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Cognitive Dysfunctions Associated With PTSD: Evidence from World War II Prisoners of War

Received May 17, 2007; revised September 3, 2007; accepted September 11, 2007. Drs. Hart, Fauver, and Tillman are affiliated with The Center for BrainHealth, University of Texas at Dallas; Drs. Hart and Pitcock are affiliated with Geriatric, Research, Education, and Clinical Centers; Drs. Kimbrell and Freeman are affiliated with the Department of Psychiatry at Central Arkansas Veterans Healthcare System in Little Rock, Ark.; Dr. Booe is affiliated with the Department of Internal Medicine at Central Arkansas Veterans Healthcare System in Little Rock; Dr. Cherry is affiliated with the Department of Psychology at California State University, Fullerton, in Calif. Address correspondence to John Hart, Jr., M.D., Center for BrainHealth, The University of Texas at Dallas, 2200 W. Mockingbird Lane, Dallas, TX 75235; jhart{at}utdallas.edu (e-mail).

The authors aim to delineate cognitive dysfunction associated with posttraumatic stress disorder (PTSD) by evaluating a well-defined cohort of former World War II prisoners of war (POWs) with documented trauma and minimal comorbidities. The authors studied a cross-sectional assessment of neuropsychological performance in former POWs with PTSD, PTSD with other psychiatric comorbidities, and those with no PTSD or psychiatric diagnoses. Participants who developed PTSD had average IQ, while those who did not develop PTSD after similar traumatic experiences had higher IQs than average (approximately 116). Those with PTSD performed significantly less well in tests of selective frontal lobe functions and psychomotor speed. In addition, PTSD patients with co-occurring psychiatric conditions experienced impairment in recognition memory for faces. Higher IQ appears to protect individuals who undergo a traumatic experience from developing long-term PTSD, while cognitive dysfunctions appear to develop with or subsequent to PTSD. These distinctions were supported by the negative and positive correlations of these cognitive dysfunctions with quantitative markers of trauma, respectively. There is a suggestion that some cognitive decrements occur in PTSD patients only when they have comorbid psychiatric diagnoses.

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