BACKGROUND Cognitive deficits might contribute to the elevated risk of life-course psychopathology observed in maltreated children. Leading theories about the links between childhood maltreatment and cognitive deficits focus on documented exposures (objective experience), but empirical research has largely relied on retrospective self-reports of these experiences (subjective experience), and the two measures identify largely non-overlapping groups. We aimed to test the associations of objective and subjective measures of maltreatment with cognitive abilities within the same individuals. METHODS We studied a cohort of individuals from the US Midwest with both objective, court-documented evidence of childhood maltreatment and subjective self-reports of individuals' histories at age 29 years. Between the ages of 29 years and 41 years, participants were assessed with a comprehensive set of cognitive tests, including tests of general verbal intelligence (Quick Test and Wide Range Achievement Test-Revised [WRAT]), non-verbal intelligence (Matrix Reasoning Test [MRT]), executive function (Stroop Test and Trail Making Test Part B [TMT-B]), and processing speed (Trail Making Test Part A [TMT-A]). Participants were also assessed for psychopathology (Center for Epidemiologic Studies Depression Scale and Beck Anxiety Inventory). We tested the associations between objective or subjective measures of childhood maltreatment with cognitive functions using ordinary least squares regression. To test whether cognitive deficits could explain previously described associations between different measures of maltreatment and subsequent psychopathology, we re-ran the analyses accounting for group differences in the Quick Test. People with lived experience were not involved in the research or writing process. FINDINGS The cohort included 1196 individuals (582 [48·7%] female, 614 [51·3%] male; 752 [62·9%] White, 417 [34·9%] Black, 36 [3·8%] Hispanic) who were assessed between 1989 and 2005. Of the 1179 participants with available data, 173 had objective-only measures of childhood maltreatment, 492 had objective and subjective measures, 252 had subjective-only measures, and 262 had no measures of childhood maltreatment. Participants with objective measures of childhood maltreatment showed pervasive cognitive deficits compared with those without objective measures (Quick Test: β=-7·97 [95% CI -9·63 to -6·30]; WRAT: β=-7·41 [-9·09 to -5·74]; MRT: β=-3·86 [-5·86 to -1·87]; Stroop Test: β=-1·69 [-3·57 to 0·20]; TMT-B: β=3·66 [1·67 to 5·66]; TMT-A: β=2·92 [0·86 to 4·98]). The associations with cognitive deficits were specific to objective measures of neglect. In contrast, participants with subjective measures of childhood maltreatment did not differ from those without subjective measures (Quick Test: β=1·73 [95% CI -0·05 to 3·50]; WRAT: β=1·62 [-0·17 to 3·40]; MRT: β=0·19 [-1·87 to 2·24]; Stroop Test: β=-1·41 [-3·35 to 0·52]; TMT-B: β=-0·57 [-2·69 to 1·55]; TMT-A: β=-0·36 [-2·38 to 1·67]). Furthermore, cognitive deficits did not explain associations between different measures of maltreatment and subsequent psychopathology. INTERPRETATION Previous studies based on retrospective reports of childhood maltreatment have probably grossly underestimated the extent of cognitive deficits in individuals with documented experiences of childhood maltreatment, particularly neglect. Psychopathology associated with maltreatment is unlikely to emerge because of cognitive deficits, but might instead be driven by individual appraisals, autobiographical memories, and associated schemas. FUNDING National Institute of Justice, National Institute of Mental Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute on Aging, Doris Duke Charitable Foundation, and National Institute for Health and Care Research.

中文翻译：

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儿童虐待的客观和主观经历及其与认知缺陷的关系：美国的一项队列研究。


背景认知缺陷可能导致在受虐待儿童中观察到的生命全程精神病理学风险升高。关于儿童虐待和认知缺陷之间联系的主要理论侧重于记录的暴露（客观经验），但实证研究很大程度上依赖于这些经历的回顾性自我报告（主观经验），并且这两种衡量标准基本上确定了不重叠的群体。我们的目的是测试虐待的客观和主观测量与同一个人的认知能力之间的关联。方法 我们对来自美国中西部的一群人进行了研究，这些人既有法庭记录的童年虐待的客观证据，也有个人 29 岁时主观自我报告的历史记录。年龄在 29 岁至 41 岁之间的参与者接受了一套全面的认知测试，包括一般语言智力测试（快速测试和大范围成就测试修订版 [WRAT]）、非语言智力测试（矩阵推理测试） [MRT]）、执行功能（Stroop 测试和轨迹制作测试 B 部分 [TMT-B]）以及处理速度（轨迹制作测试 A 部分 [TMT-A]）。还对参与者进行了精神病理学评估（流行病学研究中心抑郁量表和贝克焦虑量表）。我们使用普通最小二乘回归测试了儿童虐待的客观或主观测量与认知功能之间的关联。为了测试认知缺陷是否可以解释先前描述的不同虐待措施与随后的精神病理学之间的关联，我们重新进行了快速测试中群体差异的分析。 有生活经验的人没有参与研究或写作过程。结果 该队列包括 1196 人（582 [48·7%] 女性，614 [51·3%] 男性；752 [62·9%] 白人，417 [34·9%] 黑人，36 [3·8%] 1989 年至 2005 年间接受评估的 1179 名参与者中，173 人有儿童虐待的客观测量，492 人有客观和主观测量，252 人有仅主观测量，262 人没有儿童虐待测量。与没有客观测量的参与者相比，接受过儿童虐待客观测量的参与者表现出普遍的认知缺陷（快速测试：β=-7·97 [95% CI -9·63 至 -6·30]；WRAT：β=-7·41 [-9·09 至 -5·74]；MRT：β=-3·86 [-5·86 至 -1·87]；斯特鲁普测试：β=-1·69 [-3·57 至 0·20] TMT-B：β＝3·66[1·67至5·66]；TMT-A：β＝2·92[0·86至4·98])。与认知缺陷的关联特定于忽视的客观测量。相比之下，对儿童虐待进行主观测量的参与者与没有主观测量的参与者没有差异（快速测试：β=1·73 [95% CI -0·05 至 3·50]；WRAT：β=1·62 [- 0·17 至 3·40]；MRT：β=0·19 [-1·87 至 2·24]；Stroop 测试：β=-1·41 [-3·35 至 0·52]； ：β＝-0·57[-2·69～1·55]；TMT-A：β＝-0·36[-2·38～1·67])。此外，认知缺陷并不能解释不同的虐待措施与随后的精神病理学之间的关联。解释 先前基于儿童虐待回顾性报告的研究可能严重低估了有记录的儿童虐待经历（尤其是忽视）的个体的认知缺陷程度。 由于认知缺陷，与虐待相关的精神病理学不太可能出现，但可能是由个人评价、自传记忆和相关图式驱动的。资助国家司法研究所、国家心理健康研究所、尤尼斯·肯尼迪·施赖弗国家儿童健康和人类发展研究所、国家老龄化研究所、多丽丝·杜克慈善基金会和国家健康与护理研究所。