The impact of a history of child abuse on cognitive performance: a cross-sectional study in older patients with a depressive, anxiety, or somatic symptom disorder

Abstract

Background Child abuse is a major global burden with an enduring negative impact on mental and physical health. A history of child abuse is consistently associated with worse cognitive performance among adults; data in older age groups are inconclusive. Since affective symptoms and cognitive functioning are interrelated among older persons, a synergistic effect can be assumed in patients with affective symptoms who also have suffered from child abuse. This study examines the association between a history of child abuse and cognitive performance in such patients. Methods Cross-sectional data were collected from the ‘Routine Outcome Monitoring for Geriatric Psychiatry & Science’ project, including 179 older adults (age 60–88 years) with either a unipolar depressive, any anxiety, or somatic symptom disorder referred to specialized geriatric mental health care. A history of physical, sexual, and psychological abuse, and emotional neglect was assessed with a structured interview. Cognitive functioning was measured with three paper and pencils tests (10-words verbal memory test, Stroop Colour-Word test, Digit Span) and four tests from the computerized Cogstate Test Battery (Detection Test, Identification Test, One Card Learning Test, One Back Test). The association between a history of child abuse and cognitive performance was examined by multiple linear regression analyses adjusted for covariates. Results Principal component analyses of nine cognitive parameters revealed four cognitive domains, i.e., visual-verbal memory, psychomotor speed, working memory and interference control. A history of child abuse was not associated with any of these cognitive domains. However, when looking at the specific types of child abuse separately, a history of physical abuse and emotional neglect were associated with poorer interference control. A history of physical abuse was additionally associated with better visual-verbal memory. Conclusions The association between a history of child abuse and cognitive performance differs between the different types of abuse. A history of physical abuse might particularly be a key determinant of cognitive performance in older adults with a depressive, anxiety, or somatic symptom disorder. Future studies on the impact of these disorders on the onset of dementia should take child abuse into account. Trial registration ROM-GPS is registered at the Dutch Trial Register (NL6704 at www.trialregister.nl).

Complex Intersections Between Adverse Childhood Experiences and Negative Life Events Impact the Phenome of Major Depression

“… 76 Like working memory and set shifting (flexibility), inhibitory control is an essential component of the executive functions, which are higher-order cognitive processes. 77 Thus, our findings extend those of Tjoelker et al, 78 who found that a history of physical maltreatment and emotional neglect is associated with diminished interference control in older individuals with depressive, anxious, and somatic symptoms. A significant correlation was identified by Lund et al 79 in a systematic review between ACEs and executive deficits in children, specifically in relation to maternal depression.…”

In major depression, complex intersections between adverse childhood experiences and negative life events impact neuroticism, brooding, suicidal tendencies, insomnia, and cognitive interference

“…76 Like working memory and set shifting (flexibility), inhibitory control is an essential component of the executive functions, which are higher-order cognitive processes. 77 Thus, our findings extend those of Tjoelker et al, 78 who found that a history of physical maltreatment and emotional neglect is associated with diminished interference control in older individuals with depressive, anxious, and somatic symptoms. A significant correlation was identified by Lund et al 79 in a systematic review between ACEs and executive deficits in children, specifically in relation to maternal depression.…”

Psychological interventions for depression in children and adolescents: A bibliometric analysis

“…Intervention strategies targeting the risk factors in early life could reduce the incidence of dementia or substantially delay its onset[ 52 ]. Recent studies have found that low adolescent cognitive ability[ 53 , 54 ] and adverse childhood experiences[ 55 , 56 ] have a significant association with dementia risk in later life. Depression that occurs in childhood and adolescence is often accompanied by varying degrees of cognitive impairment in attention, memory, and executive functioning, or even interrupted educational trajectories[ 4 ].…”