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儿童创伤和创伤后应激障碍的神经心理学功能:荟萃分析。

Neuropsychological functioning of childhood trauma and post-traumatic stress disorder: A meta-analysis.

机构信息

School of Psychology and Public Health, Department of Psychology and Counselling, La Trobe University, Bundoora, Vic 3086, Australia; Child Neuropsychology, Clinical Sciences Theme, Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, Victoria 3052, Australia.

School of Psychology and Public Health, Department of Psychology and Counselling, La Trobe University, Bundoora, Vic 3086, Australia; Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel.

出版信息

Neurosci Biobehav Rev. 2017 Jan;72:68-86. doi: 10.1016/j.neubiorev.2016.11.004. Epub 2016 Nov 13.

Abstract

This study reviewed evidence for cognitive impairments in trauma-exposed children with and without PTSD. Twenty-seven studies were eligible for meta-analysis, totalling 1526 participants, including 412 trauma-exposed children (PTSD unknown), 300 children with PTSD (PTSD+), 323 children without PTSD (PTSD-), and 491 trauma-naive controls. Eligible studies mostly investigated familial-maltreatment trauma (k=22). Trauma-exposed children (PTSD unknown) performed more poorly overall than controls (d=-0.57). Cognitive deficits were seen in PTSD+ compared to controls, including a large effect size (ES) for general intelligence (d=-0.88), moderate ESs for language/verbal (d=-0.65), visuospatial (d=-0.53), information processing (d=-0.62), learning and memory (d=-0.67), and executive skills (d=-0.52). PTSD+ showed poorer general intelligence (d=-0.28) and visuospatial skills (d=-0.42) compared to PTSD-, whilst PTSD- showed poorer executive function (d=-0.23) and learning and memory (d=-0.61) compared to controls. In conclusion, trauma-exposed children showed cognitive deficits compared to controls, although greatest deficits were associated with PTSD diagnosis.

摘要

本研究回顾了创伤暴露儿童和 PTSD 儿童认知障碍的证据。有 27 项研究符合荟萃分析的条件,共有 1526 名参与者,包括 412 名创伤暴露儿童(PTSD 未知)、300 名 PTSD 儿童(PTSD+)、323 名无 PTSD 儿童(PTSD-)和 491 名创伤未暴露对照。合格研究主要调查了家庭虐待创伤(k=22)。创伤暴露儿童(PTSD 未知)的整体表现明显不如对照组(d=-0.57)。与对照组相比,PTSD+儿童存在认知缺陷,包括一般智力的大效应量(ES)(d=-0.88)、语言/言语的中等效应量(d=-0.65)、视空间(d=-0.53)、信息处理(d=-0.62)、学习和记忆(d=-0.67)和执行技能(d=-0.52)。与 PTSD-相比,PTSD+表现出较差的一般智力(d=-0.28)和视空间技能(d=-0.42),而与对照组相比,PTSD-表现出较差的执行功能(d=-0.23)和学习记忆(d=-0.61)。总之,与对照组相比,创伤暴露儿童表现出认知缺陷,尽管与 PTSD 诊断相关的缺陷最大。

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