Correlations Between Cognitive Functions and Clinical Symptoms in Adolescents With Complex Post-traumatic Stress Disorder

Abstract

Introduction: Complex post-traumatic stress disorder (C-PTSD) is characterized by the typical symptoms of PTSD, in addition to affective dysregulation, negative self-concept, and disturbances in interpersonal relationships. Children and adolescents with C-PTSD have been reported to have deficits in emotional and cognitive functions. We hypothesized that the following are associated with the severity of C-PTSD symptoms: (1) adolescents with C-PTSD who show deficits in emotional perception and cognitive functions, including executive function and attention; and (2) deficits in neurocognitive functions. Methods: Information on 69 adolescents with PTSD, aged 10-19 years, was gathered from seven shelters. All participants were assessed using complete clinical scales, including the C-PTSD Interview and Depression, Anxiety, and Stress Scales, and neurocognitive function tests, including the emotional perception, mental rotation, and modified Tower of London tests. Results: Adolescents with C-PTSD were more likely to have a history of sexual assault, dissociation, and self-harm than those with PTSD. The total and subscale scores of the C-PTSD Interview Scale in adolescents with C-PTSD were higher than that in adolescents with PTSD. In addition, neurocognitive functions, including emotional perception, attention, and working memory, were correlated with the severity of C-PTSD symptoms. Discussion: Adolescents with C-PTSD experienced more serious clinical symptoms and showed more deficits in neurocognitive functions than adolescents with PTSD. Clinicians should pay careful attention toward the emotional and neurocognitive functions when assessing and treating patients with C-PTSD.

Keywords: adolescents; complex post-traumatic stress disorder; emotional perception; spatiotemporal attention; working memory.

Figure 1

Neurocognitive function test. The images were obtained from the neurocognitive function test manufacturer MBI® (https://www.mbi-clinic.center/).

Figure 2

Correlations between C-PTSD symptoms and neurocognitive function test results. (A) The correlation between total complex post-traumatic stress disorder (C-PTSD) Interview Scale scores and the accuracy rate in the emotional test (r = −0.414, p = 0.001) in all adolescents (C-PTSD and PTSD groups). (B) The correlation between the total C-PTSD Interview Scale and the accuracy rate in the mental rotation test (r = −0.468, p < 0.001) in all adolescents. (C) The correlation between the total C-PTSD Interview Scale and the number of moved cards in the modified Tower of London test (r = 0.631, p < 0.001) in all adolescents. (D) The correlation between the total C-PTSD Interview Scale scores and the accuracy rate in the emotional test (r = −0.497, p = 0.001) in the C-PTSD group. (E) The correlation between total C-PTSD Interview Scale scores and the accuracy rate in the mental rotation test (r = −0.542, p < 0.001) in the C-PTSD group. (F) The correlation between the total C-PTSD Interview Scale scores and the number of moved cards in the modified Tower of London test (r = 0.636, p < 0.001) in the C-PTSD group.