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      Childhood maltreatment interacts with hypothalamic-pituitary-adrenal axis negative feedback and major depression: effects on cognitive performance Translated title: El maltrato infantil interactúa con la retroalimentación negativa del eje hipotalámico-hipofisario-adrenal y la depresión mayor: efectos sobre el rendimiento cognitivo. Translated title: 童年期虐待与下丘脑-垂体-肾上腺轴负反馈和重性抑郁障碍的相互作用:对认知表现的影响

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      European Journal of Psychotraumatology
      Taylor & Francis
      Childhood abuse, childhood neglect, cortisol, HPA axis, dexamethasone suppression test, cognition, memory, major depression, abuso infantil, negligencia infantil, cortisol, eje HHA, prueba de supresión de dexametasona, cognición, memoria, depresión mayor, 童年期虐待, 儿童忽视, 皮质醇, HPA轴, 地塞米松抑制试验, 认知, 记忆, 重性抑郁

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          ABSTRACT

          Background: Childhood maltreatment (CM) is associated with impaired hypothalamic-pituitary-adrenal (HPA) axis negative feedback and cognitive dysfunction, resembling those abnormalities linked to major depressive disorder (MDD).

          Objectives: We aimed to assess the potential modulating effects of MDD diagnosis or HPA axis function in the association between different types of CM and cognitive performance in adulthood.

          Methods: Sixty-eight MDD patients and 87 healthy controls were recruited. CM was assessed with the Childhood Trauma Questionnaire. We obtained three latent variables for neuropsychological performance (verbal memory, visual memory and executive function/processing speed) after running a confirmatory factor analysis with cognitive tests applied. Dexamethasone suppression test ratio (DSTR) was performed using dexamethasone 0.25 mg.

          Results: Different types of CM had different effects on cognition, modulated by MDD diagnosis and HPA axis function. Individuals with physical maltreatment and MDD presented with enhanced cognition in certain domains. The DSTR differentially modulated the association between visual memory and physical neglect or sexual abuse.

          Conclusions: HPA axis-related neurobiological mechanisms leading to cognitive impairment might differ depending upon the type of CM. Our results suggest a need for early assessment and intervention on cognition and resilience mechanisms in individuals exposed to CM to minimize its deleterious and lasting effects.

          Summary

          HIGHLIGHTS

          • We studied the effects of childhood maltreatment (CM), HPA axis feedback (DST), and depression on cognition.

          • Different types of CM had a distinct impact on cognitive performance.

          • MDD diagnosis and DST modulated the association between CM and cognition.

          Translated abstract

          Antecedentes: El maltrato infantil (MI) se asocia con una alteración en la retroalimentación negativa del eje hipotalámico-hipofisario-adrenal (HHA) y disfunción cognitiva, que se asemejan a las anomalías vinculadas al trastorno depresivo mayor (TDM).

          Objetivos: Nuestro objetivo fue evaluar los posibles efectos moduladores del diagnóstico de TDM y de la función del eje HHA en la asociación entre diferentes tipos de MI y el rendimiento cognitivo en la edad adulta.

          Métodos: Se reclutaron 68 pacientes con TDM y 87 controles sanos. El MI se evaluó con el Cuestionario de trauma infantil. Se obtuvieron tres variables latentes para el rendimiento neuropsicológico (memoria verbal, memoria visual y función ejecutiva/velocidad de procesamiento) tras realizar un análisis factorial confirmatorio con las pruebas cognitivas aplicadas. La ratio de supresión de cortisol en el test de supresión con dexametasona (DSTR) se realizó usando dexametasona 0,25 mg.

          Resultados: Los diferentes tipos de MI tuvieron diferentes efectos sobre la cognición, modulados por el diagnóstico de TDM y la función del eje HHA. Los individuos con maltrato físico y TDM presentaron una cognición mejorada en ciertos dominios. El DSTR moduló diferencialmente la asociación entre memoria visual y negligencia física o abuso sexual.

          Conclusiones: Los mecanismos neurobiológicos relacionados con el eje HHA que conducen al deterioro cognitivo pueden diferir según el tipo de MI. Nuestros resultados sugieren la necesidad de una evaluación e intervención tempranas sobre la cognición y los mecanismos de resiliencia en individuos expuestos a MI para minimizar sus efectos nocivos y duraderos.

          Translated abstract

          背景: 童年期虐待 (CM) 与下丘脑-垂体-肾上腺 (HPA) 轴负反馈受损和认知功能损伤有关, 类似于重性抑郁障碍 (MDD) 相关异常。

          目的: 我们的目的是在不同类型CM与成年认知表现之间的关联中评估MDD诊断或HPA轴功能的潜在调节作用。

          方法: 招募了68名MDD患者和87名健康对照者。通过儿童创伤问卷评估了CM。在使用认知测试进行验证性因素分析后, 我们得到了3个神经心理学表现潜变量 (语言记忆, 视觉记忆和执行功能/处理速度) 。使用0.25mg地塞米松得到地塞米松抑制试验比率 (DSTR) 。

          结果: 不同类型CM对认知的影响不同, 受到MDD诊断和HPA轴功能的调节。遭受身体虐待和MDD的个体在某些领域认知增强。 DSTR有差异地调节了视觉记忆与身体忽视或性虐待之间的关联。

          结论: 导致认知损伤的HPA轴相关神经生物学机制可能因CM类型而异。我们的结果表明需要对CM暴露个体的认知和韧性机制进行早期评估和干预, 以将其有害和持久影响最小化。

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          Most cited references85

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          A RATING SCALE FOR DEPRESSION

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            Adverse childhood experiences and the risk of depressive disorders in adulthood.

            Research examining the association between childhood abuse and depressive disorders has frequently assessed abuse categorically, thus not permitting discernment of the cumulative impact of multiple types of abuse. As previous research has documented that adverse childhood experiences (ACEs) are highly interrelated, we examined the association between the number of such experiences (ACE score) and the risk of depressive disorders. Retrospective cohort study of 9460 adult health maintenance organization members in a primary care clinic in San Diego, CA who completed a survey addressing a variety of health-related concerns, which included standardized assessments of lifetime and recent depressive disorders, childhood abuse and household dysfunction. Lifetime prevalence of depressive disorders was 23%. Childhood emotional abuse increased risk for lifetime depressive disorders, with adjusted odds ratios (ORs) of 2.7 [95% confidence interval (CI), 2.3-3.2] in women and 2.5 (95% CI, 1.9-3.2) in men. We found a strong, dose-response relationship between the ACE score and the probability of lifetime and recent depressive disorders (P<0.0001). This relationship was attenuated slightly when a history of growing up with a mentally ill household member was included in the model, but remained significant (P<0.001). The number of ACEs has a graded relationship to both lifetime and recent depressive disorders. These results suggest that exposure to ACEs is associated with increased risk of depressive disorders up to decades after their occurrence. Early recognition of childhood abuse and appropriate intervention may thus play an important role in the prevention of depressive disorders throughout the life span.
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              Neural consequences of environmental enrichment.

              Neuronal plasticity is a central theme of modern neurobiology, from cellular and molecular mechanisms of synapse formation in Drosophila to behavioural recovery from strokes in elderly humans. Although the methods used to measure plastic responses differ, the stimuli required to elicit plasticity are thought to be activity-dependent. In this article, we focus on the neuronal changes that occur in response to complex stimulation by an enriched environment. We emphasize the behavioural and neurobiological consequences of specific elements of enrichment, especially exercise and learning.
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                Author and article information

                Journal
                Eur J Psychotraumatol
                Eur J Psychotraumatol
                European Journal of Psychotraumatology
                Taylor & Francis
                2000-8198
                2000-8066
                10 March 2021
                2021
                : 12
                : 1
                : 1857955
                Affiliations
                [a ]Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health; , Barcelona, Spain
                [b ]Corporació Sanitària Parc Taulí, Department of Mental Health, I3PT; , Sabadell, Spain
                [c ]Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute; , Madrid, Spain
                [d ]Institut d'Investigació i Innovació Parc Taulí (I3PT), Department of Mental Health, Consorci Sanitari del Maresme; , Mataró, Spain
                [e ]Department of Clinical Sciences; , School of Medicine, Universitat de Barcelona, Barcelona, Spain
                [f ]Centro de Investigación Biomédica en Red de Fisiopatología Obesidad y Nutrición (CIBEROBN), Carlos III Health Institute; , Madrid, Spain
                [g ]Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona; , Bellaterra, Spain
                Author notes
                CONTACT Virginia Soria vsoria@ 123456bellvitgehospital.cat Department of Psychiatry, Bellvitge University Hospital-IDIBELL; , Feixa Llarga s/n, 08907, L´Hospitalet de Llobregat, Barcelona, Spain
                Author information
                https://orcid.org/0000-0001-5320-331X
                https://orcid.org/0000-0003-2214-1886
                https://orcid.org/0000-0002-9746-4068
                https://orcid.org/0000-0002-7877-7341
                https://orcid.org/0000-0002-0959-0356
                https://orcid.org/0000-0003-4523-1649
                https://orcid.org/0000-0002-3040-1177
                https://orcid.org/0000-0002-3596-8033
                https://orcid.org/0000-0003-4574-6597
                https://orcid.org/0000-0002-6231-6524
                https://orcid.org/0000-0001-6412-6831
                Article
                1857955
                10.1080/20008198.2020.1857955
                7968873
                332ed5ac-266e-48c9-9acc-ae1e8f62490a
                © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 1, Tables: 4, References: 85, Pages: 1
                Categories
                Research Article
                Clinical Research Article

                Clinical Psychology & Psychiatry
                childhood abuse,childhood neglect,cortisol,hpa axis,dexamethasone suppression test,cognition,memory,major depression,abuso infantil,negligencia infantil,eje hha,prueba de supresión de dexametasona,cognición,memoria,depresión mayor,童年期虐待,儿童忽视,皮质醇,hpa轴,地塞米松抑制试验,认知,记忆,重性抑郁

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