Enhancing Cognitive Function and Reintegration in Iraq and Afghanistan Veterans With Post Traumatic Stress Disorder (PTSD) Using Computer-Based Cognitive Training

Inclusion Criteria:

- An experienced clinical interviewer with Master's-level training will conduct first-
and second-level screening to determine study eligibility for enrollment in the
randomized controlled trial.

- The First-Level Eligibility Screen will be conducted by phone and will apply the
following inclusion criteria in an effort to recruit a homogeneous sample:

1. Confirmed OEF and/or OIF military service

2. Male veterans, ages 18 to 40 years with 12 to 16 years of education

3. History of a prior positive PTSD screen or diagnosis either by SFVAMC study
referral or self-report'

4. Able and willing to travel to SFVAMC

5. Able and willing to perform daily home-based computer exercises for three
months.

- The Second Level Eligibility Determination will occur in-person at the SFVAMC of
potential participants who have met first-level screening eligibility criteria.
Second-level eligibility screening will require signed informed consent (see below)
before the second-level screening is conducted. During the second-level eligibility
screen, consenting participants will be administered:

1. The Clinician-Administered PTSD screen (CAPS) and the Mini International
Neuropsychiatric Interview (MINI) 29 to assess for Diagnostic and Statistical
Manual (DSM)-IV Axis I psychiatric disorders

2. The VA TBI second-level screen [TBI event history and Neurobehavioral Symptom
Inventory (NSI) for cognitive symptoms].30

- To be eligible for enrollment in the randomized controlled, veterans at second-level
screening must:

1. Meet threshold criteria for current full or sub-syndromal PTSD by DSM-IV
criteria 31

2. Report ≥ 1 moderate or severe cognitive symptom(s) on the NSI that interfere(s)
with daily function including moderate to severe poor concentration,
forgetfulness, difficulty making decisions and slowed thinking.

- Because PTSD is a highly comorbid condition, eligible participants may have other
comorbid stable neuropsychiatric disorders, including depression or a history of a
mild traumatic brain injury.

Exclusion Criteria:

- The following exclusion criteria will apply to first-level screening:

1. Poor English comprehension and fluency

2. Unstable medical condition, injury or disability, including moderate to severe
TBI (by self-report) and hearing impairment

3. Current (or past 60 day) evidence-based PTSD or cognitive remediation therapy;
in contrast, stable supportive therapy for PTSD and/or other mental disorders,
such as group therapy or on stable psychoactive medication (> 30 days) will be
acceptable.

- The following exclusion criteria will apply to second-level screening:

1. Drug and alcohol dependence and other unstable serious mental illness (e.g.
psychosis) (assessed using the MINI)