Prefrontal Dysfunction in Girls with Post-Traumatic Stress Disorder Secondary to Child Sexual Abuse, and Its Relation to Basal Cortisol Levels

Abstract

Child sexual abuse is a stressful event that is often associated with Post-traumatic Stress Disorder (PTSD), alterations in the hypothalamic-pituitary-adrenal axis and such brain structures as the prefrontal cortex, which is related to the executive functions and other higher order processes. Though it has been reported that child sexual abuse survivors with PTSD have higher baseline cortisol levels, and that this is associated with cognitive decline, the relation between it and cognitive performance in victims of child sexual abuse with PTSD is not clear. Therefore, the objective of this research was to determine the relation between basal cortisol levels and the cognitive functions related to the prefrontal cortex in female adolescents with PTSD secondary to child sexual abuse. Twenty 12-15-year-old girls with PTSD secondary to child sexual abuse and 20 control adolescents with no history of abuse were evaluated. The groups were matched according to age, IQ, socioeconomic status and schooling. Cognitive processes related to the prefrontal cortex were evaluated using BANFE-2, BRIEF and the STOP-IT task. Also, three saliva samples were collected from each participant during two consecutive days. Findings show that the PTSD group had lower performance on most of the BANFE-2 tasks, more executive problems according to BRIEF, and higher cortisol levels than the control group. Finally, there was a correlation between basal cortisol levels and the indexes of the test that evaluated prefrontal cognitive functions; thus, it is feasible to suggest that the cognitive deficiencies observed are related to anatomo-functional alterations of the prefrontal cortex, since this structure has a high density of glucocorticoid receptors.