Service-related conditions and higher-order cognitive processing in military veteran college students

Military veterans have a significantly higher incidence of mild traumatic brain injury (mTBI), depression, and Post-traumatic stress disorder (PTSD) compared to civilians. Military veterans also represent a rapidly growing subgroup of college students, due in part to the robust and financially incentivizing educational benefits under the Post-9/11 GI Bill. The overlapping cognitively impacting symptoms of service-related conditions combined with the underreporting of mTBI and psychiatric-related conditions, make accurate assessment of cognitive performance in military veterans challenging. Recent research findings provide conflicting information on cognitive performance patterns in military veterans. The purpose of this study was to determine whether service-related conditions and self-assessments predict performance on complex working memory and executive function tasks for military veteran college students. Sixty-one military veteran college students attending classes at Arizona State University campuses completed clinical neuropsychological tasks and experimental working memory and executive function tasks. The results revealed that a history of mTBI significantly predicted poorer performance in the areas of verbal working memory and decision-making. Depression significantly predicted poorer performance in executive function related to serial updating. In contrast, the commonly used clinical neuropsychological tasks were not sensitive service-related conditions including mTBI, PTSD, and depression. The differing performance patterns observed between the clinical tasks and the more complex experimental tasks support that researchers and clinicians should use tests that sufficiently tax verbal working memory and executive function when evaluating the subtle, higher-order cognitive deficits associated with mTBI and depression.