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Rapid-Response Impulsivity Predicts Depression and Posttraumatic Stress Disorder Symptomatology at 1-Year Follow-Up in Blast-Exposed Service Members

Published:April 21, 2017DOI:https://doi.org/10.1016/j.apmr.2017.03.022

      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.

      Keywords

      List of abbreviations:

      AUDIT-C (Alcohol Use Disorders Identification Test-C), CE (commission error), CES-D (Center for Epidemiological Studies-Depression Scale), CPT-II (Continuous Performance Test version II), fMRI (functional magnetic resonance imaging), mTBI (mild traumatic brain injury), OE (omission error), OEF/OIF/OND (Operations Enduring Freedom, Iraqi Freedom, and/or New Dawn), PCL-5 (Posttraumatic Stress Disorder Checklist Version 5), PTSD (posttraumatic stress disorder), TBI (traumatic brain injury), ToMM (Test of Memory Malingering), vPFC (ventral prefrontal cortex), WTAR (Wechsler Test of Adult Reading)
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