Neurologic soft signs in chronic posttraumatic stress disorder

Background: Subtle neurologic impairment has been reported in several menta l disorders. The goals of the present study were to evaluate neurologic sta tus in patients of both sexes with chronic posttraumatic stress disorder (P TSD) from different traumatic experiences. Methods: Twenty-one adult women who were sexually abused as children (12 wi th PTSD, 9 without) and 38 male Vietnam War combat veterans (23 with PTSD, 15 without) underwent examination for 41 neurologic soft signs, which were scored by the examiner as well as a blind rater observing videotapes. Subje ct history was obtained with special attention to neurodevelopmental proble ms. Psychometrics included the Wender Utah Rating Scale for symptoms of chi ldhood attention-deficit/hyperactivity disorder and the Michigan Alcoholism Screening rest. Veterans also completed the Combat Exposure Scale and subt ests of the Wechsler Adult Intelligence Scale-Revised. Results: Average neurologic soft sign scores (interrater reliability = 0.74 ) of women with PTSD owing to sexual abuse in childhood (mean [SD], 0.77 [0 .32]) and veteran men (0.72 [0.20]) with combat-related PTSD were comparabl e and significantly (P<.001) higher than those of women sexually abused as children (0.42 [0.10]) and combat veteran men (0.43 [0.17]) without PTSD. T his effect could not be explained by a history of alcoholism or head injury . Subjects with PTSD reported more neurodevelopmental problems and more chi ldhood attention-deficit/hyperactivity disorder symptoms and had lower IQs, all of which were significantly correlated with neurologic soft signs. Conclusion: Neurologic compromise is evident from subject history and findi ngs from physical examination in both women and men with chronic PTSD who h ad experienced different kinds of traumatic events in childhood and adultho od.