Abstract
Childhood maltreatment is associated with cognitive deficits that in turn have been predictive for therapeutic outcome in psychiatric patients. However, previous studies have either investigated maltreatment associations with single cognitive domains or failed to adequately control for confounders such as depression, socioeconomic environment, and genetic predisposition. We aimed to isolate the relationship between childhood maltreatment and dysfunction in diverse cognitive domains, while estimating the contribution of potential confounders to this relationship, and to investigate gene–environment interactions. We included 547 depressive disorder and 670 healthy control participants (mean age: 34.7 years, SD = 13.2). Cognitive functioning was assessed for the domains of working memory, executive functioning, processing speed, attention, memory, and verbal intelligence using neuropsychological tests. Childhood maltreatment and parental education were assessed using self-reports, and psychiatric diagnosis was based on DSM-IV criteria. Polygenic scores for depression and for educational attainment were calculated. Multivariate analysis of cognitive domains yielded significant associations with childhood maltreatment (η²p = 0.083, P < 0.001), depression (η²p = 0.097, P < 0.001), parental education (η²p = 0.085, P < 0.001), and polygenic scores for depression (η²p = 0.021, P = 0.005) and educational attainment (η²p = 0.031, P < 0.001). Each of these associations remained significant when including all of the predictors in one model. Univariate tests revealed that maltreatment was associated with poorer performance in all cognitive domains. Thus, environmental, psychopathological, and genetic risk factors each independently affect cognition. The insights of the current study may aid in estimating the potential impact of different loci of interventions for cognitive dysfunction. Future research should investigate if customized interventions, informed by individual risk profiles and related cognitive preconditions, might enhance response to therapeutic treatments.
Highlights
Childhood maltreatment (CM) has been discussed as a major vulnerability factor for various psychiatric disorders, including affective disorders, anxiety disorders, and posttraumatic stress disorder (PTSD) [1], as well as personality disorders [2]
We find that environmental (CM and parental education (PE)), psychopathological (MDD diagnosis), and genetic variables (PGS for major depressive disorder (MDD) and educational attainment (EdA)) are all independently associated with cognitive functioning even when comprehensively controlling for each other
Our findings suggest that CM is associated with lower performance in a variety of cognitive domains
Summary
Childhood maltreatment (CM) has been discussed as a major vulnerability factor for various psychiatric disorders, including affective disorders, anxiety disorders, and posttraumatic stress disorder (PTSD) [1], as well as personality disorders [2]. Regarding major depressive disorder (MDD), there is growing evidence that CM is associated with higher risk to develop MDD, higher symptom severity, an unfavorable disease trajectory, and lower treatment response [3, 4] While these findings stress the relevance of CM to psychiatric research, it is uncertain what mechanisms drive these adverse effects. Research suggests that repeated or enduring stress during sensitive developmental stages of childhood or adolescence promotes biological long-term adverse effects, in limbic and prefrontal areas, that persist until adulthood [5,6,7,8,9] These neurobiological alterations are accompanied by functional deficits in various cognitive domains. Another meta-analysis investigating samples with several psychiatric diagnoses found that largest effects of CM on cognition were evident in the attention and Received: 4 March 2020 Revised: 8 June 2020 Accepted: 22 July 2020 Published online: 14 August 2020
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