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Association between traumatic stress load, psychopathology, and cognition in the Philadelphia Neurodevelopmental Cohort

Published online by Cambridge University Press:  15 April 2018

Ran Barzilay Open the ORCID record for Ran Barzilay [Opens in a new window] ,
Monica E. Calkins ,
Tyler M. Moore ,
Daniel H. Wolf ,
Theodore D. Satterthwaite ,
J. Cobb Scott ,
Jason D. Jones ,
Tami D. Benton ,
Ruben C. Gur  and
Raquel E. Gur
Ran Barzilay*
Affiliation:
Department of Child and Adolescent Psychiatry and Behavioral Sciences, Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; CHOP, Philadelphia, PA, USA Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
Monica E. Calkins
Affiliation:
Department of Child and Adolescent Psychiatry and Behavioral Sciences, Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; CHOP, Philadelphia, PA, USA
Tyler M. Moore
Affiliation:
Department of Child and Adolescent Psychiatry and Behavioral Sciences, Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; CHOP, Philadelphia, PA, USA
Daniel H. Wolf
Affiliation:
Department of Child and Adolescent Psychiatry and Behavioral Sciences, Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; CHOP, Philadelphia, PA, USA
Theodore D. Satterthwaite
Affiliation:
Department of Child and Adolescent Psychiatry and Behavioral Sciences, Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; CHOP, Philadelphia, PA, USA
J. Cobb Scott
Affiliation:
Department of Child and Adolescent Psychiatry and Behavioral Sciences, Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; CHOP, Philadelphia, PA, USA
Jason D. Jones
Affiliation:
Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
Tami D. Benton
Affiliation:
Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
Ruben C. Gur
Affiliation:
Department of Child and Adolescent Psychiatry and Behavioral Sciences, Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; CHOP, Philadelphia, PA, USA Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
Raquel E. Gur
Affiliation:
Department of Child and Adolescent Psychiatry and Behavioral Sciences, Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine; CHOP, Philadelphia, PA, USA Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
*
Author for correspondence: Ran Barzilay, E-mail: barzilayr@chop.email.edu
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Abstract

Background

Traumatic stressors during childhood and adolescence are associated with psychopathology, mostly studied in the context of post-traumatic stress disorder (PTSD) and depression. We investigated broader associations of traumatic stress exposure with psychopathology and cognition in a youth community sample.

Methods

The Philadelphia Neurodevelopmental Cohort (N = 9498) is an investigation of clinical and neurobehavioral phenotypes in a diverse (56% Caucasian, 33% African American, 11% other) US youth community population (aged 8–21). Participants were ascertained through children's hospital pediatric (not psychiatric) healthcare network in 2009–2011. Structured psychiatric evaluation included screening for lifetime exposure to traumatic stressors, and a neurocognitive battery was administered.

Results

Exposure rate to traumatic stressful events was high (none, N = 5204; one, N = 2182; two, N = 1092; three or more, N = 830). Higher stress load was associated with increased psychopathology across all clinical domains evaluated: mood/anxiety (standardized β = .378); psychosis spectrum (β = .360); externalizing behaviors (β = .311); and fear (β = .256) (controlling for covariates, all p < 0.001). Associations remained significant controlling for lifetime PTSD and depression. Exposure to high-stress load was robustly associated with suicidal ideation and cannabis use (odds ratio compared with non-exposed 5.3 and 3.2, respectively, both p < 0.001). Among youths who experienced traumatic stress (N = 4104), history of assaultive trauma was associated with greater psychopathology and, in males, vulnerability to psychosis and externalizing symptoms. Stress load was negatively associated with performance on executive functioning, complex reasoning, and social cognition.

Conclusions

Traumatic stress exposure in community non-psychiatric help-seeking youth is substantial, and is associated with more severe psychopathology and neurocognitive deficits across domains, beyond PTSD and depression.

Keywords

Child psychiatrycognitiondevelopmental psychopathologytraumatic stress
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 2 , January 2019 , pp. 325 - 334
Copyright
Copyright © Cambridge University Press 2018 

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