Department of Psychiatry, University of Illinois, College of Medicine.
Psychol Trauma. 2024 Oct;16(7):1139-1148. doi: 10.1037/tra0001637. Epub 2024 Jan 15.
Evidence suggests that adverse childhood experiences (ACEs) predict cognitive dysfunction, possibly through direct (e.g., brain structure/function changes) and indirect (e.g., increased psychopathology risk) pathways. However, extant studies have focused on young and older adults, with limited understanding of how ACEs affect cognitive health in midadulthood.
This study compared psychiatric and cognitive differences between adults at high- and low-risk of adverse health outcomes based on the ACE risk classification scheme.
Adult patients ( = 211; 46.9% female; = 44.1, SD = 17.1; = 13.8, = 3.0) consecutively referred for outpatient neuropsychological evaluation within a large, Midwestern academic medical center.
Patients were divided into high and low ACE groups based on the number of ACEs endorsed. Subsequently, a series of one-way analyses of variances were conducted to compare high versus low ACE groups on the Test of Premorbid Functioning, Wechsler Adult Intelligence Scale-Fourth Edition Digit Span Test, Trail Making Test-Parts A and B, Rey Auditory Verbal Learning Test, Beck Depression Inventory-II, and Beck Anxiety Inventory scores.
Significant group differences were detected for anxiety and depression with the high ACE group endorsing significantly greater depression and anxiety symptoms relative to the low ACE group. High and low ACE groups did not significantly differ on any cognitive measures.
Results indicate that an individual's psychological health, but not cognitive functioning, is impacted by the level of ACE exposure. Study findings highlight the importance of including ACE measures in neuropsychological evaluations, as it will aid in case conceptualization and tailoring treatment recommendations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
有证据表明,不良的童年经历(ACEs)可通过直接途径(例如,大脑结构/功能变化)和间接途径(例如,增加精神病理学风险)预测认知功能障碍。然而,现有的研究主要集中在年轻和老年人群体,对于 ACEs 如何影响中年人的认知健康知之甚少。
本研究通过 ACE 风险分类方案,比较了高风险和低风险不良健康结局的成年人之间的精神病理学和认知差异。
在一家大型中西部学术医疗中心,连续纳入接受门诊神经心理评估的成年患者(n=211;46.9%为女性;平均年龄=44.1 岁,标准差=17.1 岁;平均受教育年限=13.8 年,范围=3.0 年)。
根据 ACE 数量将患者分为高 ACE 组和低 ACE 组。随后,采用单因素方差分析比较了高 ACE 组和低 ACE 组在测试前功能测试、韦氏成人智力量表第四版数字符号测试、连线测试 A 和 B、瑞文听觉词汇学习测试、贝克抑郁自评量表 II 以及贝克焦虑自评量表上的差异。
高 ACE 组的焦虑和抑郁得分显著高于低 ACE 组,存在显著的组间差异。高 ACE 组和低 ACE 组在任何认知测量上均无显著差异。
结果表明,个体的心理健康,而不是认知功能,受到 ACE 暴露水平的影响。研究结果强调了在神经心理评估中纳入 ACE 测量的重要性,因为这将有助于病例概念化和制定治疗建议。