The association of posttraumatic stress disorder, depression, and head injury with mid-life cognitive function in civilian women

Rebecca B. Lawn; Shaili C. Jha; Jiaxuan Liu; Laura Sampson; Audrey R. Murchland; Jennifer A. Sumner; Andrea L. Roberts; Seth G. Disner; Francine Grodstein; Jae H. Kang; Laura D. Kubzansky; Lori B. Chibnik; Karestan C. Koenen

doi:10.1002/da.23233

The association of posttraumatic stress disorder, depression, and head injury with mid-life cognitive function in civilian women

Rebecca B. Lawn, Shaili C. Jha, Jiaxuan Liu, Laura Sampson, Audrey R. Murchland, Jennifer A. Sumner, Andrea L. Roberts, Seth G. Disner, Francine Grodstein, Jae H. Kang, Laura D. Kubzansky, Lori B. Chibnik, Karestan C. Koenen

Psychiatry & Behavioral Sciences

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

Background: Despite evidence linking posttraumatic stress disorder (PTSD), depression, and head injury, separately, with worse cognitive performance, investigations of their combined effects on cognition are limited in civilian women. Methods: The Cogstate Brief Battery assessment was administered in 10,681 women from the Nurses' Health Study II cohort, mean age 64.9 years (SD = 4.6). Psychological trauma, PTSD, depression, and head injury were assessed using online questionnaires. In this cross-sectional analysis, we used linear regression models to estimate mean differences in cognition by PTSD/depression status and stratified by history of head injury. Results: History of head injury was prevalent (36%), and significantly more prevalent among women with PTSD and depression (57% of women with PTSD and depression, 21% of women with no psychological trauma or depression). Compared to having no psychological trauma or depression, having combined PTSD and depression was associated with worse performance on psychomotor speed/attention ((Formula presented.) = −.15, p =.001) and learning/working memory ((Formula presented.) = −.15, p <.001). The joint association of PTSD and depression on worse cognitive function was strongest among women with past head injury, particularly among those with multiple head injuries. Conclusions: Head injury, like PTSD and depression, was highly prevalent in this sample of civilian women. In combination, these factors were associated with poorer performance on cognitive tasks, a possible marker of future cognitive health. Head injury should be further explored in future studies of PTSD, depression and cognition in women.

Original language	English (US)
Pages (from-to)	220-232
Number of pages	13
Journal	Depression and Anxiety
Volume	39
Issue number	3
DOIs	https://doi.org/10.1002/da.23233
State	Published - Mar 2022

Bibliographical note

Funding Information:
We acknowledge the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School for managing the NHS II. This study was supported by the National Institute of Mental Health grant R01 MH101269 (K. C. K and L. D. K) as well as the National Institute of Health grant U01 CA176726 (for NHS II infrastructure). L Sampson was supported by the National Institutes of Health grant T32 HL098048. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding Information:
We acknowledge the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School for managing the NHS II. This study was supported by the National Institute of Mental Health grant R01 MH101269 (K. C. K and L. D. K) as well as the National Institute of Health grant U01 CA176726 (for NHS II infrastructure). L Sampson was supported by the National Institutes of Health grant T32 HL098048. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2021 Wiley Periodicals LLC

Keywords

cognition
cogstate
depression
head injury
mild traumatic brain injury
posttraumatic stress disorder
women

PubMed: MeSH publication types

Journal Article
Research Support, N.I.H., Extramural

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10.1002/da.23233

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Lawn, R. B., Jha, S. C., Liu, J., Sampson, L., Murchland, A. R., Sumner, J. A., Roberts, A. L., Disner, S. G., Grodstein, F., Kang, J. H., Kubzansky, L. D., Chibnik, L. B., & Koenen, K. C. (2022). The association of posttraumatic stress disorder, depression, and head injury with mid-life cognitive function in civilian women. Depression and Anxiety, 39(3), 220-232. https://doi.org/10.1002/da.23233

Lawn, RB, Jha, SC, Liu, J, Sampson, L, Murchland, AR, Sumner, JA, Roberts, AL, Disner, SG, Grodstein, F, Kang, JH, Kubzansky, LD, Chibnik, LB & Koenen, KC 2022, 'The association of posttraumatic stress disorder, depression, and head injury with mid-life cognitive function in civilian women', Depression and Anxiety, vol. 39, no. 3, pp. 220-232. https://doi.org/10.1002/da.23233

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title = "The association of posttraumatic stress disorder, depression, and head injury with mid-life cognitive function in civilian women",

abstract = "Background: Despite evidence linking posttraumatic stress disorder (PTSD), depression, and head injury, separately, with worse cognitive performance, investigations of their combined effects on cognition are limited in civilian women. Methods: The Cogstate Brief Battery assessment was administered in 10,681 women from the Nurses' Health Study II cohort, mean age 64.9 years (SD = 4.6). Psychological trauma, PTSD, depression, and head injury were assessed using online questionnaires. In this cross-sectional analysis, we used linear regression models to estimate mean differences in cognition by PTSD/depression status and stratified by history of head injury. Results: History of head injury was prevalent (36%), and significantly more prevalent among women with PTSD and depression (57% of women with PTSD and depression, 21% of women with no psychological trauma or depression). Compared to having no psychological trauma or depression, having combined PTSD and depression was associated with worse performance on psychomotor speed/attention ((Formula presented.) = −.15, p =.001) and learning/working memory ((Formula presented.) = −.15, p <.001). The joint association of PTSD and depression on worse cognitive function was strongest among women with past head injury, particularly among those with multiple head injuries. Conclusions: Head injury, like PTSD and depression, was highly prevalent in this sample of civilian women. In combination, these factors were associated with poorer performance on cognitive tasks, a possible marker of future cognitive health. Head injury should be further explored in future studies of PTSD, depression and cognition in women.",

keywords = "cognition, cogstate, depression, head injury, mild traumatic brain injury, posttraumatic stress disorder, women",

author = "Lawn, {Rebecca B.} and Jha, {Shaili C.} and Jiaxuan Liu and Laura Sampson and Murchland, {Audrey R.} and Sumner, {Jennifer A.} and Roberts, {Andrea L.} and Disner, {Seth G.} and Francine Grodstein and Kang, {Jae H.} and Kubzansky, {Laura D.} and Chibnik, {Lori B.} and Koenen, {Karestan C.}",

note = "Funding Information: We acknowledge the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School for managing the NHS II. This study was supported by the National Institute of Mental Health grant R01 MH101269 (K. C. K and L. D. K) as well as the National Institute of Health grant U01 CA176726 (for NHS II infrastructure). L Sampson was supported by the National Institutes of Health grant T32 HL098048. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: We acknowledge the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School for managing the NHS II. This study was supported by the National Institute of Mental Health grant R01 MH101269 (K. C. K and L. D. K) as well as the National Institute of Health grant U01 CA176726 (for NHS II infrastructure). L Sampson was supported by the National Institutes of Health grant T32 HL098048. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: {\textcopyright} 2021 Wiley Periodicals LLC",

year = "2022",

month = mar,

doi = "10.1002/da.23233",

language = "English (US)",

volume = "39",

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TY - JOUR

T1 - The association of posttraumatic stress disorder, depression, and head injury with mid-life cognitive function in civilian women

AU - Lawn, Rebecca B.

AU - Jha, Shaili C.

AU - Liu, Jiaxuan

AU - Sampson, Laura

AU - Murchland, Audrey R.

AU - Sumner, Jennifer A.

AU - Roberts, Andrea L.

AU - Disner, Seth G.

AU - Grodstein, Francine

AU - Kang, Jae H.

AU - Kubzansky, Laura D.

AU - Chibnik, Lori B.

AU - Koenen, Karestan C.

N1 - Funding Information: We acknowledge the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School for managing the NHS II. This study was supported by the National Institute of Mental Health grant R01 MH101269 (K. C. K and L. D. K) as well as the National Institute of Health grant U01 CA176726 (for NHS II infrastructure). L Sampson was supported by the National Institutes of Health grant T32 HL098048. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: We acknowledge the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School for managing the NHS II. This study was supported by the National Institute of Mental Health grant R01 MH101269 (K. C. K and L. D. K) as well as the National Institute of Health grant U01 CA176726 (for NHS II infrastructure). L Sampson was supported by the National Institutes of Health grant T32 HL098048. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: © 2021 Wiley Periodicals LLC

PY - 2022/3

Y1 - 2022/3

N2 - Background: Despite evidence linking posttraumatic stress disorder (PTSD), depression, and head injury, separately, with worse cognitive performance, investigations of their combined effects on cognition are limited in civilian women. Methods: The Cogstate Brief Battery assessment was administered in 10,681 women from the Nurses' Health Study II cohort, mean age 64.9 years (SD = 4.6). Psychological trauma, PTSD, depression, and head injury were assessed using online questionnaires. In this cross-sectional analysis, we used linear regression models to estimate mean differences in cognition by PTSD/depression status and stratified by history of head injury. Results: History of head injury was prevalent (36%), and significantly more prevalent among women with PTSD and depression (57% of women with PTSD and depression, 21% of women with no psychological trauma or depression). Compared to having no psychological trauma or depression, having combined PTSD and depression was associated with worse performance on psychomotor speed/attention ((Formula presented.) = −.15, p =.001) and learning/working memory ((Formula presented.) = −.15, p <.001). The joint association of PTSD and depression on worse cognitive function was strongest among women with past head injury, particularly among those with multiple head injuries. Conclusions: Head injury, like PTSD and depression, was highly prevalent in this sample of civilian women. In combination, these factors were associated with poorer performance on cognitive tasks, a possible marker of future cognitive health. Head injury should be further explored in future studies of PTSD, depression and cognition in women.

AB - Background: Despite evidence linking posttraumatic stress disorder (PTSD), depression, and head injury, separately, with worse cognitive performance, investigations of their combined effects on cognition are limited in civilian women. Methods: The Cogstate Brief Battery assessment was administered in 10,681 women from the Nurses' Health Study II cohort, mean age 64.9 years (SD = 4.6). Psychological trauma, PTSD, depression, and head injury were assessed using online questionnaires. In this cross-sectional analysis, we used linear regression models to estimate mean differences in cognition by PTSD/depression status and stratified by history of head injury. Results: History of head injury was prevalent (36%), and significantly more prevalent among women with PTSD and depression (57% of women with PTSD and depression, 21% of women with no psychological trauma or depression). Compared to having no psychological trauma or depression, having combined PTSD and depression was associated with worse performance on psychomotor speed/attention ((Formula presented.) = −.15, p =.001) and learning/working memory ((Formula presented.) = −.15, p <.001). The joint association of PTSD and depression on worse cognitive function was strongest among women with past head injury, particularly among those with multiple head injuries. Conclusions: Head injury, like PTSD and depression, was highly prevalent in this sample of civilian women. In combination, these factors were associated with poorer performance on cognitive tasks, a possible marker of future cognitive health. Head injury should be further explored in future studies of PTSD, depression and cognition in women.

KW - cognition

KW - cogstate

KW - depression

KW - head injury

KW - mild traumatic brain injury

KW - posttraumatic stress disorder

KW - women

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The association of posttraumatic stress disorder, depression, and head injury with mid-life cognitive function in civilian women

Abstract

Bibliographical note

Keywords

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