Saperstein Alice M, Lee Seonjoo, Ronan Elizabeth J, Seeman Rachael S, Medalia Alice
Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York; andDivision of Mental Health Service and Policy Research, New York State Psychiatric Institute, New York, New York
Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York; and.
Pediatrics. 2014 Jul;134(1):e138-45. doi: 10.1542/peds.2013-4302.
There is increasing recognition of the cognitive consequences of socioeconomic adversity during childhood, which can impair learning and negatively affect social and emotional development. However, there is a paucity of research on cognitive functioning and mental health among transition-age homeless youth. This study aimed to address this knowledge gap by examining the prevalence and functional significance of cognitive impairment and mental health disorders in a sample of 18- to 22-year-old homeless youth.
Participants (N = 73) were recruited from a vocational support program at Covenant House New York, a care agency for homeless youth. Assessments included diagnostic assessment for mental health disorders and evaluation of neurocognition and vocational outcomes.
Youth demonstrated histories of academic instability, academic achievement below expectation, and high rates of untreated psychiatric disorders, the most prominent of which were anxiety, substance use, and mood disorders. Of those who had a mental health diagnosis, more than half demonstrated cognitive deficits. Performance on measures of working memory and verbal memory was <70% of that of the age-matched normative population. Cognitive impairment was associated with a significant risk for making a wage insufficient for independent living.
These data confirm the need to focus on cognitive as well as emotional and physical health in transition-age youth. Comprehensive intervention at this later developmental stage has the potential to facilitate the acquisition of skills needed for academic, vocational, and independent living success in adulthood.
童年时期社会经济逆境对认知的影响日益受到关注，这种影响会损害学习，并对社会和情感发展产生负面影响。然而，对于过渡年龄的无家可归青年的认知功能和心理健康的研究却很少。本研究旨在通过调查18至22岁无家可归青年样本中认知障碍和心理健康障碍的患病率及其功能意义，来填补这一知识空白。
研究对象（N = 73）从纽约圣约之家的一个职业支持项目中招募，该机构是一家为无家可归青年提供服务的关爱机构。评估包括心理健康障碍的诊断评估以及神经认知和职业成果的评估。
这些青年表现出学业不稳定、学业成绩低于预期的经历，以及未经治疗的精神疾病的高发病率，其中最突出的是焦虑症、物质使用障碍和情绪障碍。在那些被诊断患有精神疾病的人中，超过一半表现出认知缺陷。工作记忆和言语记忆测试的表现低于年龄匹配的正常人群的70%。认知障碍与工资不足以维持独立生活的重大风险相关。
这些数据证实了需要关注过渡年龄青年的认知以及情绪和身体健康。在这个较晚的发育阶段进行全面干预有可能促进获得成年后学业、职业和独立生活成功所需的技能。
