Cognitive Effects of Trauma Minimal in College Students

College life can be fairly turbulent for some students these days, often resulting in mood disorders, anxiety disorders, relationship issues, alcohol and drug use, sleep difficulties, eating disorders, and sometimes even suicide or other violent acts.

But some good mental health news for college students may be emerging from a new study. It has found that college students who have been seriously psychologically traumatized or even have posttraumatic stress disorder (PTSD) perform just as well neuropsychologically as do college students who have not been so traumatized.

The study was conducted by Murray Stein, M.D., a professor of psychiatry at the University of California at San Diego, and coworkers. Results appear in the May Psychiatric Research.

Studies up to now have produced no clear-cut answers about the impact of psychological trauma on cognition. For instance, a handful of studies has suggested that PTSD can impair attention, learning, memory, and executive function in combat veterans. A 2002 investigation, in contrast, found very few differences in cognition between women who had developed PTSD from intimate-partner violence and women who had not experienced such violence. So Stein and his colleagues decided to see what effect, if any, serious psychological trauma, and especially PTSD, has on the cognition of college students. They believed that by focusing on college students rather than on a sample of persons who had sought treatment for PTSD, they would reduce the possibility that their results would be distorted by subjects taking psychotropic medications.

They recruited 230 undergraduate students for their study. Psychological trauma and PTSD status of the subjects were ascertained with the Posttraumatic Stress Diagnostic Scale, developed by Edna Foa, Ph.D., a pioneer in PTSD research. It is a 49-item, self-report questionnaire designed to permit the diagnosis of PTSD and the measurement of PTSD symptom severity.

Of the subjects, 105 had experienced one or more serious psychological traumas at some point in their lives according to DSM-IV criteria; 89 had not experienced any such traumas; and the remaining 38 had not only experienced one or more serious psychological traumas, but also met full or partial DSM-IV criteria for PTSD. Partial PTSD was defined as meeting DSM-IV criteria with the exception that subjects have only two, rather than three, Criterion C symptoms and/or only one rather than two Criterion D symptoms. The three groups did not differ in age, years of education, ethnicity, or IQ.

The researchers then gave all subjects a battery of tests assessing their performance in the neuropsychological domains of attention, working memory, psychomotor speed, word generation, and executive function.

The investigators had hypothesized that nontraumatized comparison students would perform better than students with PTSD and that the performance of students who had experienced trauma but did not have PTSD would be intermediate between the two other groups. Their expectations were not borne out.

All three groups were found to perform in a comparable manner on the neuropsychological tests. There were two significant differences in performance between the control group and the PTSD group. Whereas one favored the control group— the PTSD subjects performed worse than the controls on a problem-solving test— the other favored the PTSD group—that is, PTSD subjects performed better than controls on a test measuring ability to increase learning over time. Moreover, the researchers pointed out,“ These few group differences were small in magnitude and, in our opinion, were not likely to result in clinical significance.”

“These results,” the researchers wrote, “suggest that college students with trauma exposure, regardless of PTSD status, do not exhibit marked neuropsychological dysfunction.... [And] it appears that young people with trauma exposure who are able to attend college may represent a `cognitively resilient' group.”

The study was funded by the Veterans Administration Merit Review Program and the National Institute of Mental Health.

An abstract of the study, “Neuropsychological Function in College Students With and Without Posttraumatic Stress Disorder,” can be accessed online at<www.sciencedirect.com/science/journals> by clicking on “P,” then “Psychiatric Research,” then the May issue. ▪