Comparison of executive functions in adolescent with post traumatic stress disorder who exposed to different trauma types with healthy controls

ABSTRACT Objective: In order to evaluate executive functions by using neurocognitive tests in adolescents who experienced different trauma types such as Physical and Emotional Trauma and meet the criteria of Post Traumatic Stress Disorder (PTSD), we compared the groups with different trauma types with each other and with a healthy control group. Methods: The adolescents who met the inclusion and exclusion criteria of our study were identified by screening the records of the Child and Adolescent Psychiatry Department, Department of Pediatric Surgery and Department of Forensic Medicine. The cases who applied for the outpatient clinic were evaluated and decided to be suitable for the study. Other participants, whose treatments were completed, were invited to participate in the study by a telephone contact. A clinically semi-structured interview, KSADS-PL, was performed by an experienced and certified clinician for the patient group and control group in terms of diagnosis and differential diagnosis. Socio-demographic and clinical data form prepared by the investigators for the study purposes was applied to all participants. In order to determine the level of traumatic experiences for the adolescents in the case group, the Post Traumatic Response Scale for Children was performed. Wisconsin Card Sorting Test (WCST), Stroop Test, Serial Digit Learning Test (SDLT) and Rey Auditory and Verbal learning Test (AVLT) were applied to all participants. Data was statistically analyzed with the IBM SPSS (Statistical Package for Social Sciences) 22.0 package program. Pearson's Chi-square test was used to compare categorical data. For the analysis of continuous data, it was firstly checked whether the distribution was normally distributed; Kolmogorov-Smirnov test was applied when the number of sample groups was over 30. In the comparison of non-categorical data between the groups, the difference between the two means was tested for significance (independent sample t-test) and ANOVA test was applied for those with normal distribution. A p-value less than 0.05 was accepted as statistically significant. Findings: In both case groups, SDLT, AVLT subtest, WCST completed category, WCST total error, WCST perseverative error percentage, Stroop2 time, Stroop3 time, Stroop4 time, Stroop5 time, Stroop2 correction, Stroop5 the error subscores were found to be significantly lower than those of the control group. Conclusion: In both groups of patients with PTSD, there were significant differences in neurocognitive tests in comparison to the healthy control group. When the two trauma groups were compared with each other, it was determined that although the emotional trauma group had lower scores, indicating lower performance in execuive functionning tests, the difference between the two groups were not significant.