James M Bjork1, Thomas K Burroughs2, Laura M Franke3, Treven C Pickett4, Sade E Johns5, F Gerard Moeller5, William C Walker6. 1. Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA. Electronic address: james.bjork@va.gov. 2. Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA. 3. Defense and Veterans Brain Injury Center, Richmond, VA; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA. 4. Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA. 5. Department of Psychiatry, Virginia Commonwealth University, Richmond, VA. 6. Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA; Defense and Veterans Brain Injury Center, Richmond, VA; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA.
Abstract
OBJECTIVE: To determine if elevated rapid-response impulsivity after blast exposure (as a putative marker of ventral prefrontal cortex [vPFC] damage) is predictive of future elevated affective symptomatology in blast-exposed service members. DESIGN: Longitudinal design with neurocognitive testing at initial assessment and 1-year follow-up assessment of psychiatric symptomatology by telephone interview. SETTING: Veterans Administration medical centers and postdeployment assessment centers at military bases. PARTICIPANTS: Blast-exposed U.S. military personnel (N=84) ages 19 to 39 years old. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Center for Epidemiological Studies-Depression Scale (CES-D) scores, Posttraumatic Stress Disorder Checklist Version 5 (PCL-5) scores, and Alcohol Use Disorders Identification Test-C (AUDIT-C) scores at the 12-month follow-up telephone interview. RESULTS: After controlling for age and affective symptom scores reported at the initial assessment, commission errors on the Continuous Performance Test-II of the initial assessment were predictive of higher symptom scores on the CES-D and PCL-5 at follow-up, but were not predictive of AUDIT-C scores. CONCLUSIONS: Elevated rapid-response impulsivity, as a behavioral marker of reduced top-down frontocortical control, is a risk factor for elevated mood and posttraumatic stress disorder symptoms over time in blast-exposed individuals. Future longitudinal studies with predeployment neurobehavioral testing could enable attribution of this relation to blast-related vPFC damage.
OBJECTIVE: To determine if elevated rapid-response impulsivity after blast exposure (as a putative marker of ventral prefrontal cortex [vPFC] damage) is predictive of future elevated affective symptomatology in blast-exposed service members. DESIGN: Longitudinal design with neurocognitive testing at initial assessment and 1-year follow-up assessment of psychiatric symptomatology by telephone interview. SETTING: Veterans Administration medical centers and postdeployment assessment centers at military bases. PARTICIPANTS: Blast-exposed U.S. military personnel (N=84) ages 19 to 39 years old. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Center for Epidemiological Studies-Depression Scale (CES-D) scores, Posttraumatic Stress Disorder Checklist Version 5 (PCL-5) scores, and Alcohol Use Disorders Identification Test-C (AUDIT-C) scores at the 12-month follow-up telephone interview. RESULTS: After controlling for age and affective symptom scores reported at the initial assessment, commission errors on the Continuous Performance Test-II of the initial assessment were predictive of higher symptom scores on the CES-D and PCL-5 at follow-up, but were not predictive of AUDIT-C scores. CONCLUSIONS: Elevated rapid-response impulsivity, as a behavioral marker of reduced top-down frontocortical control, is a risk factor for elevated mood and posttraumatic stress disorder symptoms over time in blast-exposed individuals. Future longitudinal studies with predeployment neurobehavioral testing could enable attribution of this relation to blast-related vPFC damage.
Authors: J Cobb Scott; Georg E Matt; Kristen M Wrocklage; Cassandra Crnich; Jessica Jordan; Steven M Southwick; John H Krystal; Brian C Schweinsburg Journal: Psychol Bull Date: 2014-11-03 Impact factor: 17.737
Authors: Charles H Bombardier; Jesse R Fann; Nancy R Temkin; Peter C Esselman; Jason Barber; Sureyya S Dikmen Journal: JAMA Date: 2010-05-19 Impact factor: 56.272
Authors: Erin Falconer; Adrian Allen; Kim L Felmingham; Leanne M Williams; Richard A Bryant Journal: J Clin Psychiatry Date: 2013-09 Impact factor: 4.384
Authors: Mary Jo V Pugh; Erin P Finley; Laurel A Copeland; Chen-Pin Wang; Polly H Noel; Megan E Amuan; Helen M Parsons; Margaret Wells; Barbara Elizondo; Jacqueline A Pugh Journal: Med Care Date: 2014-02 Impact factor: 2.983
Authors: Christine L Mac Donald; Jason Barber; Jana Patterson; Ann M Johnson; Sureyya Dikmen; Jesse R Fann; Nancy Temkin Journal: JAMA Netw Open Date: 2019-01-04