Cross-sectional research suggests that posttraumatic stress symptoms (PTSS) among war zone veterans are associated with functional impairment and poor quality of life. Less is known about the long-term functional repercussions of PTSS. This study of Iraq War veterans examined the associations between increases in PTSS and long-term functional outcomes, including the potential contributions of neurocognitive decrements. Service members and veterans (N = 594) completed self-report measures of functioning and PTSS severity before Iraq War deployment and again after their return (M = 9.3 years postdeployment). Some participants (n = 278) also completed neurocognitive testing at both times. Multiple regression analyses with the full sample—adjusted for TBI, demographic characteristics, military variables, and predeployment PTSS and functioning—revealed that increased PTSS severity over time was significantly associated with unemployment, aOR = 1.04, 95% CI [1.03, 1.06]; poorer work performance; and poorer physical, emotional, and cognitive health–related functioning at long-term follow-up, f²s = 0.37–1.79. Among participants who completed neurocognitive testing, a decline in select neurocognitive measures was associated with poorer functioning; however, neurocognitive decrements did not account for associations between increased PTSS and unemployment, aOR = 1.04, 95% CI [1.02, 1.07], with the size and direction upheld after adding neurocognitive variables, or poorer functional outcomes, with small increases after adding neurocognitive measures to the models, f²s = 0.03–0.10. War zone veterans experiencing long-term increased PTSS and/or neurocognitive decrements may be at elevated risk for higher-level functional impairment over time, suggesting that early PTSS management may enhance long-term functioning.

中文翻译：

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美国伊拉克战争退伍军人的创伤后应激症状、神经认知表现和长期功能结果增加之间的关联

横断面研究表明，战区退伍军人的创伤后应激症状 (PTSS) 与功能障碍和生活质量差有关。对 PTSS 的长期功能影响知之甚少。这项对伊拉克战争退伍军人的研究检查了 PTSS 增加与长期功能结果之间的关联，包括神经认知减退的潜在贡献。服务成员和退伍军人 ( N = 594) 在伊拉克战争部署之前和他们返回后 ( M = 9.3 年部署后) 完成了功能和 PTSS 严重程度的自我报告测量。一些参与者 ( n= 278) 两次也完成了神经认知测试。对完整样本进行的多元回归分析（针对 TBI、人口特征、军事变量以及部署前 PTSS 和功能进行了调整）表明，随着时间的推移，PTSS 严重程度的增加与失业显着相关，OR = 1.04，95% CI [1.03, 1.06] ; 工作表现较差；长期随访时身体、情绪和认知健康相关功能较差，f ² s = 0.37–1.79。在完成神经认知测试的参与者中，某些神经认知测量指标的下降与功能较差有关；然而，神经认知衰退并未解释 PTSS 增加与失业之间的关联，一个OR= 1.04, 95% CI [1.02, 1.07]，在添加神经认知变量后大小和方向保持不变，或者功能结果较差，在向模型添加神经认知测量后有小幅增加，f ² s = 0.03–0.10。经历长期 PTSS 增加和/或神经认知减退的战区退伍军人随着时间的推移可能面临更高级别功能障碍的风险，这表明早期 PTSS 管理可能会增强长期功能。