School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada.
School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada; Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
J Affect Disord. 2019 Jun 1;252:278-293. doi: 10.1016/j.jad.2019.04.026. Epub 2019 Apr 9.
Childhood maltreatment is closely related to normal cognitive development and ensuing adverse mental health outcomes and cognitive dysfunction. Our current comprehensive systematic review examines the relationship between childhood maltreatment and cognitive functioning focusing only on prospective studies, which allow us to draw inferences about the temporal relationships among the constructs and make causal inferences.
The databases, EMBASE, HealthStar, PsychoInfo, Medline, and Cochrane Library, were searched using a systematic methodology to identify prospective studies published up to December, 2017 to explore the relationship between childhood maltreatment and cognitive functioning. Quality assessment of each study was rated using Newcastle-Ottawa-Scale (NOS).
10 articles with 11 studies were included evaluating cognitive development, memory, academic achievement, literacy/verbal comprehension, intelligence, executive function, processing speed, perceptional reasoning, and non-verbal reasoning among children exposed to abuse, neglect or domestic violence either individually or combined. Intelligence and executive function were the most frequently reported cognitive impairments. The findings of this review collectively indicated that nine domains of the cognitive functioning impairments were significantly related to multiple forms of maltreatment and that significance remained in multivariable analyses after controlling for potential confounders.
A high degree of heterogeneity of various domains of cognitive functioning and different measurements among selected studies precluded the use of meta-analysis.
Childhood maltreatment is considered as one of the most consistent factors related to later life cognitive dysfunction. The study outcomes provide direction for future research on children who have experienced child abuse and have implications for the delivery of health and mental health services to develop clinical practice and intervention for maltreated children.
儿童期虐待与正常认知发展以及随后的不良心理健康结果和认知功能障碍密切相关。我们目前的全面系统评价仅关注前瞻性研究，考察了儿童期虐待与认知功能之间的关系，这些研究使我们能够推断出这些结构之间的时间关系，并进行因果推断。
使用系统方法搜索了 EMBASE、HealthStar、PsychoInfo、Medline 和 Cochrane Library 数据库，以确定截至 2017 年 12 月发表的探索儿童期虐待与认知功能之间关系的前瞻性研究。使用纽卡斯尔-渥太华量表（NOS）对每项研究的质量进行评估。
共纳入了 10 篇文章中的 11 项研究，评估了遭受虐待、忽视或家庭暴力的儿童的认知发展、记忆、学业成绩、读写/语言理解、智力、执行功能、加工速度、感知推理和非语言推理等方面。智力和执行功能是最常报告的认知障碍。本综述的研究结果表明，认知功能障碍的九个领域与多种形式的虐待显著相关，并且在控制潜在混杂因素后，多变量分析仍然具有显著性。
由于所选研究中认知功能的各个领域存在高度异质性和不同的测量方法，因此无法进行荟萃分析。
儿童期虐待被认为是与晚年认知功能障碍最相关的因素之一。这些研究结果为经历过儿童虐待的儿童的未来研究提供了方向，并对提供卫生和精神卫生服务以制定针对受虐待儿童的临床实践和干预措施产生了影响。
