Cluster-based analysis of PTSD-Checklist for DSM-5 (PCL-5) in civilians with post-concussive cognitive changes

ABSTRACT

Objective

This study explores the relationship between PTSD symptoms and cognition in patients with persistent post-concussive symptoms (PPCS).

Methods

Adults with PPCS presenting to a specialized brain injury clinic provided demographic and injury information and completed the PTSD checklist for DSM-5, Generalized Anxiety Disorder Scale-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). The Montreal Cognitive Assessment (MoCA) was used to screen for possible cognitive concerns. Multiple regression analysis (MLR) adjusting for age, sex, mechanism of injury, psychiatric history, number of previous concussions, months since most recent injury, and mental health questionnaire scores was used to determine associations between PTSD and cognition. Binomial logistic regression explored the relationship between domains of the MoCA and PCL-5 scores.

Results

We found a negative correlation between MoCA scores, PCL-5 (ρ=-0.211, p = 0.009) and PHQ-9 (ρ=-0.187, p = 0.021) in patients with PPCS and collinearity of PCL-5 and PHQ-9 scores. Significantly higher Arousal and Reactivity cluster scores within the PCL-5 were associated with poorer scores on naming and abstract tasks on the MoCA.

Conclusion

The association between specific PCL-5 clusters and lower MoCA scores may represent a viable target for psychotherapeutic and psychopharmacologic intervention in patients with cognitive changes associated with PPCS.

KEYWORDS:

• Traumatic brain injury
• persistent post concussive symptoms
• PTSD
• anxiety
• depression

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data Availability statement

Data can be accessed by emailing the corresponding author, Dr. Chantal Debert (http://[email protected]).

Authors contributions

All authors approve this version of the paper and agree to act as guarantors of this research. EAF, AJW, AI, CC, RK, MW, CTD all contributed to the design and writing of the study. AJW, AI, CC, RK, CT contributed to participant data organization and collection in the clinic. EAF, AI, MW, CTD contributed to statistical analysis of data contained within the study.

Supplemental material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02699052.2024.2381065

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.