Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Berlin, Germany.
Department of Psychiatry, New York University School of Medicine, New York, NY, USA.
Dev Psychopathol. 2020 Aug;32(3):1007-1016. doi: 10.1017/S0954579419000932.
Impaired cognitive functioning constitutes an important symptom of major depressive disorder (MDD), potentially associated with elevated cortisol levels. Adverse childhood experiences (ACE) enhance the risk for MDD and can contribute to disturbances in the stress systems, including cortisol and cognitive functions. In healthy participants, cortisol administration as well as acute stress can affect cognitive performance. In the current study, we tested cognitive performance in MDD patients with (N = 32) and without (N = 52) ACE and healthy participants with (N = 22) and without (N = 37) ACE after psychosocial stress induction (Trier Social Stress Test, TSST) and a control condition (Placebo-TSST). MDD predicted lower performance in verbal learning and both selective and sustained attention, while ACE predicted lower performance in psychomotoric speed and working memory. There were no interaction effects of MDD and ACE. After stress, MDD patients were more likely to show lower performance in working memory as well as in selective and sustained attention compared with participants without MDD. Individuals with ACE were more likely to show lower performance in verbal memory after stress compared with individuals without ACE. Our results indicate negative effects of MDD and ACE on distinct cognitive domains. Furthermore, MDD and/or ACE seem to enhance susceptibility for stress-related cognitive impairments.
认知功能障碍是重性抑郁障碍（MDD）的一个重要症状，可能与皮质醇水平升高有关。不良的童年经历（ACE）会增加 MDD 的风险，并可能导致应激系统紊乱，包括皮质醇和认知功能。在健康参与者中，皮质醇的给予以及急性应激都会影响认知表现。在目前的研究中，我们在有（N = 32）和没有（N = 52）ACE 的 MDD 患者以及有（N = 22）和没有（N = 37）ACE 的健康参与者中，测试了认知表现，这些参与者在经历心理社会应激（Trier 社会应激测试，TSST）和对照条件（安慰剂-TSST）后。MDD 预测言语学习以及选择性和持续性注意力的表现降低，而 ACE 预测运动速度和工作记忆的表现降低。MDD 和 ACE 之间没有相互作用效应。在应激后，MDD 患者在工作记忆以及选择性和持续性注意力方面表现出较低的表现的可能性高于没有 MDD 的患者。与没有 ACE 的个体相比，有 ACE 的个体在应激后言语记忆方面表现出较低的表现的可能性更高。我们的研究结果表明，MDD 和 ACE 对不同的认知领域有负面影响。此外，MDD 和/或 ACE 似乎增强了与应激相关的认知障碍的易感性。
