TY - JOUR
T1 - The impact of captivity and posttraumatic stress disorder on cognitive performance among former prisoners of war
T2 - A longitudinal study
AU - Aloni, Roy
AU - Crompton, Laura
AU - Levin, Yafit
AU - Solomon, Zahava
N1 - Publisher Copyright:
© Copyright 2018 Physicians Postgraduate Press, Inc.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Objective: War captivity is a potent pathogen for various aspects of mental health, including cognitive impairments. However, little is known about the long-term impact of war captivity and posttraumatic stress disorder (PTSD) on cognitive functioning among former prisoners of war (ex-POWs). This study assesses the effect of captivity, PTSD trajectories, and the accumulating differential effect in the prediction of cognitive performance. Methods: This longitudinal research includes 4 assessments (1991 [T1], 2003 [T2], 2008 [T3], 2015 [T4]) of Israeli ex-POWs and comparable combatants from the 1973 Yom Kippur War. Accordingly, 95 ex-POWs and 26 comparable combatants were included in this study. PTSD was assessed according to the DSM-IV, and cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA). Results: Ex-POWs reported higher levels of PTSD symptoms compared to controls (P = 0.007). No difference was found between the groups regarding MoCA total score. Ex-POWs with chronic PTSD were found to have more difficulty in overall cognitive functioning, compared to ex-POWs with delayed, recovery, and resilient trajectories (P = 0.03). Finally, physical and psychological suffering in captivity and intrusion symptoms predicted cognitive performance (P < .001, R2 = 37.9%). These findings support the potent pathogenic effects of war captivity on cognitive abilities, more than 4 decades after the end of the traumatic event. Conclusions: Our results showed captivity to be a unique and powerful traumatic experience, leading to PTSD and long-lasting and enduring neuropsychological implications. These findings highlight the importance of viewing ex-POWs, in particular those suffering from chronic PTSD, especially as they age, as a high-risk population for cognitive disorders. This requires the appropriate diagnosis and cognitive therapy as a way to preserve cognitive abilities among this population.
AB - Objective: War captivity is a potent pathogen for various aspects of mental health, including cognitive impairments. However, little is known about the long-term impact of war captivity and posttraumatic stress disorder (PTSD) on cognitive functioning among former prisoners of war (ex-POWs). This study assesses the effect of captivity, PTSD trajectories, and the accumulating differential effect in the prediction of cognitive performance. Methods: This longitudinal research includes 4 assessments (1991 [T1], 2003 [T2], 2008 [T3], 2015 [T4]) of Israeli ex-POWs and comparable combatants from the 1973 Yom Kippur War. Accordingly, 95 ex-POWs and 26 comparable combatants were included in this study. PTSD was assessed according to the DSM-IV, and cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA). Results: Ex-POWs reported higher levels of PTSD symptoms compared to controls (P = 0.007). No difference was found between the groups regarding MoCA total score. Ex-POWs with chronic PTSD were found to have more difficulty in overall cognitive functioning, compared to ex-POWs with delayed, recovery, and resilient trajectories (P = 0.03). Finally, physical and psychological suffering in captivity and intrusion symptoms predicted cognitive performance (P < .001, R2 = 37.9%). These findings support the potent pathogenic effects of war captivity on cognitive abilities, more than 4 decades after the end of the traumatic event. Conclusions: Our results showed captivity to be a unique and powerful traumatic experience, leading to PTSD and long-lasting and enduring neuropsychological implications. These findings highlight the importance of viewing ex-POWs, in particular those suffering from chronic PTSD, especially as they age, as a high-risk population for cognitive disorders. This requires the appropriate diagnosis and cognitive therapy as a way to preserve cognitive abilities among this population.
UR - http://www.scopus.com/inward/record.url?scp=85049464660&partnerID=8YFLogxK
U2 - 10.4088/JCP.17m11577
DO - 10.4088/JCP.17m11577
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C2 - 29701936
AN - SCOPUS:85049464660
SN - 0160-6689
VL - 79
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
IS - 3
M1 - 17m11577
ER -