Executive function and PTSD: disengaging from trauma

Abstract

Neuropsychological approaches represent an important avenue for identifying susceptibility and resiliency factors relating to the development and maintenance of posttraumatic stress disorder (PTSD) symptoms post-trauma. This review will summarize results from prospective longitudinal and retrospective cross-sectional studies investigating executive function associated with PTSD. This research points specifically towards subtle impairments in response inhibition and attention regulation that may predate trauma exposure, serve as risk factors for the development of PTSD, and relate to the severity of symptoms. These impairments may be exacerbated within emotional or trauma-related contexts, and may relate to dysfunction within dorsal prefrontal networks. A model is presented concerning how such impairments may contribute to the clinical profile of PTSD and lead to the use of alternative coping styles such as avoidance. Further neuropsychological research is needed to identify the effects of treatment on cognitive function and to potentially characterize mechanisms of current PTSD treatments. Knowledge gained from cognitive and neuroscientific research may prove valuable for informing the future development of novel, more effective, treatments for PTSD. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.

Fig. 1

Potential role of executive dysfunction in the development of PTSD. Most individuals experiencing a trauma may learn associations and direct attentional resources towards trauma-relevant stimuli (1a and 1b). However, subtle impairments in executive dysfunctions may relate to difficulties inhibiting responses and disengaging attention from trauma-related stimuli (1c and 1e) and lead to a reliance on avoidant coping strategies (1d), which contribute to the development of PTSD symptoms.