Journal of the International Neuropsychological Society

Research Articles

PTSD Modifies Performance on a Task of Affective Executive Control among Deployed OEF/OIF Veterans with Mild Traumatic Brain Injury

Melissa M. Amicka1a2 c1, Alexandra Clarka1, Catherine B. Fortiera1a3, Michael Estermana1a2, Ann M. Rasmussona1a2, Alexandra Kennaa1, William P. Milberga1a3a4 and Regina McGlincheya1a3a4

a1 Translational Research Center for Traumatic Brain Injury and Stress Disorders, VA Boston Healthcare System, Boston, Massachusetts

a2 Department of Psychiatry, Boston University Medical School, Boston, Massachusetts

a3 Department of Psychiatry, Harvard Medical School Boston, Massachusetts

a4 Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts


Individuals with post-traumatic stress disorder (PTSD) show a cognitive bias for threatening information, reflecting dysregulated executive control for affective stimuli. This study examined whether comorbid mild Traumatic Brain Injury (mTBI) with PTSD exacerbates this bias. A computer-administered Affective Go/No-Go task measured reaction times (RTs) and errors of omission and commission to words with a non–combat-related positive or negative valence in 72 deployed United States service members from the wars in Iraq and Afghanistan. Incidents of military-related mTBI were measured with the Boston Assessment of Traumatic Brain Injury-Lifetime. PTSD symptoms were measured with the Clinician-Administered PTSD Scale. Participants were divided into those with (mTBI+, n = 34) and without a history of military-related mTBI (mTBI−, n = 38). Valence of the target stimuli differentially impacted errors of commission and decision bias (criterion) in the mTBI+ and mTBI− groups. Specifically, within the mTBI+ group, increasing severity of PTSD symptoms was associated with an increasingly liberal response pattern (defined as more commission errors to negative distractors and greater hit rate for positive stimuli) in the positive compared to the negative blocks. This association was not observed in the mTBI− group. This study underscores the importance of considering the impact of a military-related mTBI and PTSD severity upon affective executive control. (JINS, 2013, 19, 1–10)

(Received June 28 2012)

(Revised April 04 2013)

(Accepted April 15 2013)


  • Post-traumatic stress disorder;
  • Attention;
  • Brain injury;
  • Military;
  • Cognition;
  • Deployment


c1 Correspondence and reprint requests to: Melissa M. Amick, Translational Research Center for Traumatic Brain Injury and Stress Disorders, VA Boston Healthcare System (182-JP), 150 South Huntington Avenue, Boston, MA 02130. E-mail: