Journal of the International Neuropsychological Society (2009), 15, 879–887. Copyright © INS. Published by Cambridge University Press, 2009. doi:10.1017/S135561770999049X 879 COGNITIVE IMPAIRMENT AND FUNCTIONING IN PTSD Posttraumatic Stress Disorder (PTSD) was included in the third edition of the Diagnostic and Statistical Manual (DSM-III) in 1980 (American Psychiatric Association, 1980) and began to be studied from a neuropsychological perspective soon afterward (e.g., Everly & Horton, 1989). Interest in the neuropsychological effects of stress and trauma has risen during the past decade, particularly in light of the current conflicts in Iraq and Afghanistan, along with research showing that deployment alone is a risk factor for neurocognitive dysfunction (Vasterling et al., 2006). Research on the cognitive impairments of trauma and PTSD over the past three decades has yet to yield a consensus re- garding which cognitive domains are most affected, how- ever. Impairments have been identified in almost every cognitive domain, including premorbid intellectual func- tioning (Vasterling et al., 2002), attention/working memory (Horner & Hamner, 2002; Samuelson et al., 2006; Stein, Kennedy, & Twamley, 2002; Vasterling, Brailey, Constans, & Sutker, 1998; Vasterling et al., 2002), processing speed (Samuelson et al., 2006; Stein et al., 2002), learning (Horner & Hamner, 2002; Samuelson et al., 2006; Vasterling et al., SYMPOSIUM Cognitive impairment and functioning in PTSD related to intimate partner violence ELIZABETH W. TWAMLEY, 1,2,3 CAROLYN B. ALLARD, 1,3 STEVEN R. THORP, 1,2,4 SONYA B. NORMAN, 1,2,3 SHADHA HAMI CISSELL, 1,4 KELLY HUGHES BERARDI, 3 ERIN M. GRIMES, 1,4 and MURRAY B. STEIN 1,5,6 1 Department of Psychiatry, University of California, San Diego, La Jolla, California 2 Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California 3 Psychology Service, VA San Diego Healthcare System, San Diego, California 4 Research Service, VA San Diego Healthcare System, San Diego, California 5 Psychiatry Service, VA San Diego Healthcare System, San Diego, California 6 Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California (Received December 23, 2008; Final Revision June 16, 2009; Accepted June 16, 2009) Abstract Posttraumatic stress disorder (PTSD) has been associated with neuropsychological impairments across multiple domains, but consensus regarding the cognitive profile of PTSD has not been reached. In this study of women with PTSD related to intimate partner violence ( n = 55) and healthy, demographically similar comparison participants (NCs; n = 20), we attempted to control for many potential confounds in PTSD samples. All participants were assessed with a comprehensive neuropsychological battery emphasizing executive functioning, including inhibition, switching, and abstraction. NCs outperformed PTSD participants on most neuropsychological measures, but the differences were significant only on speeded tasks (with and without executive functioning components). The PTSD group’s mean performance was within the average range on all neuropsychological tests. Within the PTSD group, more severe PTSD symptoms were associated with slower processing speed, and more severe dissociative symptoms were associated with poorer reasoning performance. These results suggest that women with PTSD related to intimate partner violence demonstrate slower than normal processing speed, which is associated with the severity of psychiatric symptoms. We speculate that the cognitive slowing seen in PTSD may be attributable to reduced attention due to a need to allocate resources to cope with psychological distress or unpleasant internal experiences. ( JINS, 2009, 15, 879–887.) Keywords: Posttraumatic stress disorder, Trauma, Stress, Neuropsychological, Cognition, Domestic violence Correspondence and reprint requests to: Elizabeth W. Twamley, Depart- ment of Psychiatry, University of California, San Diego, 140 Arbor Drive (0851), San Diego, CA 92103. E-mail: etwamley@ucsd.edu