Effect of traumatic experiences and future threats on executive functioning and verbal fluency amongst Farsi-Dari speaking immigrants, refugees, and asylum seekers

Background: Impairments in executive functioning associated with posttraumatic stress disorder (PTSD) may impact the capacity of refugees and asylum seekers. 

Aims: To examine the association between executive functioning and PTSD with and without prominent future-focused threat (FFT) intrusions at rest and after threat priming.

Method: 66 Farsi and Dari-speaking asylum-seekers, refugees, and immigrants were recruited into 3 groups: High PTSD & FFT Symptoms; High PTS Symptoms; Low PTSD & FFT symptoms. The Category Fluency Test (animals; food; flora) in Farsi was administered at baseline and after two counter-balanced future- and past-focused threat narrative tasks. 

Results: Higher PTSD and FFT symptom scores was associated with reduced verbal fluency [correct words (PTS p < 0.001; FFT p < 0.007), clustered words (PTS, p < 0.004; FFT p < 0.009) and clusters (PTS p < 0.017; FFT p < 0.009)]. The PTSD group retrieved fewer correct words (17.6, p < 0.009) using fewer clusters (p < 0.008) than the low-symptom group at baseline. It was only after exposure to the narrative task that the FFT group displayed comparable impairment. 

Conclusions: A subset of displaced persons with future threat symptoms exhibit cognitive impairment when asked to recount narrative details. Future threat may limit capacity to engage in cognitively demanding activities, such as participating in Refugee Status Determination.