Browsing by Author "Martindale, Sarah L."
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Item Coping styles as a mediator between neuropsychological functioning and quality of life outcomes in OEF/OIF Veterans.(2011-12-19) Martindale, Sarah L.; Dolan, Sara Lynn.; Psychology and Neuroscience.; Baylor University. Dept. of Psychology and Neuroscience.Veterans have returned from the OEF/OIF combat theatre with a multitude of physical and psychological problems that affect neuropsychological functioning and quality of life (QOL). Often, neuropsychological function is difficult to remedy in treatment, thus a more efficacious treatment would focus on a mediation factor to improve QOL. This study set out to determine whether coping mediated the relationship between neuropsychological functioning and QOL outcomes in Veterans. Participants were 136 men and women enrolled in an ongoing study of returning war Veterans. Results indicated that an active coping style was a full mediator between long-term verbal memory and QOL outcome. Attention and short-term verbal memory were good predictors of quality of life, but were not mediated by coping style. Treatments that include action-focused coping skills may be beneficial, however, cognitive deficits should be accounted for in treatment planning to improve QOL in Veterans.Item The neuropsychology of co-occurring posttraumatic stress disorder, traumatic brain injury, and substance use disorders in OEF/OIF/OND veterans.(2015-07-27) Martindale, Sarah L.; Dolan, Sara Lynn.A significant minority of military personnel are returning from the wars in Iraq and Afghanistan with physical and psychological injuries that affect their cognitive functioning. Among these conditions, posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), and substance use disorders (SUD) are frequently seen and commonly co-occur, complicating diagnosis and treatment. While our knowledge about the effects of these conditions on neuropsychological functioning is increasing, less is known about these impairments in veterans with either alone or in combination. Little to no information is available about specific effects of various combinations of these disorders on neuropsychological functioning in veterans, including executive functioning. The purpose of this study was to learn how symptoms of these conditions, and the complicating factors of sleep quality, anxiety symptoms, and depressive symptoms, affect cognitive functioning in OEF/OIF/OND veterans. A total of 129 veterans completed a 2.5-hour assessment of mental health and neuropsychological functioning. In the absence of PTSD symptoms, veterans with TBI and greater substance use problems had greater difficulties with attention. Additionally, PTSD symptoms were significantly associated with overall executive functioning regardless of presence of other conditions. Both PTSD symptoms and substance use problems were related to a type of complex attention (set loss errors) when TBI was absent, and TBI status was related to executive functioning (set-shifting) deficits. Finally, greater combat experiences were related to worse sleep quality that, in turn, negatively impacted processing speed and other neuropsychological functions. This study has implications for future research and treatment considerations in patients with symptoms of these conditions. First, executive functioning should be considered as a part of all neuropsychological batteries, and analyses may want to concentrate on individual aspects of executive functioning. Second, substance use problems have now shown to also impact cognitive functioning and should be considered in research. Third, combat experience has a negative impact on cognitive functioning, independent of other conditions, and exploring the effects of combat experiences can provide more information about veterans without symptoms, who still experience problems. Finally, neuropsychological deficits have behavioral consequences and an evaluation of neuropsychological functioning in veterans can aid in treatment planning.