Childhood abuse and neglect and cognitive flexibility in adolescents

Abstract

Childhood maltreatment (CM) has been associated with diminished executive functioning in children and adults; however, there is a relative paucity of study of executive function in adolescents exposed to CM. Yet, executive dysfunction in adolescence may have important adverse consequences including increased vulnerability to risky behaviors and impaired school functioning. This study investigates the relationship between self-reported CM and an executive function, cognitive flexibility, in adolescents without identified psychiatric disorders. Effects of physical and emotional, abuse and neglect, maltreatment subtypes were explored. Thirty adolescents ages 12–17 years, 50% females, completed the retrospective self-report Childhood Trauma Questionnaire (CTQ) and were administered the Wisconsin Card Sorting Test (WCST). Correlational analyses assessed the relationship between WCST perseverative error scores norm-referenced for age and education with CTQ total scores. The relationship with nonperseverative errors, as well as with physical and emotional abuse and neglect CM subscores, were explored. Total CTQ scores showed significant associations with perseverative errors on the WCST, but not with nonperseverative errors. Significant associations with perseverative errors were seen for physical abuse and physical neglect among the CTQ subscales. The results suggest both physical abuse and physical neglect are associated with diminished cognitive flexibility in adolescents. These effects were detected in adolescents without identified psychiatric diagnoses suggesting the importance of considering executive dysfunction in adolescents exposed to CM who may not meet diagnostic criteria for an Axis I disorder and that tests of perseverative errors, such as those of the WCST, may be sensitive indicators of this dysfunction.

Keywords:

• Adolescent
• Child abuse
• Child neglect
• Executive function
• Cognition

Acknowledgments

This work was supported by the National Institute of Health (NIH) Roadmap for Medical Research Common Fund grant UL1-DE19586 (RS) and the NIH Roadmap for Medical Research/Common Fund (RS), National Institute of Drug Abuse RL1DA024856 (HPB, JHK, LCM), K05DA020091 (LCM) and PL1-DA24859 (RS), the National Institute of Mental Health R01MH69747 (HPB), T32MH14276 (JHK), Women's Health Research at Yale (HPB, CMM), the National Alliance for Research in Schizophrenia and Depression (HPB, JHK), the Attias Family Foundation (HPB), Marcia Simon Kaplan (JHK), and the Klingenstein Foundation (JHK). We thank Susan Quatrano, Philip Markovich, Kathryn Armstrong, Sarah Nicholls, Matthew Freiburger, and Matthew Hirschtritt for their efforts with the research subjects and the research subjects for their participation.