Nakayama Michi, Hori Hiroaki, Itoh Mariko, Lin Mingming, Niwa Madoka, Ino Keiko, Imai Risa, Ogawa Sei, Sekiguchi Atsushi, Matsui Mie, Kunugi Hiroshi, Kim Yoshiharu
Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Front Psychiatry. 2020 Apr 24;11:344. doi: 10.3389/fpsyt.2020.00344. eCollection 2020.
Accumulated evidence shows that individuals with posttraumatic stress disorder (PTSD) have compromised cognitive function. PTSD is associated with childhood maltreatment, which also can negatively affect cognitive function. It is therefore possible that cognitive dysfunction in adult patients with PTSD can be due at least partly to childhood maltreatment, although little is documented on this issue. Here we aimed to examine the possible effect of childhood maltreatment on cognitive function in adult patients with PTSD. A total of 50 women with DSM-IV PTSD and 94 healthy control women were enrolled. Most of the patients developed PTSD after experiencing interpersonal violence during adulthood. History of childhood maltreatment was assessed using the Childhood Trauma Questionnaire (CTQ). Cognitive functions were assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Compared to controls, patients reported significantly more experiences of all types of childhood maltreatment as assessed by the CTQ and showed significantly poorer performance on immediate memory, language, attention, and the total score of RBANS. In patients, sexual abuse scores were significantly negatively correlated with RBANS language ( < 0.001) and total score ( = 0.005). Further analyses revealed that PTSD patients with childhood sexual abuse had even poorer cognitive function than those without the abuse. In controls, no significant correlation was found between CTQ and RBANS scores. These results suggest that childhood maltreatment, specifically sexual abuse, may lead to persistent cognitive impairment in individuals with PTSD. Our findings might underscore the importance of early detection and intervention of childhood maltreatment, which will be achieved by careful observation of, and listening to, maltreated children in education and welfare scenes as well as clinical settings.
越来越多的证据表明,创伤后应激障碍(PTSD)患者存在认知功能受损的情况。PTSD与童年期虐待有关,童年期虐待也会对认知功能产生负面影响。因此,成年PTSD患者的认知功能障碍可能至少部分归因于童年期虐待,尽管关于这个问题的文献记载很少。在此,我们旨在研究童年期虐待对成年PTSD患者认知功能的可能影响。总共招募了50名符合《精神疾病诊断与统计手册》第四版(DSM-IV)标准的PTSD女性患者和94名健康对照女性。大多数患者在成年期经历人际暴力后患上PTSD。使用儿童创伤问卷(CTQ)评估童年期虐待史。通过可重复神经心理状态评估量表(RBANS)评估认知功能。与对照组相比,患者报告的CTQ评估的各类童年期虐待经历显著更多,并且在即刻记忆、语言、注意力和RBANS总分方面表现明显更差。在患者中,性虐待得分与RBANS语言得分(<0.001)和总分(=0.005)显著负相关。进一步分析显示,有童年期性虐待经历的PTSD患者的认知功能比没有该虐待经历的患者更差。在对照组中,未发现CTQ与RBANS得分之间存在显著相关性。这些结果表明,童年期虐待,特别是性虐待,可能导致PTSD患者持续存在认知障碍。我们的研究结果可能强调了早期发现和干预童年期虐待的重要性,这将通过在教育、福利场景以及临床环境中仔细观察和倾听受虐待儿童来实现。