Assessment of early neurocognitive functioning increases the accuracy of predicting chronic PTSD risk

Katharina Schultebraucks, Ziv Ben-Zion, Roee Admon, Jackob Nimrod Keynan, Israel Liberzon, Talma Hendler, Arieh Y. Shalev

Research output: Contribution to journalArticlepeer-review

Abstract

Post-traumatic stress disorder (PTSD) is a protracted and debilitating consequence of traumatic events. Identifying early predictors of PTSD can inform the disorder’s risk stratification and prevention. We used advanced computational models to evaluate the contribution of early neurocognitive performance measures to the accuracy of predicting chronic PTSD from demographics and early clinical features. We consecutively enrolled adult trauma survivors seen in a general hospital emergency department (ED) to a 14-month long prospective panel study. Extreme Gradient Boosting algorithm evaluated the incremental contribution to 14 months PTSD risk of demographic variables, 1-month clinical variables, and concurrent neurocognitive performance. The main outcome variable was PTSD diagnosis, 14 months after ED admission, obtained by trained clinicians using the Clinician-Administered PTSD Scale (CAPS). N = 138 trauma survivors (mean age = 34.25 ± 11.73, range = 18–64; n = 73 [53%] women) were evaluated 1 month after ED admission and followed for 14 months, at which time n = 33 (24%) met PTSD diagnosis. Demographics and clinical variables yielded a discriminatory accuracy of AUC = 0.68 in classifying PTSD diagnostic status. Adding neurocognitive functioning improved the discriminatory accuracy (AUC = 0.88); the largest contribution emanating from poorer cognitive flexibility, processing speed, motor coordination, controlled and sustained attention, emotional bias, and higher response inhibition, and recall memory. Impaired cognitive functioning 1-month after trauma exposure is a significant and independent risk factor for PTSD. Evaluating cognitive performance could improve early screening and prevention.

Original languageEnglish
JournalMolecular Psychiatry
DOIs
StateAccepted/In press - 2022

Bibliographical note

Funding Information:
We would like to thank the research team at Tel-Aviv Sourasky Medical Center— including Nili Green, Mor Halevi, Sheli Luvton, Yael Shavit, Olga Nevenchannaya, Iris Rashap, Efrat Routledge, and Ophir Leshets for their significant contributions to participants, screening, enrollment, assessments, and follow-up and to Naomi Fine and Michal Achituv for setting up the clinical aspect of the research. Last but not least, we extend our gratitude to all the participants of this study, who completed all the assessments at three different time-points after experiencing a traumatic event. The work was supported by award number R01-MH-103287 from the National Institute of Mental Health (NIMH) given to AYS (PI), IL, and TH (co-Investigators, subcontractors), and had undergone critical review by the NIMH Adult Psychopathology and Disorders of Aging study section.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Limited.

ASJC Scopus subject areas

  • Molecular Biology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health

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