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Child Abuse and Neglect and Cognitive Function at 14 Years of Age: Findings From a Birth Cohort

忽视 虐待儿童 医学 队列 毒物控制 队列研究 混淆 儿童忽视 认知 置信区间 精神科 伤害预防 儿科 临床心理学 心理学 医疗急救 病理 内科学
作者
Ryan Mills,Rosa Alati,Michael O’Callaghan,Jake M. Najman,Gail Williams,William Bor,Lane Strathearn
出处
期刊:Pediatrics [American Academy of Pediatrics]
卷期号:127 (1): 4-10 被引量:167
标识
DOI:10.1542/peds.2009-3479
摘要

OBJECTIVE: To examine the association between child maltreatment (abuse and neglect) and long-term cognitive outcomes within a prospective birth cohort. METHODS: A birth cohort of 7223 children was recruited. Independent reports of suspected child maltreatment were confidentially linked to the longitudinal study database. The principal predictor variable was notification to the state child-protection authority for suspected maltreatment (abuse, neglect, or both). The outcome variables were scores on the Wide Range Achievement Test (WRAT) reading test and Raven's Standard Progressive Matrices (RSPM), completed at 14 years of age. Multivariate regression analysis was used to adjust for potential confounders. RESULTS: A total of 3796 subjects completed either the WRAT or RSPM. There was a higher loss to follow-up among children who had been reported to the state as suspected victims of maltreatment. After controlling for a range of possible confounders and modifiers, notification to the state for child maltreatment (abuse, neglect, or both) was associated with a lower score on both the WRAT (mean difference: −4.4 when the SD is 15 [95% confidence interval: −6.3 to −2.5]) and RSPM (mean difference: −4.8 when the SD is 15 [95% confidence interval: −6.7 to −2.9]). Both reported abuse and neglect were independently associated with lower reading ability and perceptual reasoning. CONCLUSIONS: Both child abuse and child neglect are independently associated with impaired cognition and academic functioning in adolescence. These findings suggest that both abuse and neglect have independent and important adverse effects on a child's cognitive development.
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