Original article| Volume 60, ISSUE 7, P722-729, October 01, 2006

Download started.


Stress-Induced Deficits in Working Memory and Visuo-Constructive Abilities in Special Operations Soldiers


      Pre-clinical and clinical studies have shown acute stress may impair working memory and visuo-spatial ability. This study was designed to clarify the nature of stress-induced cognitive deficits in soldiers and how such deficits may contribute to operational or battlefield errors.


      One hundred eighty-four Special Operations warfighters enrolled in Survival School completed pre-stress measures of dissociation and trauma exposure. Subjects were randomized to one of three assessment groups (Pre-stress, Stress, Post-stress) and were administered the Rey Ostereith Complex Figure (ROCF). All subjects completed post-stress measures of dissociation.


      ROCF copy and recall were normal in the Pre- and Post-stress groups. ROCF copy and recall were significantly impaired in the Stress Group. Stress group ROCF copy performance was piecemeal, and ROCF recall was impaired. Symptoms of dissociation were negatively associated with ROCF recall in the Stress group. Baseline dissociation and history of traumatic stress predicted cognitive impairment during stress.


      Stress exposure impaired visuo-spatial capacity and working memory. In rats, monkeys, and humans, high dopamine and NE turnover in the PFC induce deficits in cognition and spatial working memory. Improved understanding of stress-induced cognitive deficits may assist in identification of soldiers at risk and lead to the development of better countermeasures.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Biological Psychiatry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Arnsten A.F.T.
        Catecholamine regulation of pre-frontal cortex.
        J Psychopharmacol. 1997; 11: 151-162
        • Arnsten A.F.T.
        Catecholamine moducation of prefrontal cortical cognitive function.
        Trends Cognit Sci. 1998; 2: 436-447
        • Arnsten A.F.T.
        The biology of being frazzled.
        Science. 1998; 280: 1711-1712
        • Aston Jones G.
        • Valentio R.
        • Van Bockstaele E.
        Locus coeruleus, stress, and PTSD: Neurobiological and clinical parallels.
        in: Murburg Catecholamine Function in Post Traumatic Stress Disorder: Emerging Concepts. APA Press, Washington, DC1994
        • Baddeley A.D.
        Working Memory. Clarendon Press, Oxford1986
        • Belenky G.
        • Balkin T.J.
        • Redmond D.P.
        • Sing H.C.
        • Thomas M.L.
        • Thorne D.R.
        • et al.
        Sustaining Performance during Continuous Operations: The US Army’s Sleep Management System.
        in: Friedl K. Lieberman H. Ryan D.H. Bray G.A. Pennington Center Nutritional Series, Vol. 10, Countermeasures for Battlefield Stressors. Louisiana State University Press, Baton Rouge, LA2000
        • Berry D.T.R.
        • Allen R.S.
        • Schmitt F.A.
        Rey-Ostereith figure: Psychometric characteristics in a geriatric sample.
        Clin Neuropsychol. 1991; 5: 143-153
        • Birnbaum S.
        • Gobeske K.T.
        • Auerbach J.
        • Taylor J.R.
        • Arnsten A.F.T.
        A role for norepinephrine in stress-induced cognitive deficits: Alpha-1-adrenoceptor mediation in the prefrontal cortex.
        Biol Psychiatry. 1999; 46: 1266-1274
        • Bremner J.D.
        • Krystal J.H.
        • Putnam F.W.
        • Southwick S.M.
        • Marmar C.
        • Charney D.S.
        • Mazure C.M.
        Measurement of dissociative states with the Clinician-Administered Dissociative States Scale (CADSS).
        J Traumatic Stress. 1998; 11: 125-136
        • Bremner J.D.
        • Innis R.B.
        • Ng C.K.
        • Staib L.H.
        • Salomon R.M.
        • Bronen R.A.
        • et al.
        Positron emission tomography measurement of cerebral metabolic correlates of yohimbine administration in combat-related posttraumatic stress disorder.
        Arch Gen Psychiatry. 1997; 54: 246-254
        • Cooper J.A.
        • Sagar H.J.
        • Jordan N.
        • et al.
        Cognitive impairment in early untreated Parkinson’s disease and its relationship to motor disability.
        Brain. 1991; 114: 2095-2122
        • Diamond B.J.
        • DeLuca J.
        Rey-Osterrieth Complex Figure Test performance following anterior communicating artery aneurysm.
        Arch Neuropsychol. 1996; 11: 21-28
        • Fedio P.
        • Cox C.S.
        • Neophytides A.
        • et al.
        Neuropsychological profile of Huntington’s disease: Patients and those at risk.
        in: Chase T.N. Wexler N.S. Barbeau A. Advances in Neurology. Vol. 23. Raven Press, New York1979
        • Gaab J.
        • Blattler N.
        • Menzi T.
        • Pabst B.
        • Stoyer S.
        • Ehlert U.
        Randomized controlled evaluation of the effects of cognitive-behavioral stress management on cortisol responses to acute stress in healthy subjects.
        Psychoneuroendocrinology. 2003; 28: 767-779
        • Henry C.
        • Guegant G.
        • Arnauld E.
        • Arsaut J.
        • Le Moal M.
        • Demotes-Mainard J.
        Prenatal stress in rats facilitates amphetamine-induced sensitization and induces long-lasting changes in dopamine receptors in the nucleus accumbens.
        Brain Res. 1995; 685: 179-186
        • Hoffman R.
        • Al Absi M.
        The effect of acute stress on subsequent neuropsychological test performance.
        Arch Clin Neuropsychol. 2004; 19: 497-506
        • Introini-Collison I.B.
        • Saghfi D.
        • Novack G.D.
        • McGaugh J.L.
        Memory-enhancing effects of post-training dipivefrin and epinephrine: Involvement of peripheral and central adrenergic receptors.
        Brain Res. 1992; 572: 81-86
        • Janowsky J.S.
        • Thomas-Thrapp L.J.
        Complex figure recall in the elderly: A deficit in memory or constructional strategy?.
        J Clin Exp Neuropsychol. 1993; 15: 159-169
        • Lezak M.D.
        Neuropsychological Assessment. 3rd ed. Oxford University Press, New York1995
        • Lezak M.D.
        Neuropsychological Assessment. 4th ed. Oxford University Press, New York2004
        • Leininger B.E.
        • Gramling S.E.
        • Farrell A.D.
        • et al.
        Neuropsychological deficits in symptomatic minor head injury patients after concussion and mild concussion.
        J Neurol Neurosurg Psychiatry. 1990; 53: 293-296
        • Loring D.W.
        • Martin R.C.
        • Meador K.J.
        • Lee G.P.
        Psychometric construction of the Rey-Ostereith Complex Figure Test: Methodological considerations and interrater reliability.
        Arch Clin Neuropsychol. 1990; 5: 1-14
        • Morgan C.A.
        • Grillon C.
        • Southwick S.
        • Nagy L.M.
        • Davis M.
        • Krystal J.H.
        • Charney D.
        Yohimbine facilitated acoustic startle in combat veterans with post-traumatic stress disorder.
        Psychopharmacology. 1995; 117: 466-471
        • Morgan III, C.A.
        • Wang S.
        • Mason J.
        • Hazlett G.
        • Fox P.
        • Southwick S.M.
        • et al.
        Hormone profiles in humans experiencing military survival training.
        Biol Psychiatry. 2000; 47: 891-901
        • Morgan III, C.A.
        • Wang S.
        • Southwick S.M.
        • Rasmusson A.
        • Hauger R.
        • Charney D.S.
        Plasma neuropeptide-Y in humans exposed to military survival training.
        Biol Psychiatry. 2000; 47: 902-909
        • Morgan III, C.A.
        • Hazlett G.
        • Wang S.
        • Richardson G.
        • Schnurr P.
        • Southwick S.M.
        Symptoms of dissociation in humans experiencing acute uncontrollable stress: A prospective investigation.
        Am J Psychiatry. 2001; 158: 1239-1247
        • Morgan III, C.A.
        • Wang S.
        • Hazlett G.
        • Rassmusson A.
        • Anderson G.
        • Charney D.S.
        Relationships among cortisol, catecholamines, neuropeptide y and human performance during uncontrollable stress.
        Psychosomatic Med. 2001; 63: 412-442
        • Morgan III, C.A.
        • Rassmusson A.
        • Wang S.
        • Hauger R.
        • Hazlett G.
        Neuropeptide-Y, cortisol and subjective distress in humans exposed to acute stress: Replication and extension of a previous report.
        Biol Psychiatry. 2002; 52: 136-142
        • Morgan III, C.A.
        • Southwick S.M.
        • Krystal J.H.
        Toward a pharmacology of acute stress disorders.
        Biol Psychiatry. 2003; 53: 834-843
        • Morgan III, C.A.
        • Hazlett G.A.
        • Doran T.
        • Garrett S.
        • Hoyt G.
        • Baranoski M.
        • et al.
        Accuracy of eyewitness memory for persons encountered during exposure to highly intense stress.
        Int J Psychiatry Law. 2004; 27: 265-279
        • Myers J.
        • Meyers K.
        The Meyers Scoring System for the Rey Complex Figure and the Recognition Trial: Professional Manual. Psychological Assessment Resources, Odessa, FL1995
        • Ogden J.A.
        • Growdon J.H.
        • Corkin S.
        Deficits in visuospatial tests involving forward planning in high-functioning Parkinsonians.
        Neuropsychiatry Neuropsychol Behav Neurol. 1990; 3: 125-139
        • Poulton R.G.
        • Moffitt T.E.
        The Rey-Osterrieth Complex Figure Test: Norms for young adolescents and an examination of validity.
        Arch Clin Neuropsychol. 1995; 10: 47-56
        • Redmond Jr, D.E.
        Studies of the nucleus locus caeruleus in monkeys and hypotheses for neuropsychopharmacology.
        in: Meltzer H.Y. Psychopharmacology: The Third Generation of Progress. Raven Press, New York1987
        • Rosselli M.
        • Ardila A.
        Cognitive effects of cocaine and poly-drug abuse.
        J Clin Exp Neuropsychol. 1996; 18: 122-135
        • Schnurr P.P.
        • Vieilhauer M.J.
        • Weathers F.
        • Findler M.
        The Brief Trauma Questionnaire. National Center for Post Traumatic Stress, White River Junction, VT1999
        • Shin M.S.
        • Park J.S.
        • Kim M.S.
        • Lee Y.H.
        • Ha T.H.
        • Kwon J.S.
        Deficits of organizational strategy and visual memory in Obsessive-Compulsive Disorder.
        Neuropsychology. 2004; 18: 665-672
        • Southwick S.M.
        • Bremner J.D.
        • Rasmusson A.
        • Morgan III, C.A.
        • Arnsten A.
        • Charney D.S.
        Role of norepinephrine in the pathophysiology and treatment of posttraumatic stress disorder.
        Biol Psychiatry. 1999; 46: 1192-1204
        • Taylor L.B.
        Scoring criteria for the ROCF.
        in: Spreen O. Strauss E. A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. Oxford, New York1991
        • Uddo M.
        • Vasterling J.J.
        • Brailey K.
        • Sutker P.B.
        Memory and attention in combat-related post traumatic stress disorder (PTSD).
        J Psychopathol Behav Assess. 1993; 15: 43-52
        • Van Stegren A.H.
        • Everaerd W.
        • Cahill L.
        • McGaugh J.L.
        • Gooren L.J.
        Memory for emotional events: Differential effects of centrally versus peripherally acting beta-blocking agents.
        Psychopharmacology. 1998; 138: 305-310
        • Waber D.P.
        • Holmes J.
        Assessing children’s copy productions of the Rey-Ostereith Complex Figure.
        J Clin Exp Neuropsychol. 1985; 7: 264-280
        • Waber D.P.
        • Holmes J.
        Assessing children’s memory productions of the Rey-Ostereith Complex Figure.
        J Clin Exp Neuropsychol. 1986; 8: 563-580
        • Zahrt J.
        • Taylor J.R.
        • Mathrew R.G.
        • Arnsten A.F.T.
        Supranormal stimulation of D1 dopamine receptors in the rodent cortex impairs spatial working memory performance.
        J Neurosci. 1997; 17: 8528-8535