Neuropsychological Function in Posttraumatic Stress Disorder: A Meta-Analytic Review

Subjective cognitive complaints are frequently reported among individuals with Posttraumatic Stress Disorder (PTSD). However, attempts to empirically corroborate these complaints using objective, standardized neuropsychological measures have been inconsistent. Previous meta­analytic studies examining neuropsychological performances in PTSD have lacked sufficient moderator analyses, relied exclusively upon published studies, or focused primarily on memory function. In the current meta-analytic review, 41 published and unpublished studies (k = 704; N = 4793) examining neuropsychological outcomes between PTSD and comparison groups were identified from 1993 and 2011. Neuropsychological performances of 1282 PTSD cases and 3511 comparison cases (with or without prior trauma exposure) on standardized neuropsychological measures were examined. PTSD and comparison groups consisted of military service members, victims of sexual and physical assault, Holocaust survivors, police officers, and civilian war refugees. Results indicated an overall small composite effect size between PTSD and comparison groups (d= .30, 95% CI = .21 to .38), with small to moderate effect sizes observed across cognitive domains. Findings suggest that PTSD has a modest, though meaningful effect on cognitive function. Analyses also suggest that the relationship between PTSD and cognitive function may be moderated by several factors (diagnostic strategy, co-morbidity, substance misuse). Implications for clinical and counseling psychologists are discussed.