ABSTRACT

Background: Childhood maltreatment (CM) is associated with impaired hypothalamic-pituitary-adrenal (HPA) axis negative feedback and cognitive dysfunction, resembling those abnormalities linked to major depressive disorder (MDD).

Objectives: We aimed to assess the potential modulating effects of MDD diagnosis or HPA axis function in the association between different types of CM and cognitive performance in adulthood.

Methods: Sixty-eight MDD patients and 87 healthy controls were recruited. CM was assessed with the Childhood Trauma Questionnaire. We obtained three latent variables for neuropsychological performance (verbal memory, visual memory and executive function/processing speed) after running a confirmatory factor analysis with cognitive tests applied. Dexamethasone suppression test ratio (DSTR) was performed using dexamethasone 0.25 mg.

Results: Different types of CM had different effects on cognition, modulated by MDD diagnosis and HPA axis function. Individuals with physical maltreatment and MDD presented with enhanced cognition in certain domains. The DSTR differentially modulated the association between visual memory and physical neglect or sexual abuse.

Conclusions: HPA axis-related neurobiological mechanisms leading to cognitive impairment might differ depending upon the type of CM. Our results suggest a need for early assessment and intervention on cognition and resilience mechanisms in individuals exposed to CM to minimize its deleterious and lasting effects.

摘要

背景：童年虐待 (CM) 与受损的下丘脑-垂体-肾上腺 (HPA) 轴负反馈和认知功能障碍有关，类似于与重度抑郁症 (MDD) 相关的那些异常。

目标：我们旨在评估 MDD 诊断或 HPA 轴功能在不同类型 CM 与成年期认知表现之间的关联中的潜在调节作用。

方法：招募了 68 名 MDD 患者和 87 名健康对照者。CM 是通过童年创伤问卷进行评估的。在应用认知测试进行验证性因素分析后，我们获得了神经心理学表现的三个潜在变量（语言记忆、视觉记忆和执行功能/处理速度）。使用地塞米松 0.25 mg 进行地塞米松抑制试验比率 (DSTR)。

结果：不同类型的 CM 对认知有不同的影响，受 MDD 诊断和 HPA 轴功能调节。遭受身体虐待和 MDD 的个体在某些领域表现出增强的认知。DSTR 差异调节视觉记忆与身体忽视或性虐待之间的关联。

结论：导致认知障碍的 HPA 轴相关神经生物学机制可能因 CM 的类型而异。我们的结果表明，需要对暴露于 CM 的个体的认知和恢复机制进行早期评估和干预，以尽量减少其有害和持久的影响。