Associations Among Increases in Posttraumatic Stress Symptoms, Neurocognitive Performance, and Long‐Term Functional Outcomes in U.S. Iraq War Veterans. Issue 3 (2nd March 2021)

• Record Type: Journal Article
• Authors: Jackson, Colleen E.; Ciarleglio, Maria M.; Aslan, Mihaela; Marx, Brian P.; Ko, John; Concato, John; Proctor, Susan P.; Vasterling, Jennifer J.
• Is Part Of: Journal of traumatic stress. Volume 34:Issue 3(2021)
• Page Start: 628
• Page End: 640
• Publication Date: 2021-03-02
• Subjects: Post-traumatic stress disorder -- Periodicals; 616.8521
• DOI: 10.1002/jts.22663
• Languages: English
• ISSNs: 0894-9867

Abstract

Abstract: Cross‐sectional research suggests that posttraumatic stress symptoms (PTSS) among war zone veterans are associated with functional impairment and poor quality of life. Less is known about the long‐term functional repercussions of PTSS. This study of Iraq War veterans examined the associations between increases in PTSS and long‐term functional outcomes, including the potential contributions of neurocognitive decrements. Service members and veterans ( N = 594) completed self‐report measures of functioning and PTSS severity before Iraq War deployment and again after their return ( M = 9.3 years postdeployment). Some participants ( n = 278) also completed neurocognitive testing at both times. Multiple regression analyses with the full sample—adjusted for TBI, demographic characteristics, military variables, and predeployment PTSS and functioning—revealed that increased PTSS severity over time was significantly associated with unemployment, a OR = 1.04, 95% CI [1.03, 1.06]; poorer work performance; and poorer physical, emotional, and cognitive health–related functioning at long‐term follow‐up, f 2 s = 0.37–1.79. Among participants who completed neurocognitive testing, a decline in select neurocognitive measures was associated with poorer functioning; however, neurocognitive decrements did not account for associations between increased PTSS and unemployment, a OR = 1.04, 95% CI [1.02, 1.07], with the size and direction upheld after adding neurocognitive variables, or poorer functional outcomes, with small increases after adding neurocognitive measures to the models, f 2 s = 0.03–0.10. War zone veterans experiencing long‐term increased PTSS and/or neurocognitive decrements may be at elevated risk for higher‐level functional impairment over time, suggesting that early PTSS management may enhance long‐term functioning. 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯: JOTS‐20‐0129.R2_Vasterling_Cantonese Traditional Chinese 美國伊拉克戰爭退伍軍人的創傷後壓力症狀、神經認知表現及 長期功能結果的增加之間的關係 摘要: 橫斷面研究表明, 戰區退伍軍人的創傷後壓力症候群(PTSS)與功能障礙和生活質量差有關。但對創傷後壓力症候群的長期功能影響卻知之甚少。這項對伊拉克戰爭退伍軍人的研究考察了創傷後壓力症候群的增加與長期功能結果之間的聯繫, 包括神經認知能力下降的潛在貢獻。服役人員和退伍軍人(N = 594人)在伊拉克戰爭部署前和返回後(M =部署後9.3年)分別完成了功能和PTSS嚴重程度的自我報告。一些參與者(n = 278人)也在這兩個時間段完成了神經認知測試。對TBI、人口統計學特徵、軍事變量、部署前PTSS和功能進行全樣本調整的多元回歸分析顯示, PTSS嚴重程度隨著時間的推移而增加與失業顯著相關, aOR=1.04, 95%CI[1.03, 1.06];工作表現較差;長期隨訪時身體、情緒和認知健康相關功能較差, 即f2s = 0.37‐1.79。在完成神經認知測試的參與者中, 某些神經認知指標的下降與較差的功能有關;然而, 神經認知指標的下降並不能說明PTSS增加與失業之間的關係, aOR=1.04, 95%CI[1.02, 1.07], 在加入神經認知變量後, 其規模和方向保持不變;或較差的功能結果, 在加入神經認知指標後有小幅增加。計量模型, F2s = 0.03‐0.10。戰區退伍軍人經歷了長期的PTSS增加和/或神經認知功能下降, 可能會有更高層次的功能障礙風險。這表明早期PTSS管理可提高長期功能。 Simplified Chinese 美国伊拉克战争退伍军人的创伤后压力症状、神经认知表现及 长期功能结果的增加之间的关系 摘要: 横断面研究表明, 战区退伍军人的创伤后压力症候群(PTSS)与功能障碍和生活质量差有关。但对创伤后压力症候群的长期功能影响却知之甚少。这项对伊拉克战争退伍军人的研究考察了创伤后压力症候群的增加与长期功能结果之间的联系, 包括神经认知能力下降的潜在贡献。服役人员和退伍军人(N = 594人)在伊拉克战争部署前和返回后(M =部署后9.3年)分别完成了功能和PTSS严重程度的自我报告。一些参与者(n = 278人)也在这两个时间段完成了神经认知测试。对TBI、人口统计学特征、军事变量、部署前PTSS和功能进行全样本调整的多元回归分析显示, PTSS严重程度随着时间的推移而增加与失业显著相关, aOR=1.04, 95%CI[1.03, 1.06];工作表现较差;长期随访时身体、情绪和认知健康相关功能较差, 即f2s = 0.37‐1.79。在完成神经认知测试的参与者中, 某些神经认知指标的下降与较差的功能有关;然而, 神经认知指标的下降并不能说明PTSS增加与失业之间的关系, aOR=1.04, 95%CI[1.02, 1.07], 在加入神经认知变量后, 其规模和方向保持不变;或较差的功能结果, 在加入神经认知指标后有小幅增加。计量模型, F2s = 0.03‐0.10。战区退伍军人经历了长期的PTSS增加和/或神经认知功能下降, 可能会有更高层次的功能障碍风险。这表明早期PTSS管理可提高长期功能。