Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06511, USA.
Child Neuropsychol. 2012;18(2):182-9. doi: 10.1080/09297049.2011.595400. Epub 2011 Sep 26.
Childhood maltreatment (CM) has been associated with diminished executive functioning in children and adults; however, there is a relative paucity of study of executive function in adolescents exposed to CM. Yet, executive dysfunction in adolescence may have important adverse consequences including increased vulnerability to risky behaviors and impaired school functioning. This study investigates the relationship between self-reported CM and an executive function, cognitive flexibility, in adolescents without identified psychiatric disorders. Effects of physical and emotional, abuse and neglect, maltreatment subtypes were explored. Thirty adolescents ages 12-17 years, 50% females, completed the retrospective self-report Childhood Trauma Questionnaire (CTQ) and were administered the Wisconsin Card Sorting Test (WCST). Correlational analyses assessed the relationship between WCST perseverative error scores norm-referenced for age and education with CTQ total scores. The relationship with nonperseverative errors, as well as with physical and emotional abuse and neglect CM subscores, were explored. Total CTQ scores showed significant associations with perseverative errors on the WCST, but not with nonperseverative errors. Significant associations with perseverative errors were seen for physical abuse and physical neglect among the CTQ subscales. The results suggest both physical abuse and physical neglect are associated with diminished cognitive flexibility in adolescents. These effects were detected in adolescents without identified psychiatric diagnoses suggesting the importance of considering executive dysfunction in adolescents exposed to CM who may not meet diagnostic criteria for an Axis I disorder and that tests of perseverative errors, such as those of the WCST, may be sensitive indicators of this dysfunction.
儿童虐待(CM)与儿童和成人的执行功能减退有关;然而,在经历 CM 的青少年中,对执行功能的研究相对较少。然而,青春期的执行功能障碍可能会产生重要的不良后果,包括增加对危险行为的易感性和对学校功能的损害。本研究调查了在没有明确精神障碍的青少年中,自我报告的 CM 与执行功能(认知灵活性)之间的关系。探讨了身体和情感虐待、忽视以及虐待亚型的影响。30 名 12-17 岁的青少年,女性占 50%,完成了回顾性自我报告的儿童创伤问卷(CTQ),并进行了威斯康星卡片分类测试(WCST)。相关分析评估了 WCST 持续错误分数(年龄和教育的参考分数)与 CTQ 总分之间的关系。还探讨了与非持续错误的关系,以及与身体和情感虐待和忽视 CM 子分数的关系。CTQ 总分与 WCST 上的持续错误显著相关,但与非持续错误无关。在 CTQ 子量表中,身体虐待和身体忽视与持续错误显著相关。结果表明,身体虐待和身体忽视都与青少年认知灵活性的降低有关。这些影响在没有明确精神诊断的青少年中被发现,这表明在经历 CM 的青少年中,考虑执行功能障碍的重要性,这些青少年可能不符合轴 I 障碍的诊断标准,并且 WCST 等持续错误测试可能是这种功能障碍的敏感指标。