Executive function as a mediator in the link between single or complex trauma and posttraumatic stress in children and adolescents

Kelder, Rosanne op den; Ensink, Judith; Overbeek, Geertjan; Marić, Marija; Lindauer, Ramón

doi:10.1007/s11136-017-1535-3

Cited by 22 publications

(24 citation statements)

References 45 publications

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“…Nevertheless, psychopathology remained associated with complex trauma even after accounting for early childhood vulnerabilities. These findings from a large, population-based cohort strengthen and extend the limited empirical evidence in this area, 10–13 and caution that conflating complex and non-complex traumas in research and clinical practice has likely led to an underestimation of psychopathology, cognitive deficits and pre-existing vulnerabilities linked with complex trauma.…”

Section: Discussionsupporting

confidence: 66%

Unravelling the contribution of complex trauma to psychopathology and cognitive deficits: a cohort study

et al. 2021

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Background Complex traumas are traumatic experiences that involve multiple interpersonal threats during childhood or adolescence, such as repeated abuse. These traumas are hypothesised to cause more severe psychopathology and poorer cognitive function than other non-complex traumas. However, empirical testing has been limited to clinical/convenience samples and cross-sectional designs. Aims To investigate psychopathology and cognitive function in young people exposed to complex, non-complex or no trauma, from a population-representative longitudinal cohort, and to consider the role of pre-existing vulnerabilities. Method Participants were from the Environmental Risk Longitudinal Twin Study, a population-representative birth cohort of 2232 British children. At age 18 years (93% participation), we assessed lifetime exposure to complex and non-complex trauma, past-year psychopathology and current cognitive function. We also prospectively assessed early childhood vulnerabilities: internalising and externalising symptoms at 5 years of age, IQ at 5 years of age, family history of mental illness, family socioeconomic status and sex. Results Participants exposed to complex trauma had more severe psychopathology and poorer cognitive function at 18 years of age, compared with both trauma-unexposed participants and those exposed to non-complex trauma. Early childhood vulnerabilities predicted risk of later complex trauma exposure, and largely explained associations of complex trauma with cognitive deficits, but not with psychopathology. Conclusions By conflating complex and non-complex traumas, current research and clinical practice underestimate the severity of psychopathology, cognitive deficits and pre-existing vulnerabilities linked with complex trauma. A better understanding of the mental health needs of people exposed to complex trauma could inform the development of new, more effective interventions.

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Section: Discussionsupporting

confidence: 66%

Unravelling the contribution of complex trauma to psychopathology and cognitive deficits: a cohort study

et al. 2021

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“…Heightened levels of stress, both subjective and objective, have been reported in observational studies to be associated with executive dysfunction across multiple populations, including individuals with disabilities, individuals exposed to trauma, older adults, and healthy adult controls (12,(20)(21)(22)(23)(24)(25). Greater perceived stress, a measure of subjective stress in response to external stressors, has been found to be associated with poorer cognitive functioning including attentional control, processing speed, and working memory (20,22).…”

Section: Stress and Cognitive Functionmentioning

confidence: 99%

“…Greater perceived stress, a measure of subjective stress in response to external stressors, has been found to be associated with poorer cognitive functioning including attentional control, processing speed, and working memory (20,22). Likewise, objective indices of stress (e.g., life events, parenting a child with a disability) have been associated with similar aberrations in executive function across diverse populations (24,25). These objective stressors have been found to be associated with cognitive dysfunction (including poorer episodic memory) (26), decreased well-being (27), poor mental health (28,29), as well as changes to biological mechanisms, such as dampened cortisol-awakening-responses (30)(31)(32), and alterations to the neural structures that underlie stress-related responses (21,22,33).…”

Section: Stress and Cognitive Functionmentioning

confidence: 99%

Genetic and Environmental Influences on Self-Reported Cognitive Functioning: Associations of Diverse Measures of Stress across the FMR1 CGG Repeat Range

Maltman

DaWalt

Hong

et al. 2020

Preprint

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Background: The FMR1 gene is essential for neural development and healthy synaptic function. The modal number of CGG repeats in FMR1 is 30, but the range is large with the reported copy number extending down to as few as 6 CGGs and up to over 200 CGGs. Prior work suggests that behavioral phenotypes, including cognitive function, may vary along the continuum of the FMR1 CGG repeat range. Stress also negatively influences cognitive function; however, it is not known whether FMR1-related variability (i.e., CGG repeat length), in addition to stress, independently influences cognitive function across the CGG range. Methods: Participants included 1275 mothers who had between 18 and 123 CGG repeats. Participants completed self-report measures of executive function (BRIEF-A), memory, subjective stress (i.e., perceived stress), and objective stress (i.e., number of life events, parenting a child with a disability). Stress and CGG repeat length were examined as predictors of self-reported executive function and memory difficulty. Results: Each measure of stress (i.e., perceived stress, life events, and parenting a child with a disability) significantly predicted greater self-reported difficulties in executive function and the likelihood of memory problems, net of age and level of education. Additionally, above and beyond stress effects, CGG repeat number significantly predicted executive functioning and memory difficulties. Conclusions: These findings suggest that CGG repeat length confers independent contributions to self-reported executive function difficulty and memory problems over and above indices of stress, suggesting additive effects of genetic variation and environmental exposure.

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Section: Stress and Cognitive Functionmentioning

confidence: 99%

“…Greater perceived stress, a measure of subjective stress in response to external stressors, has been found to be associated with poorer cognitive functioning including attentional control, processing speed, and working memory (24,26). Likewise, objective indices of stress (e.g., life events, parenting a child with a disability) may prompt similar aberrations in executive function across diverse populations (28,29). These objective stressors have also been found to be associated with cognitive dysfunction (including poorer episodic memory) (30), decreased well-being (31), poor mental health (32,33), as well as changes to biological mechanisms, such as dampened cortisol-awakeningresponses (34)(35)(36), and alterations to the neural structures that underlie stress-related responses (25,26,37).…”

Section: Stress and Cognitive Functionmentioning

confidence: 99%

Genetic and Environmental Influences on Self-Reported Cognitive Functioning: Associations of Diverse Measures of Stress across the FMR1 CGG Repeat Range

Maltman¹,

DaWalt²,

Hong³

et al. 2020

Preprint

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Background : The FMR1 gene is essential for neural development and healthy synaptic function. The modal number of CGG repeats in FMR1 is 30, but the range is large with the reported copy number extending down to as few as 6 CGGs and up to over 200 CGGs, conferring fragile X syndrome. Prior work suggests that behavioral phenotypes, including cognitive function, may vary along the continuum of the FMR1 CGG repeat range. Stress may negatively influence cognitive function; however, it is not known whether FMR1 -related variability (i.e., CGG repeat length), in addition to stress, independently influences cognitive function across the CGG range. Methods : Participants included 1275 mothers who had CGGs ranging from 18 to 123 repeats. Participants completed self-report measures of executive function (BRIEF-A), memory, subjective stress (i.e., perceived stress), and objective stress (i.e., number of life events, parenting a child with a disability). Stress and FMR1 -related variability (i.e., CGG repeat length) were examined as predictors of self-reported executive function and memory difficulty. Results : Each measure of stress (i.e., perceived stress, life events, and parenting a child with a disability) significantly predicted greater self-reported difficulties in executive function and the likelihood of memory problems, net of age and level of education. Additionally, above and beyond stress effects, CGG repeat number significantly predicted executive functioning and memory difficulties. There was a linear association of CGG repeat number with executive functioning limitations. The association of CGGs with memory difficulties was curvilinear, with participants in the premutation range having the greatest likelihood of reporting such difficulties. Conclusions : These findings suggest that CGG repeat length confers independent contributions to self-reported executive function difficulty and memory problems over and above indices of stress, suggesting additive effects of genetic variation and environmental exposure. Keywords : Stress, Cognitive Function, Executive Function, Memory, FMR1 , CGG Repeats

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Executive function as a mediator in the link between single or complex trauma and posttraumatic stress in children and adolescents

Cited by 22 publications

References 45 publications

Unravelling the contribution of complex trauma to psychopathology and cognitive deficits: a cohort study

Unravelling the contribution of complex trauma to psychopathology and cognitive deficits: a cohort study

Genetic and Environmental Influences on Self-Reported Cognitive Functioning: Associations of Diverse Measures of Stress across the FMR1 CGG Repeat Range

Genetic and Environmental Influences on Self-Reported Cognitive Functioning: Associations of Diverse Measures of Stress across the FMR1 CGG Repeat Range

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