B-99: Dysexecutive Profile in Post-Traumatic Stress Disorder: A Case Study

Abstract

Objective: Posttraumatic stress disorder (PTSD) has been proposed to be a disorder of basic memory function. This view provides a mechanistic account such as altered stress and memory consolidation-reconsolidation relationships leading to the maintenance of trauma symptoms (e.g., flashbacks, hypervigilance). However, memory systems involve complex hippocampal-cortical processes that facilitate memory consolidation. Thus, PTSD symptomatology is likely accounted for by disruption of complex networks causing cognitive impairments beyond memory functions. This case study demonstrates the major involvement of attention and executive functioning impairments in support of a complex neuropsychiatric account. Method/Data Selection: Patient was a 47-year-old woman with history of chronic childhood abuse presenting with cognitive and somatic complaints. Traumatic symptoms exacerbated after COVID-19 exposure and worsened following two head injuries. Recent neuroimaging was unremarkable, whereas PTSD symptoms persist and impair daily functioning. Results/Data Synthesis: Neuropsychological assessment results revealed impaired attention, processing speed, and executive functioning. Memory functions were notable for inefficient encoding of verbal information, a variable verbal learning curve, but generally preserved retrieval of and recognition of unstructured verbal information; however, encoding, retrieval, and recognition of a narrative were impaired. Learning and retrieval of visual information were also relatively better when presented with simpler, two-dimensional shapes as opposed to complex shapes. Depression, anxiety, and PTSD symptoms were moderate to severe. Conclusions: Results contribute to a more complex neuropsychiatric PTSD account in which multifaceted cognitive abilities are disrupted. Memory impairment often seen in individuals with PTSD may be secondary to functional disruptions in networks involved in attention and information processing, consistent with a more global dysexecutive profile.