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. 2025 Aug 14;20(8):e0329810.
doi: 10.1371/journal.pone.0329810. eCollection 2025.

Inhibitory control impairments underlie associative memory deficits in posttraumatic stress disorder

Jonathan Guez  1   2 , Rotem Saar-Ashkenazy  3 , Eldad Keha  1 , Hadar Shalev  4
Affiliations

Inhibitory control impairments underlie associative memory deficits in posttraumatic stress disorder

Jonathan Guez et al. PLoS One. .

Abstract

Objective: Posttraumatic-stress disorder (PTSD) patients suffer from cognitive dysfunction and show impairments even in non-trauma-related memory. Research has focused on the relationship between associative-memory and PTSD severity due to patients' tendency to over-generalize from traumatic cues to neutral ones, leading to escalation of traumatic symptoms. In this study we aim to test to what extent inhibitory control impairments are correlated to associative-memory deficits in PTSD.

Method: Twenty PTSD and 22 control participants were included. Posttraumatic symptoms were assessed via a board-qualified psychiatrist and the Post-Traumatic Diagnostic Scale. Inhibitory abilities were evaluated using the anti-saccade task and memory performance was probed using a words/pictures item-association paradigm.

Results: Generally, PTSD patients performed lower than controls in both tasks. Lower associative-memory performance was observed in posttraumatic patients and was attributed to increased false-alarm rate in this group. In addition, we observed a strong significant positive correlation between associative pictorial memory performance and inhibitory performance, and in accordance, a significant negative correlation between the number of false-alarm responses in the associative pictorial test and inhibitory performance in the PTSD group.

Conclusions: These results support the hypothesis that inhibitory control impairments are associated with (pictorial) associative-memory deficits in PTSD.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Anti-saccade paradigm.
Participants are asked to look toward a fixation point centered at the middle of the computer monitor. A visual distracter was presented on one side of the computer monitor (left/right) and was followed by a target stimulus which was quickly masked in the opposite side to the distracter. Participants were asked to respond to the target using a keyboard; for example, if the distracter appeared on the right side of the computer monitor, the target (e.g., a down arrow) appeared on its’ left side and participants are required to press the correct (down) arrow on the keyboard. Stimulus-onset-asynchrony (SOA) varied and ranged between 200-500 milliseconds.
Fig 2
Fig 2. Memory accuracy.
Item and associative memory accuracy for words (A) and pictures (B). Error bars represent the standard error of the mean.
Fig 3
Fig 3. Inhibitory performance.
Accuracy is presented for 200-500 stimulus-onset-asynchrony (SOA), for PTSD patients and controls. Error bars represent the standard error of the mean.
Fig 4
Fig 4. Correlation analysis results for memory and inhibition measures.
Inhibitory performance was positively correlated to pictorial associative recognition (A) and negatively correlated to the number of false-alarm (FA) responses (B) in PTSD patients.
See this image and copyright information in PMC

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