Citation

Danese A, Moffitt TE, Arseneault L, Bleiberg BA, Dinardo PB, Gandelman SB, Houts R, Ambler A, Fisher HL, Poulton R, Caspi A. Am. J. Psychiatry 2016; 174(4): 349-361.

Affiliation

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.

Copyright

(Copyright © 2016, American Psychiatric Association)

DOI

10.1176/appi.ajp.2016.16030333

PMID

27794691

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.

Language: en