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Neuropsychological findings in childhood neglect and their relationships to pediatric PTSD

Published online by Cambridge University Press:  01 November 2009

MICHAEL D. DE BELLIS ,
STEPHEN R. HOOPER ,
EVE G. SPRATT  and
DONALD P. WOOLLEY
MICHAEL D. DE BELLIS*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
STEPHEN R. HOOPER
Affiliation:
Departments of Psychiatry and Pediatrics, and The Center for Development and Learning, Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill, North Carolina
EVE G. SPRATT
Affiliation:
Department of Pediatrics and Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
DONALD P. WOOLLEY
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
*
*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
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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.)

Keywords

Neurocognitive functioning in maltreatmentChildhood maltreatmentCognitive functioning in neglectAcademic achievementAttentionmemoryIQExecutive functionNeuropsychological tests
Type
Symposia
Information
Journal of the International Neuropsychological Society , Volume 15 , Issue 6 , November 2009 , pp. 868 - 878
Copyright
Copyright © The International Neuropsychological Society 2009

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