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Neuropsychological Impact of Trauma-Related Mental Illnesses: A Systematic Review of Clinically Meaningful Results.
Neuropsychology Review ( IF 5.4 ) Pub Date : 2020-07-23 , DOI: 10.1007/s11065-020-09444-6
Kristen Silveira 1 , Mauricio A Garcia-Barrera 1, 2 , Colette M Smart 1, 2
Affiliation  

A trauma history is present in approximately 90% of adults in the United States. Comparatively, lifetime post-traumatic stress disorder (PTSD) prevalence is only 8.3% (Kilpatrick et al. Journal of Traumatic Stress, 26, 537-547, 2013). A neuropsychological understanding of trauma is essential to effective trauma-informed assessments and treatments. Prior reviews have focused on PTSD, specific neuropsychological domains, and statistically rather than clinically significant results. The current systematic review investigated standardized test performance across neuropsychological domains in participants with trauma histories and any psychiatric diagnosis. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From 2350 records, the search returned 21 eligible studies: 8 for combat trauma, 2 for childhood trauma, 2 for intimate partner violence and sexual assault, 2 for accidental trauma, 1 for refugee trauma, and 6 for unspecified trauma. Mean neuropsychological scores ranged from low to high average, with one mean verbal memory score in the borderline range. These findings diverge from reports of between-group differences or experimental task performance, which suggest greater levels of static cognitive impairment. Current results are limited by lack of distinction between trauma types in the literature, a dearth of cognitive domains examined, wide use of self-report trauma measures, and publication and outcome reporting biases. Clinical implications for assessment and rehabilitation are discussed in relation to clinical significance, state versus trait based changes, intra-individual variability, changes from pre- to post-trauma, and within-group variability in resilience. Future directions are recommended in consideration of cultural factors, prospective and follow-up designs, and psychiatric diagnosis.

中文翻译:

与创伤有关的精神疾病的神经心理学影响:对临床有意义结果的系统评价。

在美国,大约90%的成年人存在创伤史。相比较而言,一生中创伤后应激障碍(PTSD)的患病率仅为8.3%(Kilpatrick等人,Journal of Traumatic Stress,26,537-547,2013)。对创伤的神经心理学理解对于有效的针对创伤的评估和治疗至关重要。先前的评论集中在PTSD,特定的神经心理学领域以及统计学上而非临床上的重要结果。目前的系统评价调查了具有创伤史和任何精神病学诊断的参与者在整个神经心理学领域的标准化测试表现。审查是根据系统评价和荟萃分析的首选报告项目(PRISMA)指南进行的。从2350条记录中,搜索返回了21项合格的研究:8项针对战斗创伤,2项针对童年创伤,2项针对亲密伴侣暴力和性侵犯,2项针对偶然创伤,1项针对难民创伤,6项针对未指明的创伤。平均神经心理学得分范围从低到高,平均语言记忆得分在临界范围内。这些发现与小组间差异或实验性任务表现的报告不同,后者提示更高水平的静态认知障碍。当前的结果受到文献中创伤类型之间缺乏区分,缺乏检查的认知领域,广泛使用自我报告创伤措施以及出版和结果报告偏倚的限制。讨论了有关评估和康复的临床意义,涉及临床意义,基于状态与特征的变化,个体内部变异性,创伤前后的变化以及复原力的组内变异性。考虑到文化因素,前瞻性和后续设计,建议未来的方向,
更新日期:2020-07-23
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