Executive Function And Affective Decision-making In Posttraumatic Stress Disorder

Objective Posttraumatic stress disorder(PTSD) has increasingly been associated with impairments in neurocognitive functioning. The relationship between the impairments in neurocognitive domains and the clinical symptoms have been controversial. There have been few studies in the ability of decision-making so far. This study examines the the ability of inhibition,set shifting,refreshing in executive function the ability of affective decision-making under ambiguity in Posttraumatic Stress Disorder,investigate the relationship of this deficiency with cognitive function and clinical symptoms and the role of comorbid depressive symptoms on the executive function in post-traumatic stress disorder. Methods Experiment 1:39 patients who met the International Classification of Diseases Tenth Revision(ICD- 10) diagnostic for PTSD(recruited from inpatient and outpatient of Mental Health Center of Anhui Province) Posttraumatic Stress Disorder, 39 age and tender and education matched normal people were chosen as the control group. The clinical symptoms in Posttraumatic Stress Disorder were assessed using Post-traumatic stress disorder Self-rating scale, Self-rating anxiety scale and Self-rating depression scale. A battery of neuropsychological tests in all subjects were assessed using Abbreviated Mental Test,Stroop color word test,Wisconsin Card Sorting Test,The Trail Making Test and Semantic Verbal Fluency Test.Experiment 2: Experiment 1:31 patients who met the International Classification of Diseases Tenth Revision(ICD- 10) diagnostic for PTSD(recruited from inpatient and outpatient of Mental Health Center of Anhui Province) Posttraumatic Stress Disorder, 31 age and tender and education matched normal people were chosen as the control group. The clinical symptoms in Posttraumatic Stress Disorder were assessed using Post-traumatic stress disorder Self-rating scale,Self-rating anxiety scale and Self-rating depression scale. The general background cognitive functions in all subjects were assessed using Abbreviated Mental Test,Stroop test and Semantic Verbal Fluency Test(t=-3.273,t=3.979,t=2.550,all P<0.05).The ability of affective decision-making under ambiguity was analyzed using Iowa Gambling Task(IGT). Results Experiment 1: As compared to the control group, on the Stroop color word test,PTSD group performed longer time in Stroop-CW and SIE(all P<0.05). On Wisconsin Card Sorting Test, named less numbers of categories and correct responses, performed more more perseverative errors in PTSD group(P<0.05). On the Trail Making Test,PTSD group completed significantly longer and more interference time(P<0.05).On Verbal Fluency Test,PTSD group showed significantly worse(P<0.05). As compared to the PTSD group, PTSD with comorbid depression performed worse in the Stroop test on the Stroop-CW and SIE classification, classification numbers of the WSCT, the part of B and interference time of the TMT and SVFT(all P<0.05). Experiment 2:As compared to the control group, PTSD group performed significantly worse on Stroop test and Semantic Verbal Fluency Test.There was significant difference in IGT task scores between groups. Posttraumatic Stress Disorder group scored lower than the control group in total score of IGT(t=-2.241,P<0.05).2(group)×5(Block)analysis of variance revealed a significant main effect of Block on IGT task scores(F =11.030,P<0.05),it also revealed a significant main effect of group on IGT task scores(F =2.796,P<0.05),and a significant interaction between Block and group(F = 3.870,P<0.05). the relationship of this deficiency with clinical symptoms and other cognitive function was analyzed in Pearson Correlation. The frequency of choosing the advantage options in IGT was correlated with Stroop test and the severity of Posttraumatic symptoms(r =-0.383,P <0.01).Conclusions The early PTSD patients showed impairment in the ability of affective decision-making under ambiguity as well as executive function. The ability impairment is possiblely correlated with the decreased executive function and the severity of Posttraumatic symptoms. Conclusions PTSD patients showed impairment in the ability of executive function and as well as affective decision-making under ambiguity. The ability impairment of affective decision-making under ambiguity is possiblely correlated with the decreased executive function and the severity of Posttraumatic symptoms.The impairment in executive function were showed PTSD patients and more obvious impairment were performed in PTSD comorbid depressive symptoms. The ability impairment is not only possiblely correlated with Posttraumatic symptoms,but also depressive symptoms.