Skip to main content
×
×
Home

Neuropsychological findings in childhood neglect and their relationships to pediatric PTSD

  • MICHAEL D. DE BELLIS (a1), STEPHEN R. HOOPER (a2), EVE G. SPRATT (a3) and DONALD P. WOOLLEY (a1)
Abstract
Abstract

Although child neglect is the most prevalent form of child maltreatment, the neurocognitive effects of neglect are understudied. We examined IQ, reading, mathematics, and neurocognitive domains of fine-motor skills, language, visual-spatial, memory/learning, and attention/executive functions in two groups of nonsexually abused medically healthy neglected children, one with DSM-IV posttraumatic stress disorder (PTSD) and one without, and a demographically similar healthy nonmaltreated control group. Significantly lower IQ, reading, mathematics, and selected differences in complex visual attention, visual memory, language, verbal memory and learning, planning, problem solving, and speeded naming were seen in Neglect Groups. The Neglect with PTSD Group performed worse than controls on NEPSY Design Copying, NEPSY Tower, and Mathematics; and performed worse than controls and Neglect without PTSD on NEPSY Memory for Faces-Delayed. Negative correlations were seen between PTSD symptoms, PTSD severity, and maltreatment variables, and IQ, Academic Achievement, and neurocognitive domains. Neglected children demonstrated significantly lower neurocognitive outcomes and academic achievement than controls. Lower IQ, neurocognitive functions, and achievement may be associated with more PTSD symptoms (particularly re-experiencing symptoms), greater PTSD severity, and a greater number of maltreatment experiences. Trauma experiences may additionally contribute to subsequent neurodevelopmental risk in neglected children. (JINS, 2009, 15, 868–878.)

Copyright
Corresponding author
*Correspondence and reprint requests to: Michael D. De Bellis, MD, MPH, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3613, Durham, North Carolina, 27710. E-mail: debel002@mc.duke.edu
References
Hide All
Allen R.E., & Oliver J.M. (1982). The effects of child maltreatment on language development. Child Abuse and Neglect, 6(3), 299305.
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed.), Text Revision (DSM-IV-TR). Washington, DC: Author.
Angold A., Prendergast M., Cox A., Harrington R., Simonoff E., & Rutter M. (1995). The Child and Adolescent Psychiatric Assessment (CAPA). Psychological Medicine, 25, 739753.
Arnsten A.F.T. (1998). The biology of being frazzled. Science, 17111712.
Arnsten A.F.T., & Goldman-Rakic P.S. (1998). Noise stress impairs cortical function: Evidence for a hyperdopaminergic mechanism, 55, 362368.
Beers S.R., & De Bellis M.D. (2002). Neuropsychological function in children with maltreatment-related posttraumatic stress disorder. American Journal of Psychiatry, 159, 483486.
Bremner J.D., Southwick S.M., Johnson D.R., Yehuda R., & Charney D.S. (1993). Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans. American Journal of Psychiatry, 150, 235239.
Burns B.J., Philips S.D., Wagner H.R., Barth R.P., Kolko D.J., Campbell Y., et al. (2004). Mental health need and access to mental health services by youths involved with child welfare: A national survey. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 960970.
Carrey N.J., Butter H.J., Persinger M.A., & Bialik R.J. (1995). Physiological and cognitive correlates of child abuse. Journal of the American Academy of Child and Adolescent Psychiatry, 34(8), 10671075.
Carrion V.G., Weems C.F., Ray R.D., & Reiss A.L. (2001). Toward an empirical definition of pediatric PTSD: The phenomenology of PTSD symptoms in youth. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 166173.
Carrion V.G., Weems C.F., & Reiss A.L. (2007). Stress predicts brain changes in children: A pilot longitudinal study on youth stress, PTSD and the hippocampus. Pediatrics, 119, 509516.
Cicchetti D., & Toth S. (1995). Child maltreatment and attachment organization: Implications of intervention. In Goldberg S., Muir R., & Kerr J. (Eds.), Attachment theory: Social, developmental and clinical perspectives (pp. 279308). London: Analytic Press.
Cohen J.A., Deblinger E., Mannarino A.P., & Steer R.A. (2004). A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 393402.
Cohen N.J. (2001). Language impairment and psychopathology in infants, children, and adolescents. Thousand Oaks, CA: Sage Publications.
Conners D.K., & Systems Multi-Health. (2000). Conners’ Continuous Performance Test-II. Toronto, Ontario: Multi-Health Systems, Inc.
Copeland W., Keeler G., Angold A., & Costello E. (2007). Traumatic Events and Posttraumatic Stress in Childhood. Archives of General Psychiatry, 64, 577584.
De Bellis M.D. (2001). Developmental traumatology: The psychobiological development of maltreated children and its implications for research, treatment, and policy. Development and Psychopathology, 13, 537561.
De Bellis M.D. (2005). The psychobiology of neglect. Child Maltreatment, 10, 150172.
De Bellis M.D., Keshavan M., Clark D.B., Casey B.J., Giedd J., Boring A.M., et al. (1999). A.E. Bennett Research Award. Developmental traumatology, Part II: Brain development. Biological Psychiatry, 45, 12711284.
De Bellis M.D., Keshavan M., Shifflett H., Iyengar S., Beers S.R., Hall J., Moritz G. (2002). Brain structures in pediatric maltreatment-related PTSD: A sociodemographically matched study. Biological Psychiatry, 52, 10661078.
Dunn L.M., Dunn L.M., & Williams K.T. (1997). Peabody Picture Vocabulary Test (3rd ed.). Circle Pines, MN: American Guidance Service.
Duyme M., Dumaret A.-C., & Tomkiewicz S. (1999). How can we boost IQs of “dull children”?: A late adoption study. Proceedings of the National Academy of Sciences of the United States of America, 96, 87908794.
Eckenrode J., Laird M., & Doris J. (1993). School performance and disciplinary problems among abused and neglected children. Developmental Psychology, 29, 5362.
Eisen M.L., Goodman G.S., Qin J., Davis S., & Crayton J. (2007). Maltreated children’s memory: Accuracy, suggestibility, and psychopathology. Developmental Psychology, 43(6), 12751294.
Gaudin J.M. Jr. (1999). Child neglect: Short-term and long-term outcomes. In Dubowitz H. (Ed.), Neglected children: Research, practice, and policy (pp. 89108). Thousand Oaks, CA: Sage Publications.
Harlow H.F., Harlow M.K., & Suomi S.J. (1971). From thought to therapy: Lessons from a primate laboratory. American Scientist, 59, 538549.
Hazen A.L., Connelly C.D., Kelleher K., Landsverk J., & Barth R. (2004). Intimate partner violence among female caregivers of children reported for child maltreatment. Child Abuse & Neglect 28, 301319.
Kaufman J., Birmaher B., Brent D., Rao U., Flynn C., Moreci P., et al. (1997). Schedule for Affective Disorders and Schizophrenia for school-age children–Present and Lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36(7), 980988.
Kaufman J., Jones B., Stieglitz E., Vitulano L., & Mannarino A. (1994). The use of multiple informants to assess children’s maltreatment experiences. Journal of Family Violence, 9, 227248.
Kendall-Tackett K.A., & Eckenrode J. (1996). The effects of neglect on academic achievement and disciplinary problems: A developmental perspective. Child Abuse and Neglect, 20(3), 161169.
Kinard E.M. (2001). Perceived and actual academic competence in maltreated children. Child Abuse and Neglect 25, 3345.
Koenen K.C., Moffitt T.E., Caspi A., Taylor A., & Purcell S. (2003). Domestic violence is associated with environmental suppression of IQ in young children. Development and Psychopathology, 15, 297311.
Kolko D. (1992). Characteristics of child victims of physical violence: Research findings and clinical implications. Journal of Interpersonal Violence, 7, 244276.
Koluchova J. (1972). Severe deprivation in twins: A case study. Journal of Child Psychology and Psychiatry, 13, 107114.
Koluchova J. (1976). The further development of twins after severe and prolonged deprivation: A second report. Journal of Child Psychology and Psychiatry, 17, 181188.
Korkman M., Kemp S.L., & Kirk U. (2001). Developmental assessment of neuropsychological function with the aid of the NEPSY. In Kaufman A.S. & Kaufman N.L. (Eds.), Specific learning disabilities and difficulties in children and adolescents: Psychological assessment and evaluation. New York: Cambridge University Press.
Lee V., & Hoaken P.N.S. (2007). Cognition, emotion, and neurobiological development: Mediating the relation between maltreatment and aggression. Child Maltreatment, 12(3), 281298.
Levy H.B., Markovic J., Chaudry U., Ahart S., & Torres H. (1995). Reabuse rates in a sample of children followed for 5 years after discharge from a child abuse inpatient assessment program. Child Abuse and Neglect, 11, 13631377.
Lupien S.J., Fiocco A., & Wan N. (2005). Stress hormones and human memory function across the lifespan. Psychoneuroendocrinology, 30, 225242.
Macklin M.L., Metzger L.J., Litz B.T., McNally R.J., Lasko N.B., Orr S.P., & Pitman R.K. (1998). Lower precombat intelligence is a risk factor for posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 66(2), 323326.
McGloin J.M., & Widom C.S. (2001). Resilience among abused and neglected children grown up. Development and Psychopathology, 13, 10211038.
Nolin P., & Ethier L. (2007). Using neuropsychological profiles to classify neglected children with or without physical abuse. Child Abuse and Neglect, 31, 631643.
Pears K., & Fisher P.A. (2005). Emotion understanding and theory of mind among maltreated children in foster care: Evidence of deficits. Development and Psychopathology, 17(1), 4765.
Perez C., & Widom C.S. (1994). Childhood victimization and long-term intellectual and academic outcomes. Child Abuse and Neglect, 18(8), 617633.
Saltzman K., Weems C.F., & Carrion V.G. (2006). IQ and posttraumatic stress symptoms in children exposed to interpersonal violence. Child Psychiatry and Human Development, 36, 261272.
Scannapieco M. (2008). Developmental outcomes of child neglect. APSAC Advisor, 20(1), 713.
Scheeringa M.S., Wright M.J., Hunt J.P., & Zeanah C.H. (2006). Factors affecting the diagnosis and prediction of PTSD symptomatology in children and adolescents. American Journal of Psychiatry, 163(4), 644651.
Schmitt N. (1996). Uses and abuses of coefficient alpha. Psychological Assessment, 8, 350353.
Stano J.F. (1999). Wechsler Abbreviated Scale of Intelligence. San Antonio, TX: The Psychological Corporation.
Strathearn L., Gray P.H., O’Callaghan F., & Wood D.O. (2001). Childhood neglect and cognitive development in extremely low birth weight infants: A prospective study. Pediatrics, 108, 142151.
Teicher M.H., Ito Y., Glod C.A., Andersen S.L., Dumont N., & Ackerman E. (Eds.). (1997). Preliminary evidence for abnormal cortical development in physically and sexually abused children using EEG coherence and MRI. Annals of the New York Academy of Sciences, 821.
Trickett P.K., & McBride-Chang C. (1995). The developmental impact of different forms of child abuse and neglect. Developmental Review, 15, 311337.
Urquiza A.J., Wirtz S.J., Peterson M.S., & Singer V.A. (1994). Screening and evaluating abused and neglected children entering protective custody. Child Welfare 73(2), 155171.
Wechsler D. (1989). Wechsler Preschool and Primary Scale of Intelligence (Rev. ed). San Antonio, TX: The Psychological Corporation.
Wechsler D. (1991). Wechsler Intelligence Scale for Children (3rd ed.). San Antonio, TX: The Psychological Corporation.
Widom C.S., DuMont K., & Czaja S.J. (2007). A prospective investigation of major depressive disorder and comorbidity in abused and neglected children grown up. Archives of General Psychiatry, 64(1), 4956.
Woodcock R.W., McGrew K.S., & Mather N. 2001 Woodcock-Johnson® III Test. Riverside Publishing Company. Itasca, IL.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 32
Total number of PDF views: 246 *
Loading metrics...

Abstract views

Total abstract views: 1346 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 21st February 2018. This data will be updated every 24 hours.