The role of executive functioning in PTSD and its treatment
Abstract
The current review describes evidence for the critical role of executive functioning in the development and/or maintenance of posttraumatic stress disorder (PTSD). As part of this review, we describe associations between executive functioning, intrusive thoughts, and PTSD. Moreover, we explore evidence for the utility of cognitive training programs to improve executive functioning as a potential novel treatment approach. A model is presented that depicts how poor executive functioning and associated intrusive thoughts, in the context of unsuccessful attempt to regulate cognitions and emotions, may lead to or perpetuate PTSD symptoms. Keywords: Cognition, cognitive training, executive functioning, PTSD, trauma, treatment.
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Deficits in executive functioning contribute to difficulty regulating cognitions and emotions, sustaining PTSD.
“We have previously hypothesized that such deficits in executive functioning contribute to difficulty regulating cognitions and emotions, sustaining PTSD.”
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 [17]
Remediation of deficits in executive functioning may help to resolve PTSD symptoms.
“We further suggested that remediation of such deficits may help to resolve PTSD symptoms [17].”
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 [17]
Cited by
Sorted by citations
Bomyea, J. A., & Lang, A. J. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.12.021 · Cited by 42 · see citing works
Self-citationFlanagan, J. C., Hand, A., Jarnecke, A. M., Maria, M. M. M., Brady, K. T., & Joseph, J. E. (2018) · Experimental and Clinical Psychopharmacology · doi:10.1037/pha0000197 · Cited by 45 · see citing works
Neurocognition in PTSD: Treatment Insights and Implications
Jak, A. J., Crocker, L. D., Aupperle, R. L., Clausen, A. N., & Bomyea, J. A. (2016) · Current topics in behavioral neurosciences · doi:10.1007/7854_2016_62 · Cited by 38 · see citing works
Self-citationOn the relation between mind wandering, PTSD symptomology, and self-control
Brosowsky, N. P., Smith, A. C., Smilek, D., & Seli, P. (2022) · Consciousness and Cognition · doi:10.1016/j.concog.2022.103288 · Cited by 17 · see citing works
“…we expect positive associations between unintentional mind wan-dering and traumatic intrusions partly because both involve deficits in control (Aupperle, Melrose, Stein, & Paulus, 2012; Bomyea & Lang, 2015; DeGutis et al., 2015; Isacescu et al., 2017; Phillips et al., 2016; Verwoerd et al., 2009).”
BackgroundYoga as an intervention for PTSD: a theoretical rationale and review of the literature
Wells, S. Y., Lang, A. J., Schmalzl, L., Groessl, E. J., & Strauss, J. L. (2016) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-016-0068-7 · Cited by 13 · see citing works
Self-citationLansing, A. E., Plante, W. Y., Golshan, S., Fennema‐Notestine, C., & Thuret, S. (2017) · Learning and Individual Differences · doi:10.1016/j.lindif.2017.01.014 · Cited by 15 · see citing works
“…higher re-experiencing and lower avoidance symptoms, indicated less efficient verbal learning which is consistent with conceptualizations of PTSD as a disorder of cognitive control (impaired executive function) over thought and negative emotion regulation (for review, see Bomyea & Lang, 2015).”
Maja, R. A., Kilshaw, R. E., García-Barrera, M. A., & Karr, J. E. (2021) · Psychological Reports · doi:10.1177/0033294120979690 · Cited by 9 · see citing works
“However, researchers have conceptualized this relationship in a reverse direction, where executive function difficulties increase susceptibility to PTS symptomology (Bomyea & Lang, 2015).”
BackgroundRandomized controlled trial of computerized working memory training for Veterans with PTSD
Bomyea, J. A., Caudle, M. M., Bartolovich, A. L., Simmons, A. N., Jak, A. J., & Golshan, S. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.11.072 · Cited by 7 · see citing works
“Re-experiencing symptoms are thought to stem from deficits in working memory ability needed to regulate the contents of thought generally (Anderson and Levy, 2009; Aupperle et al., 2012; Bomyea and Lang, 2015).”
InfluentialSelf-citationLang, A. J., Malaktaris, A., Maluf, K. S., Kangas, J., Sindel, S., Herbert, M., Bomyea, J., Simmons, A. N., Weaver, J., Velez, D., et al. (2021) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2021.100719 · Cited by 5 · see citing works
“We further suggested that remediation of such deficits may help to resolve PTSD symptoms [17].”
BackgroundSelf-citationBlekić, W., Wauthia, É., Arachchige, K. K., Lefèbvre, L., & Rossignol, M. (2020) · Canadian Psychology/Psychologie canadienne · doi:10.1037/cap0000257 · Cited by 6 · see citing works
Davey, D. K., Caudle, M. M., Hoffman, S. N., Jak, A. J., Bomyea, J. A., & Crocker, L. D. (2024) · Psychological Medicine · doi:10.1017/s0033291724003106 · Cited by 2 · see citing works
“…EF gains, resulting in better downstream effects during treatment on processes linked to cognitive skills (e.g. better cognitive flexibility to modify maladaptive thoughts or inhibit negative thinking [Bomyea & Lang, 2015] and improved emotion regulation [Schmeichel, Volokhov, & Demaree, 2008]).”
Self-citationStocco, A., Smith, B. M., PeConga, E. K., & Zoellner, L. A. (2021) · doi:10.31234/osf.io/rwz6u · Cited by 1 · see citing works
Somatomotor Beta Bursts Mediate the Negative Impact of PTSD Severity on Conflict MonitoringPreprint
Rawls, E., Marquardt, C. A., & Sponheim, S. R. (2022) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2022.12.23.521828
Hunt, C., Caudle, M. M., Jak, A. J., Simmons, A. N., & Bomyea, J. A. (2026) · Psychological Medicine · doi:10.1017/s0033291726103298
“However, trials of EF training for PTSD have typically investigated the intervention in PTSD patients as a whole and not for the specific subgroup of patients whom the intervention might benefit most (Badura-Brack et al., 2015; Bomyea et al., 2015).”
InfluentialSelf-citation
- Authors
- Bomyea, J., & Lang, A.
- Affiliations
- University of California San Diego (US)
- ORCID
- Venue
- Current Psychiatry Reviews
- Publisher
- Bentham Science Publishers Ltd.
- Published
- 2015-07-29
- Volume
- 11
- Issue
- 3
- Pages
- 160-171
- ISSN
- 1573-4005 (ISSN-L)
- OpenAlex
- W2775822796
- Cited by
- 14
- References
- 0
- Citations by year
- 2026: 1 · 2024: 2 · 2022: 2 · 2021: 3 · 2020: 1 · 2018: 1 · 2017: 1 · 2016: 2 · 2015: 1
- FWCI
- 2.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Psychiatry Reviews (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- executive function, post-traumatic stress disorder, intrusive thoughts, cognitive training, cognitive regulation, emotion regulation, trauma
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