Rapid-response impulsivity predicts depression and PTSD symptomatology at 1-year follow-up in blast-exposed service members

Objective To determine if elevated rapid-response impulsivity following blast exposure (as a putative marker of ventral prefrontal cortex (vPFC) damage) is predictive of future elevated affective symptomatology in blast-exposed service members. Design Longitudinal design with neurocognitive testing at initial assessment and one-year follow-up assessment of psychiatric symptomatology by telephone interview. Setting Veterans Administration medical centers and post-deployment assessment centers at military bases. Participants Blast-exposed US military personnel (N=84) age 19-39. Interventions Not applicable. Main outcome measures Center for Epidemiological Studies-Depression Scale (CES-D) scores, post-traumatic stress disorder (PTSD) checklist (PCL-5) scores, and Alcohol Use Disorders Identification Test-C (AUDIT-C) scores at the 12-month follow-up telephone interview. Results After controlling for age and affective symptom scores reported at initial assessment, commission errors on the Continuous Performance Test-II of the initial assessment were predictive of higher symptom scores in CES-D and PCL-5 at follow-up, but were not predictive of AUDIT-C scores. Conclusion Elevated rapid-response impulsivity, as a behavioral marker of reduced top-down frontocortical control, is a risk factor for elevated mood and PTSD symptoms over time in blast-exposed individuals. Future longitudinal studies with pre-deployment neurobehavioral testing could enable attribution of this relationship to blast-related vPFC damage.