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长期认知后遗症:未患创伤后应激障碍的受虐儿童。

Long-term cognitive sequelae: abused children without PTSD.

作者信息

Perna Robert B, Kiefner Mark

机构信息

Behavioral Medicine Department, Walton Rehabilitation Hospital, Augusta, GA 30901, USA.

出版信息

Appl Neuropsychol Child. 2013;2(1):1-5. doi: 10.1080/09084282.2011.595460. Epub 2012 Apr 25.

Abstract

Many lines of research suggest that childhood abuse and neglect are associated with later developing psychiatric diagnoses, academic problems, cognitive difficulty, and possible brain changes as measured through brain imaging. Data were collected on children (N = 41) who completed a neuropsychological evaluation. Of those evaluated, 18 had a documented history of physical and/or emotional abuse or significant neglect and 23 had no history of abuse/neglect. When controlling for Full-Scale IQ (FSIQ), the abused children had significantly lower scores on measures of executive functioning (Wisconsin Card-Sorting Test-Categories, Maintenance of Set, and Perseveration and Wechsler Intelligence Scale for Children-Fourth Edition Working Memory), and effect sizes were large for these variables. Neither group had any test scores significantly lower than their FSIQ. Cross-tabulation analyses showed that the abused children were more likely to subsequently be diagnosed with a behavioral or emotional disorder. Consistent with psychobiological theories and imaging studies, our data are suggestive that childhood abuse and neglect are associated with later development of behavioral and emotional disorders and areas of cognitive weakness and possible impairment. Future research may be conducted to clarify these effects, the possibility of a dose-effect relationship, and timing of possible critical periods of brain vulnerability.

摘要

多项研究表明,童年期遭受虐待和忽视与日后出现精神疾病诊断、学业问题、认知困难以及通过脑成像测量的可能的大脑变化有关。对完成神经心理学评估的儿童(N = 41)收集了数据。在接受评估的儿童中,18名有身体和/或情感虐待或严重忽视的记录,23名没有虐待/忽视史。在控制全量表智商(FSIQ)时,受虐待儿童在执行功能测量(威斯康星卡片分类测验-类别、定势维持、持续错误以及韦氏儿童智力量表第四版工作记忆)上的得分显著更低,并且这些变量的效应量很大。两组的任何测试分数均未显著低于其FSIQ。交叉表分析表明,受虐待儿童随后更有可能被诊断为行为或情绪障碍。与心理生物学理论和成像研究一致,我们的数据表明童年期虐待和忽视与行为和情绪障碍的后期发展以及认知弱点和可能的损伤区域有关。未来的研究可以进行,以阐明这些影响、剂量效应关系的可能性以及大脑易损性可能的关键期的时间。

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