B – 21 Childhood Trauma, PTSD Symptom Severity, and Executive Dysfunction: Baseline Predictors in a CBD Trial

Abstract Objective Posttraumatic stress disorder (PTSD) is associated with cognitive deficits, particularly in executive functioning, which may be influenced by both past trauma and current symptom severity. We hypothesized that individuals with higher scores on the Childhood Trauma Questionnaire (CTQ) and the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) would show poorer performance on the Trail Making Test B, a measure of cognitive flexibility and executive function, and their interaction would compound these deficits. Method This study examined the relationship between childhood trauma, PTSD symptom severity, and executive functioning in a baseline sample of 60 individuals aged 18 to 70 across races and gender, enrolled in a clinical trial at an Academic Medical Center investigating the effects of cannabidiol (CBD) for PTSD. A factorial ANOVA was used to assess how CTQ and CAPS-5 scores, as well as their interaction, predicted performance on Trail B. Results:The overall model was significant, F(45, 14) = 3.77, p = .004, accounting for 91.7% of the variance in Trail B scores. Higher CTQ scores were associated with poorer performance, F(4, 14) = 5.30, p = .007, as were higher CAPS-5 scores, F(29, 14) = 3.34, p = .008. A significant CTQ by CAPS-5 interaction, F(11, 14) = 3.19, p = .020, revealed that individuals with both high childhood trauma exposure and elevated PTSD symptoms demonstrated the greatest impairments in executive function. Conclusion These findings underscore the compounding effects of early-life adversity and current PTSD severity on cognitive functioning, highlighting neurocognitive vulnerabilities in PTSD and informing the potential cognitive implications of CBD treatment.