A-148: Subclinical PTSD Symptoms Subtly Shift Recognition Memory Response Style

Abstract

Objective: Research demonstrates executive dysfunction in Posttraumatic Stress Disorder (PTSD) undermines decision-making processes. We examined if PTSD Checklist (PCL-5) symptoms influenced Veterans’ response bias (RB) during recognition memory on the California Verbal Learning Test-II (CVLT-II). Method/Data Selection: 189 LIMBIC-CENC combat Veterans (10.4% women, 53% college-educated, 60% White, ages 25-77; 34% PCL-5 ≥33, 94% ≥7 on WAIS-IV Reliable Digit Span [RDS], median mild traumatic brain injury (TBI) exposures =2) completed the CVLT-II. Linear regressions examined whether PCL-5 total scores predicted RB, controlling for total number of lifetime mild TBI exposures, age, education, sex, recognition discriminability, and RDS. RB scores < 0 (range -0.7:0.9) reflect a tendency to endorse items as previously learned target words, regardless of the overall ability to distinguish targets from distractors. Results/Data Synthesis: PCL-5 total scores predicted RB, (p=.02, adjusted R^2=.05). Greater PTSD symptom burden was associated with a greater tendency to endorse items as previously learned (β=-.20, 95%CI -0.19, -0.03, FDR-adjusted p=.01). Clusters D (Negative Alterations to Cognition and Mood) and E (Hyperarousal) were similarly associated with decreased RB (FDR-adjusted ps=.01), but their effects did not persist when also accounting for PCL-5 total symptom severity. Conclusions: Greater PTSD symptom burden, even at subclinical levels, was associated with a subtle increase in the tendency to endorse items during recognition independent of recognition discriminability and mild TBI history. These findings suggest PTSD symptoms are associated with response style (i.e., accuracy-bias tradeoffs) rather than memory performance per se. Clarifying the contributions of specific symptom dimensions may require samples with greater clinical severity.