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Executive function and PTSD: disengaging from trauma.
Open accessAbstract
Neuropsychological approaches represent an important avenue for identifying susceptibility and resiliency factors relating to the development and maintenance of posttraumatic stress disorder (PTSD) symptoms post-trauma. This review will summarize results from prospective longitudinal and retrospective cross-sectional studies investigating executive function associated with PTSD. This research points specifically towards subtle impairments in response inhibition and attention regulation that may predate trauma exposure, serve as risk factors for the development of PTSD, and relate to the severity of symptoms. These impairments may be exacerbated within emotional or trauma-related contexts, and may relate to dysfunction within dorsal prefrontal networks. A model is presented concerning how such impairments may contribute to the clinical profile of PTSD and lead to the use of alternative coping styles such as avoidance. Further neuropsychological research is needed to identify the effects of treatment on cognitive function and to potentially characterize mechanisms of current PTSD treatments. Knowledge gained from cognitive and neuroscientific research may prove valuable for informing the future development of novel, more effective, treatments for PTSD. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.
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“Finally, individuals with PTSD have shown impairments in executive dysfunction that can be traced to the prefrontal cortex (Shin et al., 2006; Hopper et al., 2007; Aupperle et al., 2012; Swick et al., 2013; DeGutis et al., 2015; Fenster et al., 2018; Holmes et al., 2018; Lebois et al., 2020).”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Aupperle et al., 2012
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“PTSD has been linked to impaired attention regulation and inhibitory control [[13], [14], [15], [16]].”
From A randomized controlled trial of yoga vs nonaerobic exercise for veterans with PTSD: Understanding efficacy, mechanisms of change, and mode of delivery (2021) · cites this paper as [13]
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“However, a review of the literature including a wider range of inhibition tasks suggests that individuals with PTSD do experience inhibition deficits (Aupperle et al., 2012).”
From Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches (2015) · cites this paper as Aupperle et al., 2012
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“Finally, there is inconsistent evidence for planning deficits associated with PTSD (Aupperle et al., 2012).”
From Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches (2015) · cites this paper as Aupperle et al., 2012
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“Semantic verbal fluency is also impaired in individuals with BD (medium effect sizes), OCD (small effect sizes), and ADHD (small effect sizes), while there is inconsistent evidence for verbal fluency in individuals with PTSD (Aupperle et al., 2012).”
From Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches (2015) · cites this paper as Aupperle et al., 2012
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“As described above, the dorsal prefrontal cortex is thought to be critical for multisensory integration (Aupperle et al., 2012; Picó-Pérez et al., 2017) and its activation is necessary for carrying out additional executive functioning tasks, including emotion regulation (Menon, 2011; Cromheeke and Mueller, 2014).”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Aupperle et al., 2012
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“At the center of the cognitive control disturbance is difficulty disengaging attention from salient stimuli that may be interpreted as potentially threatening, even if neutral or positively valenced”
From Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation (2019) · cites this paper as [75]
In the citing paper
“The resulting intrusions and arousal can contribute to the welldocumented deficits in neuropsychological functions such as concentration, sustained attention, executive control, and working memory 111 .”
From Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges (2019) · cites this paper as [111]
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“, 2021) given its important role in either disorder (Aupperle et al., 2012; Koob & Volkow, 2016; Kwako et al., 2016).”
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Complex post-traumatic stress disorder (CPTSD), executive function and attachment
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Aupperle, R. L., & Berg, H. E. (2024) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2023.11.006
Self-citation
Metadata
- Authors
- Aupperle, R. L., Melrose, A. J., Stein, M. B., & Paulus, M. P.
- Affiliations
- University of California San Diego (US)
- Corresponding author
- Aupperle, Robin L.
- Venue
- Neuropharmacology
- Publisher
- Elsevier BV
- Published
- 2012-02
- Volume
- 62
- Issue
- 2
- Pages
- 686-694
- ISSN
- 0028-3908 (ISSN-L)
- PMC
- PMC4719148
- OpenAlex
- W2106557234
- Cited by
- 657
- References
- 147
- Citations by year
- 2026: 30 · 2025: 33 · 2024: 47 · 2023: 48 · 2022: 49 · 2021: 58 · 2020: 65 · 2019: 62 · 2018: 58 · 2017: 46 · 2016: 49 · 2015: 44 · 2014: 27 · 2013: 20 · 2012: 14
- FWCI
- 3.18
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neuropharmacology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01DA016663)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- post-traumatic stress disorder, executive function, response inhibition, attentional control, prefrontal cortex, avoidance coping, risk factors, symptom severity, trauma exposure, neuropsychological assessment, PTSD treatment
- MeSH terms
- Adaptation, Psychological, Attention, Humans, Inhibition, Psychological, Memory, Short-Term, Stress Disorders, Post-Traumatic, Executive Function
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