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Impact of Common Mental Health Disorders on Cognition: Depression and Posttraumatic Stress Disorder in Forensic Neuropsychology Context

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Abstract

The assessment and diagnosis of posttraumatic stress disorder (PTSD) and depression in forensic evaluations may lack an acknowledgement of the neurocognitive impact of these disorders and how they interact with other causative factors, such as traumatic brain injury (TBI), pain or fatigue. Both PTSD and depression have a complex, growing and consolidating neuroscientific and neuropsychological evidence base, and both can affect neuropsychological test results. In forensic neuropsychological assessments, they are often considered to be confounding factors in evaluating TBI and neurodegenerative disorders but not a source of cognitive impairment in their own right. Yet, an accurate neuropsychological assessment of both cognition and affect is vital to causality determination, prognosis and treatment planning. To complicate matters, selective brain injuries, contingent on the location of injury, can produce symptoms of depression that also affect the neurocognitive profile. Therefore, behavior can overlap not only due to overlapping or comorbid diagnoses, but also due to similar neuroanatomical correlates of both conditions. This paper focuses on reviewing and integrating the available empirical evidence from neuroscience and neuropsychology regarding the cognitive impact of PTSD and depression. Our critical review will emphasize the implications of the more recent evidence for forensic assessment determinations regarding causality, diagnosis, and the impact on function, prognosis and treatment. Hence, electronic search engines, PubMed, PsycINFO, and Google Scholar (up to January 2018) were screened and reviewed both for the neuroscience and neuropsychological literature related to depression and PTSD.

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Notes

  1. It is important to note that sources of collateral information (e.g., family members) are not always independent sources of information. However, their information is helpful if also consistent with observations of other collateral sources, such as peers and employers. We would emphasize that none of the collateral data via interviews is truly objective. Collateral interview methodology is poorly described in the assessment literature and, in our opinion, warrants a separate paper. The addition of standardized instruments with validity scales for collateral informants (such as in the BRIEF-A) may improve the quality of the data obtained in this area.

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  1. The University of British Columbia, Vancouver, Canada

    Izabela Z. Schultz, Amir A. Sepehry & Sarah C. Greer

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  1. Izabela Z. Schultz
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  2. Amir A. Sepehry
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Correspondence to Izabela Z. Schultz.

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Schultz, I.Z., Sepehry, A.A. & Greer, S.C. Impact of Common Mental Health Disorders on Cognition: Depression and Posttraumatic Stress Disorder in Forensic Neuropsychology Context. Psychol. Inj. and Law 11, 139–152 (2018). https://doi.org/10.1007/s12207-018-9322-1

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