Journal of the International Neuropsychological Society

Symposia

Neuropsychological findings in childhood neglect and their relationships to pediatric PTSD

MICHAEL D. DE BELLISa1 c1, STEPHEN R. HOOPERa2, EVE G. SPRATTa3 and DONALD P. WOOLLEYa1

a1 Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina

a2 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

a3 Department of Pediatrics and Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina

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.)

(Received December 18 2008)

(Reviewed March 22 2009)

(Accepted May 12 2009)

Correspondence:

c1 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