Child abuse is associated with greater cognitive difficulties than previously thought

New research from the Institute of Psychiatry, Psychology and Neuroscience (IoPPN) at King’s College London and the City University of New York suggests that cognitive difficulties associated with child abuse, and particularly neglect, have been largely underestimated in previous studies.

The research, published in Lancet Psychiatrysuggests that the over-reliance on retrospective self-reports of maltreatment in research has resulted in a biased evidence base that overlooks the challenges faced by children and young people with documented exposure to maltreatment.

The researchers in this study tested the relative associations between court-documented exposure to childhood maltreatment and adult recall of that maltreatment and cognitive abilities in the same individuals. A group of 1,179 participants was identified from an ongoing cohort in the United States. All participants underwent a series of tests to assess their cognitive abilities in adulthood.

The researchers found that participants with a formal history of childhood maltreatment showed, on average, cognitive deficits on most tests compared to those without. In contrast, participants who had retrospectively reported maltreatment showed no deficits compared to those who had not.

The researchers also noted that these results were not consistent across different types of abuse. Participants who had a history of neglect had cognitive deficits, but those with a history of physical and sexual abuse did not.

Andrea Danese, Professor of Child and Adolescent Psychiatry at King’s IoPPN and one of the study’s co-authors, said: “Although there are some important exceptions, most research in this area has relied on retrospective reports of child maltreatment from adult participants. Our study showed that this reliance on retrospective reports has likely led researchers and clinicians to underestimate the extent to which people with documented abuse, and particularly neglect, suffer from cognitive deficits.

“Our study highlights the importance of identifying young people who have experienced neglect so that appropriate support can be put in place, for example to mitigate negative consequences in education and employment.”

Further research is needed to understand why people with a documented history of neglect exhibit cognitive deficits. Researchers suspect that this may be due to a lack of stimulation in childhood, familial transmission of cognitive problems, and/or the role of other experiences that often accompany neglect, such as family poverty. Unraveling the mechanisms underlying the observed associations will provide useful information for developing effective interventions.