Cognitive Impairment and Predicting Response to Treatment in an Intensive Clinical Program for Post-9/11 Veterans With Posttraumatic Stress Disorder

What is it about?

This study examined whether objectively measured pre-treatment cognitive impairment predicted worse response to treatment for posttraumatic stress disorder (PTSD). Participants were 113 veterans and active duty service members who participated in a new, multidisciplinary two-week intensive clinical program that included individual trauma-focused cognitive-behavioral therapy, group psychotherapy, psychoeducation, skills-building groups, and complementary and alternative medicine treatments (age: M=39.7, SD=8.5; 20% women). Before treatment, participants completed a brief computerized cognitive battery and were operationalized as having cognitive impairment if they scored ≤5th percentile on two or more of five core cognitive domains. Participants completed measures of traumatic stress, depression, cognitive self-efficacy, and satisfaction with their ability to participate in social roles before and after treatment. There were no significant correlations between pre-treatment individual cognitive test scores and change in the clinical outcome measures. Half of the sample met criteria for cognitive impairment. Our analyses indicated that the pre- to post-treatment changes in outcome scores were not significantly different for the cognitively impaired vs. the cognitively intact group. Cognitive impairment was not associated with worse response to treatment in veterans with severe and complex mental health problems. Veterans with and without cognitive impairment reported large improvements in symptoms and functioning after treatment.

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