Child Maltreatment Analysis

Child Maltreatment and the Effects it has Middle Adulthood

Valentina Nikulina and Cathy Spatz Widon authored Child Maltreatment and Executive Functioning in Middle Adulthood: A Prospective Examination. In this journal article Nikulina and Widom search for answers to determine if childhood maltreatment predicts components of executive functioning and nonverbal reasoning ability in middle adulthood and whether PTSD moderates this relationship. Over a million children are maltreated everyday in America. Maltreatment is defined as the physical, sexual or emotional maltreatment or neglect of a child or children. Although researchers have hypothesized that childhood maltreatment has a detrimental
effect on brain development no longitudinal studies had been conducted until this particular study was conducted.

This study is designed to provide answers to four fundamental questions: Does childhood maltreatment predict executive functioning and nonverbal reasoning deficits in middle adulthood? Are there differences in the impact of child maltreatment on executive functioning and nonverbal reasoning by the type of childhood abuse and/or neglect (sexual abuse, physical abuse, and neglect? Does childhood maltreatment predict executive functioning and nonverbal reasoning deficits in middle adulthood, after other factors (IQ, current levels of depression, or excessive alcohol consumption) are taken out?
Does a history of PTSD moderate or mediate the relation between child abuse/ neglect and executive functioning and nonverbal reasoning deficits in middle adulthood (Nikulina, et.al,2013).

Executive functions and nonverbal reasoning are directly affiliated with planning, inhibition, organization, and monitoring of complex behavior; memory, cognitive flexibility, sustained attention, nonverbal problem solving and rational reasoning. The prefrontal cortex controls these two functions and is though to be damaged by childhood maltreatment. PTSD has been linked to prenatal cortex by theory and research. There are mixed findings between the role of childhood maltreatment and PTSD.

The children used in this study had substantiated cases of childhood maltreatment. The initial sample of maltreated children was 908. The 908 maltreated children were carefully matched with non abused children with similar age, sex, race/ethnicity and social class. The abused
and non abused child was born from 1967-1971 and lived in the midwestern metropolitan area.

The initial phase of the study showed that abused/neglected children were at a higher risk for delinquency, adult criminality and violence. This was based primarily on criminal histories of the individual. In this phase they found that the majority of maltreated children did not become delinquent or criminal.

Later more studies were conducted to evaluated executive function and nonverbal reasoning. The sample still maintained a diverse population but it skewed at the lower end of the SES scale). These individuals completed the neuropsychological assessments in 1989-1995(n=1196), 2000-2002(n=896) and in 2003-2005(n=807). This article bases its information off of the first and third assessments’. All tests assessments are standardized. Cognitive flexibility and processing speed was measured by using the standardized Trail Making Tests-Part A -processing and psychomotor speed. Trail Making Test Part B-switching of cognitive sets. Higher scores indicate more time to complete Test A and

Test B reflect poorer performance. Nonverbal reasoning
In multivariate analyses, childhood maltreatment overall and childhood neglect predicted poorer executive functioning and nonverbal reasoning at age 41 years, whereas physical and sexual abuse did not. A was tested with a Matrix Test (indentify the pattern and complete with the missing part) higher scores indicate better performance. All types of neglect scored lower except for sexual abuse which was almost the same as the controls. Interviews by trained professional were administered to evaluate PTSD. Individuals with documented abuse and neglect are more susceptible to PTSD. Data was analyzed using ordinary least squares regressions, controlling for age, sex, and race, and possible confounds of IQ, depression, and excessive alcohol use.

past history of PTSD did not mediate or moderate these relations.
Childhood maltreatment and neglect specifically have profound affects on the long-term functioning of executive functioning and nonverbal reasoning. There is certainly a need to prevent child maltreatment in order to avoid these hindering long term affects.
Critique:
Within the sample different ages, sexes, races/ethnicity, and social classes were represented. Although the sample size was large it only covered the midwesten metropolitan area. A bigger more diverse geographical sample would have rendered more accurate results for a national consensus.
For the time period (1967-1971) and the resources available at the time this study is very impressive.

The instrument utilized was the Trail Making Type A and B, The Matrix reasoning test and PTSD interviews. The tests are standardized assessments. The interviewers received a week of study –specific training. To
prevent interview drift and to maintain quality their was frequent contact between interviews and supervisors. The supervisors re-contacted a random 10% of respondents to help validate the quality of the information recorded. Great measures are taken here to provide quality information. Some of the confounding variables’ were regressed for. Interviewers and participants were both blind to the reason for the study.
When all the scores were compared sexual and physical abuse did not predict deficits in middle adulthood as indicated by the Trail Making Test A and B and the Matrix Reasoning
Test while maltreatment and neglect did show correlation with deficits in tested areas.

This study was well constructed and conducted overall. It required great efforts to attain this information. A larger sample size with more geographical diversity would have certainly given the study more merit. Overall the study is very insightful about the affects of childhood maltreatment.

References:

Child Maltreatment. (n.d.). In Wikipedia. Retrieved October 14, 2013, from http://en.wikipedia.org/wiki/Child Maltreatment

Nikulina,V., & Spatx- Widom, C. (2013). Child Maltreatment And Executive Functioning in Middle Adulthood: A Prospective Examination. Neuropsychology Vol. 27, NO.4, 417-427. doi: 10.1037/a002811