Research Reports - Association of acute posttraumatic stress, depression, and pain to cognitive functioning in mild traumatic brain injury

Neuropsychology. 2015 Jul;29(4):530-42. doi: 10.1037/neu0000192. Epub 2015 Mar
30.

Massey JS(1), Meares S(1), Batchelor J(1), Bryant RA(2).

OBJECTIVE: Few studies have examined whether psychological distress and pain
affect cognitive functioning in the acute to subacute phase (up to 30 days
postinjury) following mild traumatic brain injury (mTBI). The current study
explored whether acute posttraumatic stress, depression, and pain were associated
with performance on a task of selective and sustained attention completed under
conditions of increasing cognitive demands (standard, auditory distraction, and
dual-task), and on tests of working memory, memory, processing speed, reaction
time (RT), and verbal fluency.
METHOD: At a mean of 2.87 days (SD = 2.32) postinjury, 50 adult mTBI
participants, consecutive admissions to a Level 1 trauma hospital, completed
neuropsychological tests and self-report measures of acute posttraumatic stress,
depression, and pain. A series of canonical correlation analyses was used to
explore the relationships of a common set of psychological variables to various
sets of neuropsychological variables.
RESULTS: Significant results were found on the task of selective and sustained
attention. Strong relationships were found between psychological variables and
speed (rc = .56, p = .02) and psychological variables and accuracy (rc = .68, p =
.002). Pain and acute posttraumatic stress were associated with higher speed
scores (reflecting more correctly marked targets) under standard conditions.
Acute posttraumatic stress was associated with lower accuracy scores across all
task conditions. Moderate but nonsignificant associations were found between
psychological variables and most cognitive tasks.
CONCLUSIONS: Acute posttraumatic stress and pain show strong associations with
selective and sustained attention following mTBI.

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