symptom Change in U.S. Veterans with Posttraumatic Stress Disorder and Subjective Neurocognitive Impairment written by Megan M. McArthur and published by . This book was released on 2018 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Although the literature remains equivocal, the past few decades of research has yielded substantial evidence that individuals who develop posttraumatic stress disorder (PTSD) may experience functional impairment due to subtle weaknesses in multiple neurocognitive domains. However, a causal link between the development of PTSD and acquired cognitive deficits has not been definitively established, given the lack of prospective study utilizing objective testing both predating and following trauma exposure. Advances in genetic testing, use of biomarkers, and neuroimaging are providing new insight into the impact of trauma exposure and PTSD and cognitive performance. In the U.S. veteran population, PTSD and its sequelae require broad utilization of health care resources, leading to rising cost for patients, stakeholders, and payors. Individuals seeking treatment for PTSD frequently report comorbid short-term memory and attentional problems, often leading to neuropsychology referrals. The current study addressed a significant gap in empirical research, exploring how neuropsychological assessment was utilized to inform follow-up treatment in veterans with suspected PTSD and differential diagnostic consideration of a neurocognitive disorder. Individual electronic health records (EHRs) of 51 veterans who met screening criteria for PTSD based on the PTSD Checklist for DSM-5 (PCL-5) and completed neuropsychological testing at a large Department of Veterans Affairs (VA) medical facility were extracted. Data on frequency of recommendations, PTSD screening scores at time of testing and within 1 year following testing, and attention and processing speed performance were collected. Results demonstrated a significant correlation between PCL-5 score and implemented psychiatric recommendations (p = .01), suggesting appropriate referrals to mental health services were placed for veterans who endorsed higher levels of symptoms. Results did not reflect a significant dose-dependent relationship between attention task performance on RBANS and WAIS-IV Digit Span tasks and Trail-Making Test A and B and overall PTSD symptom severity, while findings were likely limited by small sample size. Future research is needed to expand our knowledge of clinical outcomes of neuropsychological testing, identifying how testing and related referrals can help improve interdisciplinary care and treatment outcomes for veterans and their families. Keywords: neuropsychology, cognitive, attention, outcomes, veterans, PTSD