The Origins of Cognitive Deficits in Victimized Children: Implications for Neuroscientists and Clinicians.
The Origins of Cognitive Deficits in Victimized Children: Implications for Neuroscientists and Clinicians.
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DOI：
10.1176/appi.ajp.2016.16030333
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发表时间：
2017-04-01
期刊：
影响因子：
--
通讯作者：
Caspi A
中科院分区：
文献类型：
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作者：
Danese A;Moffitt TE;Arseneault L;Bleiberg BA;Dinardo PB;Gandelman SB;Houts R;Ambler A;Fisher HL;Poulton R;Caspi A
报告有儿童暴力受害史的人大脑功能受损。然而，这些发现的临床意义、可重复性和因果关系存在争议。我们直接测试了这些研究空白。我们测试了前瞻性收集的儿童暴力受害和认知功能在童年，青春期和成年期的英国电子风险研究的2,232名成员和新西兰达尼丁研究的1,037名成员之间的关联，他们分别从出生到18岁和38岁进行随访。我们使用了受害和认知的多项措施，并包括对受害不一致的双胞胎的认知评分进行比较。我们发现，暴露于童年受害的个体在青春期和成年期的临床相关认知功能，包括一般智力，执行功能，处理速度，记忆，知觉推理和言语理解方面存在广泛的障碍。然而，观察到的认知缺陷在受害者的个人在很大程度上解释了认知缺陷，早在童年受害和混淆遗传和环境风险。来自两个人口代表性的出生队列的研究结果表明，与传统的解释相反，儿童暴力受害与后来的认知之间的关联在很大程度上是非因果关系，这两个出生队列共有3,000多人，出生时间为20年，相距20,000公里。这些发现促使我们在压力神经科学中采用更谨慎的方法来进行因果推理。临床上，认知缺陷应被概念化为受害的个体风险因素以及治疗期间潜在的并发症特征。
Individuals reporting a history of childhood violence victimization have impaired brain function. However, the clinical significance, reproducibility, and causality of these findings are disputed. We directly tested these research gaps. We tested the association between prospectively-collected measures of childhood violence victimization and cognitive functions in childhood, adolescence, and adulthood among 2,232 members of the UK E-Risk Study and 1,037 members of the New Zealand Dunedin Study, who were followed-up from birth until ages 18 and 38 years, respectively. We used multiple measures of victimization and cognition, and included comparisons of cognitive scores for twins discordant for victimization. We found that individuals exposed to childhood victimization had pervasive impairments in clinically-relevant cognitive functions including general intelligence, executive function, processing speed, memory, perceptual reasoning, and verbal comprehension in adolescence and adulthood. However, the observed cognitive deficits in victimized individuals were largely explained by cognitive deficits that predated childhood victimization and by confounding genetic and environmental risks. Findings from two population-representative birth cohorts totaling more than 3,000 individuals and born 20 years and 20,000 kilometers apart suggest that the association between childhood violence victimization and later cognition is largely non-causal, in contrast to conventional interpretations. These findings urge adopting a more circumspect approach to causal inference in the neuroscience of stress. Clinically, cognitive deficits should be conceptualized as individual risk factors for victimization as well as potential complicating features during treatment.