Brain Fog and Cognitive Dysfunction in Posttraumatic Stress Disorder: An Evidence-Based Review

Brahm D Sanger,1,2,* Arij Alarachi,1,2,* Heather E McNeely,2,3 Margaret C McKinnon,2– 4 Randi E McCabe2,3 1Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, ON, Canada; 2St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada; 3Department of Psychiat...

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Main Authors: Sanger BD, Alarachi A, McNeely HE, McKinnon MC, McCabe RE
Format: Article
Language:English
Published: Dove Medical Press 2025-03-01
Series:Psychology Research and Behavior Management
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Online Access:https://www.dovepress.com/brain-fog-and-cognitive-dysfunction-in-posttraumatic-stress-disorder-a-peer-reviewed-fulltext-article-PRBM
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author Sanger BD
Alarachi A
McNeely HE
McKinnon MC
McCabe RE
author_facet Sanger BD
Alarachi A
McNeely HE
McKinnon MC
McCabe RE
author_sort Sanger BD
collection DOAJ
description Brahm D Sanger,1,2,* Arij Alarachi,1,2,* Heather E McNeely,2,3 Margaret C McKinnon,2– 4 Randi E McCabe2,3 1Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, ON, Canada; 2St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada; 3Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; 4Homewood Research Institute, Homewood Health Centre, Guelph, ON, Canada*These authors contributed equally to this workCorrespondence: Randi E McCabe, Anxiety Treatment and Research Clinic, St Joseph’s Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L9C 0E3, Canada, Email mccabr@mcmaster.caAbstract: The term “brain fog” has long been used both colloquially and in research literature in reference to various neurocognitive phenomenon that detract from cognitive efficiency. We define “brain fog” as the subjective experience of cognitive difficulties, in keeping with the most common colloquial and research use of the term. While a recent increase in use of this term has largely been in the context of the post-coronavirus-19 condition known as long COVID, “brain fog” has also been discussed in relation to several other conditions including mental health conditions such as post-traumatic stress disorder (PTSD). PTSD is associated with both subjective cognitive complaints and relative deficits on cognitive testing, but the phenomenology and mechanisms contributing to “brain fog” in this population are poorly understood. PTSD psychopathology across cognitive, affective and physiological symptom domains have been tied to “brain fog”. Furthermore, dissociative symptoms common in PTSD also contribute to the experience of “brain fog”. Comorbid physical and mental health conditions may also increase the risk of experiencing “brain fog” among individuals with PTSD. Considerations for the assessment of “brain fog” in PTSD as part of psychodiagnostic assessment are discussed. While standard psychological intervention for PTSD is associated with a reduction in subjective cognitive deficits, other cognitive interventions may be valuable when “brain fog” persists following PTSD remission or when “brain fog” interferes with treatment. Limitations of current research on “brain fog” in PTSD include a lack of consistent definition and operationalization of “brain fog” in the literature, as well as limited tools for measurement. Future research should address these limitations, as well as further evaluate the use of cognitive remediation as an intervention for “brain fog”.Keywords: subjective cognition, cognitive complaints, mental fatigue, trauma
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spelling doaj-art-574c2af7218f4ee98f1c08b246fb45262025-08-20T02:57:13ZengDove Medical PressPsychology Research and Behavior Management1179-15782025-03-01Volume 18589606101060Brain Fog and Cognitive Dysfunction in Posttraumatic Stress Disorder: An Evidence-Based ReviewSanger BDAlarachi AMcNeely HEMcKinnon MCMcCabe REBrahm D Sanger,1,2,* Arij Alarachi,1,2,* Heather E McNeely,2,3 Margaret C McKinnon,2– 4 Randi E McCabe2,3 1Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, ON, Canada; 2St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada; 3Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; 4Homewood Research Institute, Homewood Health Centre, Guelph, ON, Canada*These authors contributed equally to this workCorrespondence: Randi E McCabe, Anxiety Treatment and Research Clinic, St Joseph’s Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L9C 0E3, Canada, Email mccabr@mcmaster.caAbstract: The term “brain fog” has long been used both colloquially and in research literature in reference to various neurocognitive phenomenon that detract from cognitive efficiency. We define “brain fog” as the subjective experience of cognitive difficulties, in keeping with the most common colloquial and research use of the term. While a recent increase in use of this term has largely been in the context of the post-coronavirus-19 condition known as long COVID, “brain fog” has also been discussed in relation to several other conditions including mental health conditions such as post-traumatic stress disorder (PTSD). PTSD is associated with both subjective cognitive complaints and relative deficits on cognitive testing, but the phenomenology and mechanisms contributing to “brain fog” in this population are poorly understood. PTSD psychopathology across cognitive, affective and physiological symptom domains have been tied to “brain fog”. Furthermore, dissociative symptoms common in PTSD also contribute to the experience of “brain fog”. Comorbid physical and mental health conditions may also increase the risk of experiencing “brain fog” among individuals with PTSD. Considerations for the assessment of “brain fog” in PTSD as part of psychodiagnostic assessment are discussed. While standard psychological intervention for PTSD is associated with a reduction in subjective cognitive deficits, other cognitive interventions may be valuable when “brain fog” persists following PTSD remission or when “brain fog” interferes with treatment. Limitations of current research on “brain fog” in PTSD include a lack of consistent definition and operationalization of “brain fog” in the literature, as well as limited tools for measurement. Future research should address these limitations, as well as further evaluate the use of cognitive remediation as an intervention for “brain fog”.Keywords: subjective cognition, cognitive complaints, mental fatigue, traumahttps://www.dovepress.com/brain-fog-and-cognitive-dysfunction-in-posttraumatic-stress-disorder-a-peer-reviewed-fulltext-article-PRBMsubjective cognitioncognitive complaintsmental fatiguetrauma
spellingShingle Sanger BD
Alarachi A
McNeely HE
McKinnon MC
McCabe RE
Brain Fog and Cognitive Dysfunction in Posttraumatic Stress Disorder: An Evidence-Based Review
Psychology Research and Behavior Management
subjective cognition
cognitive complaints
mental fatigue
trauma
title Brain Fog and Cognitive Dysfunction in Posttraumatic Stress Disorder: An Evidence-Based Review
title_full Brain Fog and Cognitive Dysfunction in Posttraumatic Stress Disorder: An Evidence-Based Review
title_fullStr Brain Fog and Cognitive Dysfunction in Posttraumatic Stress Disorder: An Evidence-Based Review
title_full_unstemmed Brain Fog and Cognitive Dysfunction in Posttraumatic Stress Disorder: An Evidence-Based Review
title_short Brain Fog and Cognitive Dysfunction in Posttraumatic Stress Disorder: An Evidence-Based Review
title_sort brain fog and cognitive dysfunction in posttraumatic stress disorder an evidence based review
topic subjective cognition
cognitive complaints
mental fatigue
trauma
url https://www.dovepress.com/brain-fog-and-cognitive-dysfunction-in-posttraumatic-stress-disorder-a-peer-reviewed-fulltext-article-PRBM
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AT mckinnonmc brainfogandcognitivedysfunctioninposttraumaticstressdisorderanevidencebasedreview
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