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Abstract

Objective:

Individuals reporting a history of childhood violence victimization have impaired brain function. However, the clinical significance, reproducibility, and causality of these findings are disputed. The authors used data from two large cohort studies to address these research questions directly.

Method:

The authors tested the association between prospectively collected measures of childhood violence victimization and cognitive functions in childhood, adolescence, and adulthood among 2,232 members of the U.K. E-Risk Study and 1,037 members of the New Zealand Dunedin Study who were followed up from birth until ages 18 and 38 years, respectively. Multiple measures of victimization and cognition were used, and comparisons were made of cognitive scores for twins discordant for victimization.

Results:

Individuals exposed to childhood victimization had pervasive impairments in clinically relevant cognitive functions, including general intelligence, executive function, processing speed, memory, perceptual reasoning, and verbal comprehension in adolescence and adulthood. However, the observed cognitive deficits in victimized individuals were largely explained by cognitive deficits that predated childhood victimization and by confounding genetic and environmental risks.

Conclusions:

Findings from two population-representative birth cohorts totaling more than 3,000 individuals and born 20 years and 20,000 km apart suggest that the association between childhood violence victimization and later cognition is largely noncausal, in contrast to conventional interpretations. These findings support the adoption of a more circumspect approach to causal inference in the neuroscience of stress. Clinically, cognitive deficits should be conceptualized as individual risk factors for victimization as well as potential complicating features during treatment.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 349 - 361
PubMed: 27794691

History

Received: 20 March 2016
Revision received: 2 June 2016
Revision received: 3 August 2016
Accepted: 8 August 2016
Published online: 31 October 2016
Published in print: April 01, 2017

Keywords

  1. Stress
  2. Child Maltreatment
  3. Victimization
  4. Cognition
  5. IQ
  6. Executive Function

Authors

Details

Andrea Danese, M.D., Ph.D.
From the MRC Social, Genetic, and Developmental Psychiatry Centre and the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, De Crespigny Park, London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience and the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, N.C.; and the Department of Psychology, University of Otago, Dunedin, New Zealand.
Terrie E. Moffitt, Ph.D.
From the MRC Social, Genetic, and Developmental Psychiatry Centre and the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, De Crespigny Park, London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience and the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, N.C.; and the Department of Psychology, University of Otago, Dunedin, New Zealand.
Louise Arseneault, Ph.D.
From the MRC Social, Genetic, and Developmental Psychiatry Centre and the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, De Crespigny Park, London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience and the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, N.C.; and the Department of Psychology, University of Otago, Dunedin, New Zealand.
Ben A. Bleiberg, B.S.
From the MRC Social, Genetic, and Developmental Psychiatry Centre and the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, De Crespigny Park, London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience and the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, N.C.; and the Department of Psychology, University of Otago, Dunedin, New Zealand.
Perry B. Dinardo, B.A.
From the MRC Social, Genetic, and Developmental Psychiatry Centre and the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, De Crespigny Park, London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience and the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, N.C.; and the Department of Psychology, University of Otago, Dunedin, New Zealand.
Stephanie B. Gandelman, B.S.
From the MRC Social, Genetic, and Developmental Psychiatry Centre and the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, De Crespigny Park, London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience and the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, N.C.; and the Department of Psychology, University of Otago, Dunedin, New Zealand.
Renate Houts, Ph.D.
From the MRC Social, Genetic, and Developmental Psychiatry Centre and the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, De Crespigny Park, London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience and the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, N.C.; and the Department of Psychology, University of Otago, Dunedin, New Zealand.
Antony Ambler, M.Sc.
From the MRC Social, Genetic, and Developmental Psychiatry Centre and the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, De Crespigny Park, London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience and the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, N.C.; and the Department of Psychology, University of Otago, Dunedin, New Zealand.
Helen L. Fisher, Ph.D.
From the MRC Social, Genetic, and Developmental Psychiatry Centre and the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, De Crespigny Park, London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience and the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, N.C.; and the Department of Psychology, University of Otago, Dunedin, New Zealand.
Richie Poulton, Ph.D.
From the MRC Social, Genetic, and Developmental Psychiatry Centre and the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, De Crespigny Park, London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience and the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, N.C.; and the Department of Psychology, University of Otago, Dunedin, New Zealand.
Avshalom Caspi, Ph.D.
From the MRC Social, Genetic, and Developmental Psychiatry Centre and the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, De Crespigny Park, London; the National and Specialist Clinic for Child Traumatic Stress and Anxiety Disorders, South London and Maudsley NHS Foundation Trust, London; the Department of Psychology and Neuroscience and the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, N.C.; and the Department of Psychology, University of Otago, Dunedin, New Zealand.

Notes

Address correspondence to Dr. Danese ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

Jacobs Foundation10.13039/501100003986
Medical Research Council10.13039/501100000265: G1002190, MR/K00381X
National Institute on Aging10.13039/100000049: R01AG032282, R01AG048895, R01AG049789
National Institute of Child Health and Human Development10.13039/100000071: HD077482
Economic and Social Research Council10.13039/501100000269: ES/M010309/1
The Environmental Risk (E-Risk) Longitudinal Twin Study is funded by grant G1002190 from the U.K. Medical Research Council. Additional support was provided by grant HD077482 from the U.S. National Institute of Child Health and Development and by the Jacobs Foundation. Dr. Fisher is supported by the MQ: Transforming Mental Health Fellowship MQ14F40. The Dunedin Multidisciplinary Health and Development Research Unit is funded by the New Zealand Health Research Council and the New Zealand Ministry of Business, Innovation, and Employment. Additional support was provided by grants R01AG032282, R01AG049789, and R01AG048895 from the U.S. National Institute on Aging, grant MR/K00381X from the U.K. Medical Research Council, grant ES/M010309/1 from the Economic and Social Research Council, and by the Jacobs Foundation.

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