A study of U.S. veterans found that their episodic visual memory, motor learning, and sustained visual attention improved after treatment for PTSD. The magnitude of these improvements was associated with PTSD symptom reduction. However, there were no differences in the effects of the two treatments applied – cognitive processing therapy and Sudarshan Kriya yoga. The paper was published in the Journal of Traumatic Stress.
Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after a person experiences or witnesses a psychologically traumatizing event usually involving actual or threatened death, serious injury, or sexual violence. Such events include war and combat, physical or sexual assault, severe accidents, natural disasters, or sudden loss of a loved one.
Symptoms of PTSD include persistent intrusive memories or flashbacks, nightmares, avoidance of reminders of the trauma, negative changes in mood or beliefs, and heightened arousal, such as irritability or hypervigilance. These symptoms last longer than one month and cause significant distress or impairment in daily functioning.
PTSD is common among military veterans, first responders, refugees, and survivors of violence, but it can occur in anyone exposed to trauma. However, not everyone who experiences trauma develops PTSD, as individual vulnerability, prior experiences, and social support play important roles. PTSD often co-occurs with depression, anxiety disorders, or substance use problems.
Study author Zulkayda Mamat and her colleagues wanted to explore the changes in cognitive functioning of U.S. veterans after treatment for PTSD. They hypothesized that cognitive function would improve after treatment across domains known to be impaired in PTSD. These include attention, working memory, episodic memory, information processing speed, and executive functioning. They further hypothesized that these improvements would be proportional to the degree of improvement in PTSD symptoms.
The researchers recruited 85 U.S. veterans with clinically significant PTSD symptoms, 62 of whom completed both the baseline and post-treatment cognitive assessments. Ten of the initial participants were women. They were randomly divided into two groups. The average age of participants in the final analysis was roughly 58 for the cognitive processing therapy group and 61 for the yoga group.
Participants in the first group were assigned to undergo a type of trauma-focused therapy called cognitive processing therapy (CPT). The other group was to undergo Sudarshan Kriya yoga (SKY). The group undergoing CPT had two 1-hour sessions per week for 6 weeks, for a total of 12 hours. The yoga group started with a 5-day intensive workshop that lasted 3 hours per day. This was followed by twice-weekly group sessions for 6 weeks, for an additional total of 25 hours of contact time (approximately 40 hours total).
Cognitive processing therapy is a structured, evidence-based psychotherapy for post-traumatic stress disorder that helps individuals identify and modify unhelpful beliefs related to trauma in order to reduce distress and improve functioning. Sudarshan Kriya yoga is a structured breathing-based practice originating from yogic traditions that uses specific rhythmic breathing patterns to reduce stress, regulate emotions, and support mental well-being.
Before and after the treatments, participants completed assessments of PTSD symptom severity (using CAPS-5), depression (Beck Depression Inventory-II), and cognitive functioning (tests from the CANTAB battery). The cognitive functioning assessment looked into participants’ episodic visual memory and learning; visual, movement, and comprehension difficulties; visual sustained attention; and working memory and strategy use.
The results showed that the cognitive functioning of participants from both groups improved after both treatments. More specifically, participants showed moderate improvements in visual memory, motor learning, and visual sustained attention. However, performance in spatial working memory declined in both groups.
The magnitude of improvements was similar in the two groups – there were no significant differences between participants who underwent cognitive processing therapy and those who participated in yoga workshops regarding the magnitude of cognitive improvements. Changes in overall cognitive functioning were associated with PTSD symptom reduction across the full sample. However, exploratory analyses indicated that this correlation was statistically significant only within the cognitive processing therapy group, not the yoga group.
“Regardless of treatment, cognitive function improved alongside PTSD symptom reduction. These findings provide evidence that treating PTSD not only alleviates PTSD symptoms but may also improve associated cognitive function,” the study authors concluded.
The study contributes to the scientific knowledge about PTSD treatment. However, it should be noted that cognitive improvements were observed equally in both groups without a passive control group (such as a waitlist). Therefore, while the two treatments appeared equally effective, it remains unclear whether the cognitive improvements resulted strictly from the treatments or from other processes not considered in the study, such as practice effects or the natural passage of time.
The paper, “Cognition improvement in U.S. veterans undergoing treatment for posttraumatic stress disorder: Secondary analyses from a randomized controlled trial,” was authored by Zulkayda Mamat, Danielle C. Mathersul, and Peter J. Bayley.