Child maltreatment and executive functioning in middle adulthood: a prospective examination.
Child maltreatment and executive functioning in middle adulthood: a prospective examination.
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DOI：
10.1037/a0032811
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发表时间：
2013-07
期刊：
影响因子：
2.4
通讯作者：
Widom, Cathy Spatz
中科院分区：
文献类型：
--
作者：
Nikulina, Valentina;Widom, Cathy Spatz
有大量证据表明，儿童期虐待对智商、学业成绩和创伤后应激障碍(PTSD)的负面影响，并增加了对神经生物学后果的关注。然而，很少有前瞻性研究评估滥用和忽视对执行功能的长期影响。目前的研究考察了童年虐待和忽视是否可以预测成年后执行功能和非语言推理能力的组成部分，以及创伤后应激障碍是否会调节这种关系。采用前瞻性队列设计，对法院证实的儿童期身体和性虐待和忽视(年龄0-11岁)和匹配的对照组的大样本(N=792)进行跟踪调查，直到成年(平均年龄=41岁)。执行功能评定采用连线B测验，非言语推理采用矩阵推理。在29岁时评估PTSD(DSM-III-R终生诊断)。数据用普通的最小二乘回归进行分析，控制了年龄、性别和种族，以及可能的智商、抑郁和过度饮酒的混淆。在多变量分析中，童年虐待和童年忽视预示着41岁时执行功能和非语言推理能力较差，而身体和性虐待则不能。过去的创伤后应激障碍病史并没有调停或调和这些关系。童年虐待和忽视具体地对成人神经心理功能的重要方面产生重大的长期影响。这些调查结果表明，有必要作出有针对性的努力，专门对被忽视的儿童进行干预。
There is extensive evidence of negative consequences of childhood maltreatment for IQ, academic achievement, and post-traumatic stress disorder (PTSD) and increased attention to neurobiological consequences. However, few prospective studies have assessed the long-term effects of abuse and neglect on executive functioning. The current study examines whether childhood abuse and neglect predicts components of executive functioning and nonverbal reasoning ability in middle adulthood and whether PTSD moderates this relationship. Using a prospective cohort design, a large sample (N = 792) of court-substantiated cases of childhood physical and sexual abuse and neglect (ages 0-11) and matched controls were followed into adulthood (mean age = 41). Executive functioning was assessed with the Trail Making B test and non-verbal reasoning with Matrix Reasoning. PTSD (DSM-III-R lifetime diagnosis) was assessed at age 29. Data were analyzed using ordinary least squares regressions, controlling for age, sex, and race and possible confounds of IQ, depression, and excessive alcohol use. In multivariate analyses, childhood maltreatment overall and childhood neglect predicted poorer executive functioning and non-verbal reasoning at age 41, whereas physical and sexual abuse did not. A past history of PTSD did not mediate or moderate these relations. Childhood maltreatment and neglect specifically have a significant long-term impact on important aspects of adult neuropsychological functioning. These findings suggest the need for targeted efforts dedicated to interventions for neglected children.
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