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

Abstract

Several studies have identified relationships between cognitive functioning and posttraumatic stress disorder (PTSD). 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 = 1,484; 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 symptoms ‘having difficulty concentrating’ and ‘trouble experiencing positive feelings’. Results largely replicated at the 3-year follow-up, suggesting that PTSD symptoms may play a causal role in the development or maintenance of 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.

Authors 4

1. Mia Maria Günak Aachen Department of Clinical Psychology

   Leiden University · Ludwig-Maximilians-Universität München

   Affiliation as printed

   Department of Clinical Psychology , Leiden University , Pieter de la Court Building , Wassernaarseweg 52 , 2333 AK Leiden , Netherlands

   Department of Psychology , LMU Munich , Leopoldstr. 13 , 80802 Munich , Germany

   Department of Clinical Psychology, Leiden University, Pieter de la Court Building, Wassernaarseweg 52, 2333 AK Leiden, Netherlands

   Department of Psychology, LMU Munich, Leopoldstr. 13, 80802 Munich, Germany

2. Omid V. Ebrahimi

   University of Oslo · University of Amsterdam

   Affiliation as printed

   Department of Clinical Psychology , University of Oslo , Forskningsveien 3A , 0373 Oslo , Norway

   Department of Psychology , University of Amsterdam , Roeterseiland Campus , Nieuwe Achtergracht 129-B , 1018 WS Amsterdam , Netherlands

   Department of Clinical Psychology, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway

   Department of Psychology, University of Amsterdam, Roeterseiland Campus, Nieuwe Achtergracht 129-B, 1018 WS Amsterdam, Netherlands

3. Robert H. Pietrzak

   United States Department of Veterans Affairs · Yale University

   Affiliation as printed

   Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA

   Department of Social and Behavioral Sciences, Yale School of Public Health, P.O. Box 208034, 60 College Street, New Haven, CT 06520-0834, USA

   U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, West Haven, CT 06516, USA

4. Eiko I. Fried Aachen Department of Clinical Psychology

   Leiden University

   Affiliation as printed

   Department of Clinical Psychology , Leiden University , Pieter de la Court Building , Wassernaarseweg 52 , 2333 AK Leiden , Netherlands

   Department of Clinical Psychology, Leiden University, Pieter de la Court Building, Wassernaarseweg 52, 2333 AK Leiden, Netherlands