New research suggests that the cognitive difficulties associated with childhood maltreatment, and particularly neglect, have been grossly underestimated in previous studies.
The research, published in Lancet Psychiatry, suggests that the overreliance 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.
Researchers at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London and City University of New York tested the relative associations of court-documented exposure to, and adult recall of, childhood maltreatment with cognitive abilities within the same individuals. 1179 participants were identified from an ongoing cohort in the USA. All participants underwent a variety of tests in order to assess their cognitive abilities in adult life.
Researchers found that participants with official records of childhood maltreatment showed, on average, cognitive deficits across most tests undertaken compared to those without records. In contrast, the participants who retrospectively self-reported maltreatment did not demonstrate deficits when compared with those without reports.
Researchers also noted that these findings were not consistent across the different types of maltreatment. Participants who had documented experiences of neglect demonstrated cognitive deficits, but those who had documented experiences of physical and sexual abuse did not.
While there are some important exceptions, most research in this area has relied on retrospective reports of childhood maltreatment from adult participants. Our study has shown that this reliance on retrospective reports has likely resulted in researchers and clinicians underestimating the extent to which individuals with documented cases of maltreatment, and particularly neglect, are experiencing cognitive deficits.
Andrea Danese, Professor of Child & Adolescent Psychiatry at King's IoPPN and study co-author
Professor Danese continued: "Our study highlights the importance of identifying young people who have experienced neglect so that the proper support can be put in place, for example, to mitigate the negative consequences in education and employment."
More research is needed to understand why individuals with documented histories of neglect have cognitive deficits. The researchers suspect this might be due to a lack of stimulation in childhood, the familial transmission of cognitive challenges, and/or the role of other experiences that often accompany neglect, such as family poverty. Disentangling the mechanisms underlying the observed associations will provide helpful insights to develop effective interventions.
The research was supported by funding from the National Institute of Justice, the National Institute of Mental Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute on Aging.
"Objective and subjective experiences of childhood maltreatment and their relationships with cognitive deficits: a cohort study in the USA" (Andrea Danese, Cathy Spatz Widom) was published in Lancet Psychiatry (DOI: 10.1016/ S2215-0366(24)00209-8).
