Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea.
Sci Rep. 2021 Mar 23;11(1):6669. doi: 10.1038/s41598-021-85979-9.
There are individual differences in health outcomes following exposure to childhood maltreatment, yet constant individual variance is often assumed in analyses. Among 286 Black, South African women, the association between childhood maltreatment and neurocognitive health, defined here as neurocognitive performance (NP), was first estimated assuming constant variance. Then, without assuming constant variance, we applied Goldstein's method (Encyclopedia of statistics in behavioral science, Wiley, 2005) to model "complex level-1 variation" in NP as a function of childhood maltreatment. Mean performance in some tests of information processing speed (Digit-symbol, Stroop Word, and Stroop Color) lowered with increasing severity of childhood maltreatment, without evidence of significant individual variation. Conversely, we found significant individual variation by severity of childhood maltreatment in tests of information processing speed (Trail Making Test) and executive function (Color Trails 2 and Stroop Color-Word), in the absence of mean differences. Exploratory results suggest that the presence of individual-level heterogeneity in neurocognitive performance among women exposed to childhood maltreatment warrants further exploration. The methods presented here may be used in a person-centered framework to better understand vulnerability to the toxic neurocognitive effects of childhood maltreatment at the individual level, ultimately informing personalized prevention and treatment.
在接触儿童期虐待后，健康结果存在个体差异，但在分析中通常假设个体方差是恒定的。在 286 名南非黑人女性中，我们首先假设方差恒定，来估计儿童期虐待与神经认知健康（这里定义为神经认知表现（NP））之间的关联。然后，我们没有假设方差恒定，而是应用 Goldstein 的方法（《行为科学中的统计百科全书》，Wiley，2005 年），将 NP 的“复杂一级变异”建模为儿童期虐待的函数。随着儿童期虐待严重程度的增加，一些信息处理速度测试（数字符号、斯特鲁普字和斯特鲁普颜色）的平均表现降低，但没有明显的个体变异证据。相反，我们发现信息处理速度测试（连续作业测试）和执行功能测试（颜色连线测试 2 和斯特鲁普颜色-字）中，存在儿童期虐待严重程度的显著个体变异，而不存在平均差异。探索性结果表明，在接触儿童期虐待的女性中，神经认知表现存在个体水平的异质性，这值得进一步探索。这里提出的方法可以在以人为中心的框架中使用，以更好地了解儿童期虐待的毒性神经认知影响在个体层面的脆弱性，最终为个性化预防和治疗提供信息。
