Objective cognitive impairment and subjective cognitive problems in veterans initiating psychotherapy for posttraumatic stress disorder: An exploratory study.

The prevalence of cognitive impairment in Veterans initiating an evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD) is not yet established and has implications for service delivery. Our objectives were to (1) describe the type, severity, and prevalence of objective cognitive impairment and subjective cognitive problems experienced by Veterans at the time they began an EBP for PTSD and (2) determine whether assessments of objective cognitive impairment and subjective cognitive problems agree. We conducted objective and subjective (self-report) cognitive assessments in a sample of 38 Veterans initiating EBP for PTSD at one Veterans Affairs Medical Center. Thirty Veterans produced valid assessments. Almost half (14/30) of the participants demonstrated objective impairment in one or more cognitive domains, primarily in the areas of learning, memory, and processing speed. Almost all (29/30) participants endorsed moderate or greater cognitive problems on at least one self-report measure. After adjustment for multiple comparisons, there were no significant correlations between objective and subjective assessments. Objective cognitive impairment and subjective cognitive problems are common in Veterans beginning an EBP for PTSD. Longitudinal research on a larger sample is warranted to better understand relationships among subjective cognitive problems, objective cognitive impairment, and PTSD treatment participation and outcomes.