Patterning of individual variability in neurocognitive health among South African women exposed to childhood maltreatment

Christy A Denckla,Sun Yeop Lee,Soraya Seedat,Georgina Spies,Jennifer J Vasterling,Rockli Kim,S V Subramanian

doi:10.1038/s41598-021-85979-9

Abstract

There are individual differences in health outcomes following exposure to childhood maltreatment, yet constant individual variance is often assumed in analyses. Among 286 Black, South African women, the association between childhood maltreatment and neurocognitive health, defined here as neurocognitive performance (NP), was first estimated assuming constant variance. Then, without assuming constant variance, we applied Goldstein’s method (Encyclopedia of statistics in behavioral science, Wiley, 2005) to model “complex level-1 variation” in NP as a function of childhood maltreatment. Mean performance in some tests of information processing speed (Digit-symbol, Stroop Word, and Stroop Color) lowered with increasing severity of childhood maltreatment, without evidence of significant individual variation. Conversely, we found significant individual variation by severity of childhood maltreatment in tests of information processing speed (Trail Making Test) and executive function (Color Trails 2 and Stroop Color-Word), in the absence of mean differences. Exploratory results suggest that the presence of individual-level heterogeneity in neurocognitive performance among women exposed to childhood maltreatment warrants further exploration. The methods presented here may be used in a person-centered framework to better understand vulnerability to the toxic neurocognitive effects of childhood maltreatment at the individual level, ultimately informing personalized prevention and treatment.

Highlights

There are individual differences in health outcomes following exposure to childhood maltreatment, yet constant individual variance is often assumed in analyses
Given the implications of compromised neurocognitive competence on health and well-being across the lifespan associated with exposure to childhood maltreatment, we sought to quantify the magnitude of individual variability because understanding the factors that systematically contribute to differential variation in health outcomes might inform personalized approaches to prevention and treatment
Given that this study was an exploratory analysis, we broadly hypothesized that exposure to childhood maltreatment would be associated with increased individual variability in neurocognitive performance compared to non-exposed individuals given prior findings documenting individual differences associated with exposure to childhood m altreatment[31,32]

Summary

Introduction

There are individual differences in health outcomes following exposure to childhood maltreatment, yet constant individual variance is often assumed in analyses. The extant literature applying Goldstein’s22 methodology to understand individual variation in health outcomes has identified systematic heterogeneity in body mass index by low and middle income country r esidence[24] and adult anthropometry by wealth and e ducation[25], suggesting non-random factors are driving some of the individual variation in these health indicators These studies illustrate that understanding factors that systematically contribute to differential variation may have downstream clinical and public health implications, and may inform personalized clinical intervention and prevention strategies. We predicted that exposure to childhood maltreatment would be associated with increased variability in neurocognitive performance independent of the average association, even when controlling for other sources of potential variability including background demographic variables and psychiatric burden of depressive and posttraumatic stress symptoms

Methods

Results

Conclusion