Abstract
Evidence points to an independent relationship among childhood maltreatment, impairments in executive functions (EF) and disruptive behavior disorders (DBD). However, it is still not fully understood how these three factors are interrelated. This study evaluated the association between childhood maltreatment and DBD testing the role of EF performance as a mediator or moderator. We studied a probabilistic school-based sample of 2016 children from 6 to 12 years. Mental disorders were assessed using the Development and Well-Being Assessment with parents and children. Children answered questions about exposure to child maltreatment and were evaluated with a set of cognitive tasks addressing inhibitory control, working memory, cognitive flexibility and planning. Childhood maltreatment was strongly associated with DBD (OR = 7.7, CI 95% 4.5–12.9). No association was found between childhood maltreatment and EF performance. Children with DBD showed worse performance in cognitive flexibility, which was not identified as a mediator or moderator of the association between childhood maltreatment and DBD. Results indicate that the association between maltreatment and disruptive behavior occurs regardless of performance in executive function in a community sample. Future studies are essential to confirm these findings and elucidate the cognitive mechanisms involved in this association.
Similar content being viewed by others
References
Leeb RT, Paulozzi LJ, Melanson C et al (2008) Child maltreatment surveillance: uniform definitions for public health and recommended data elements. Annu Rev Clin Psychol. https://doi.org/10.1177/1077559599004001005
Teicher MH, Samson JA, Anderson CM, Ohashi K (2016) The effects of childhood maltreatment on brain structure, function and connectivity. Nat Rev Neurosci 17:652–666
Hart H, Rubia K (2012) Neuroimaging of child abuse: a critical review. Front Hum Neurosci. https://doi.org/10.3389/fnhum.2012.00052
Bucker J, Kapczinski F, Post R et al (2012) Cognitive impairment in school-aged children with early trauma. Compr Psychiatry 53:758–764. https://doi.org/10.1016/j.comppsych.2011.12.006
Majer M, Nater UM, Lin J-MS et al (2010) Association of childhood trauma with cognitive function in healthy adults: a pilot study. BMC Neurol 10:61. https://doi.org/10.1186/1471-2377-10-61
Fishbein D, Warner T, Krebs C et al (2009) Differential relationships between personal and community stressors and children’s neurocognitive functioning. Child Maltreat 14:299–315. https://doi.org/10.1177/1077559508326355
Spann MN, Mayes LC, Kalmar JH et al (2012) Childhood abuse and neglect and cognitive flexibility in adolescents. Child Neuropsychol 18:182–189. https://doi.org/10.1080/09297049.2011.595400
Nolin P, Ethier L (2007) Using neuropsychological profiles to classify neglected children with or without physical abuse. Child Abus Negl 31:631–643. https://doi.org/10.1016/j.chiabu.2006.12.009
De Sanctis VA, Trampush JW, Harty SC et al (2008) Childhood maltreatment and conduct disorder: independent predictors of adolescent substance use disorders in youth with attention deficit/hyperactivity disorder. J Clin Child Adolesc Psychol 37:785–793. https://doi.org/10.1080/15374410802359650
Ehrensaft MK, Cohen P, Brown J et al (2003) Intergenerational transmission of partner violence: a 20-year prospective study. J Consult Clin Psychol 71:741–753. https://doi.org/10.1037/0022-006X.71.4.741
Jaffee SR, Caspi A, Moffitt TE et al (2005) Nature X nurture: genetic vulnerabilities interact with physical maltreatment to promote conduct problems. Dev Psychopathol 17:67–84. https://doi.org/10.1017/S0954579405050042
Ford JD, Racusin R, Ellis CG et al (2000) Child maltreatment, other trauma exposure, and posttraumatic symptomatology among children with oppositional defiant and attention deficit hyperactivity disorders. Child Maltreat 5:205–217. https://doi.org/10.1177/1077559500005003001
Polanczyk GV, Salum GA, Sugaya LS et al (2015) Annual Research Review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry 56:345–365. https://doi.org/10.1111/jcpp.12381
Hughes C, Ensor R (2008) Does executive function matter for preschoolers’ problem behaviors? J Abnorm Child Psychol 36:1–14. https://doi.org/10.1007/s10802-007-9107-6
Young SE, Smolen A, Hewitt JK et al (2006) Interaction between MAO-A genotype and maltreatment in the risk for conduct disorder: failure to confirm in adolescent patients. Am J Psychiatry 163:1019–1025. https://doi.org/10.1176/appi.ajp.163.6.1019
Li JJ, Lee SS (2010) Latent class analysis of antisocial behavior: interaction of serotonin transporter genotype and maltreatment. J Abnorm Child Psychol 38:789–801. https://doi.org/10.1007/s10802-010-9409-y
Raaijmakers MAJ, Smidts DP, Sergeant JA et al (2008) Executive functions in preschool children with aggressive behavior: impairments in inhibitory control. J Abnorm Child Psychol 36:1097–1107. https://doi.org/10.1007/s10802-008-9235-7
Diamond A, Barnett WS, Thomas J, Munro S (2007) Supporting Online Materials for Preschool program improves cognitive control. Science (80–) 318:1387–1388. https://doi.org/10.1126/science.1151148
Hobson CW, Scott S, Rubia K (2011) Investigation of cool and hot executive function in ODD/CD independently of ADHD. J Child Psychol Psychiatry Allied Discip 52:1035–1043
Ellis ML, Weiss B, Lochman JE (2009) Executive functions in children: associations with aggressive behavior and appraisal processing. J Abnorm Child Psychol 37:945–956. https://doi.org/10.1007/s10802-009-9321-5
Urazán-Torres GR, Puche-Cabrera MJ, Caballero-Forero M, Rey-Anacona CA (2013) Cognitive and executive functions in colombian school children with conduct disorder: sex differences. Rev Colomb Psiquiatr 42:324–332. https://doi.org/10.1016/S0034-7450(13)70029-5
Saarinen S, Fontell T, Vuontela V et al (2015) Visuospatial working memory in 7- to 12-year-old children with disruptive behavior disorders. Child Psychiatry Hum Dev 46:34–43. https://doi.org/10.1007/s10578-014-0449-3
Moreno-López L, Stamatakis EA, Fernández-Serrano MJ et al (2012) Neural correlates of hot and cold executive functions in polysubstance addiction: association between neuropsychological performance and resting brain metabolism as measured by positron emission tomography. Psychiatry Res - Neuroimaging 203:214–221. https://doi.org/10.1016/j.pscychresns.2012.01.006
Castellanos FX, Sonuga-Barke EJS, Milham MP, Tannock R (2006) Characterizing cognition in ADHD: beyond executive dysfunction. Trends Cogn Sci 10:117–124
Ardila A (2008) On the evolutionary origins of executive functions. Brain Cogn 68:92–99. https://doi.org/10.1016/j.bandc.2008.03.003
Diamond A, Barnett WS, Thomas J, Munro S (2007) Preschool program improves cognitive control. Science 318:1387–1388. https://doi.org/10.1126/science.1151148
Jurado MB, Rosselli M (2007) The elusive nature of executive functions: a review of our current understanding. Neuropsychol Rev 17:213–233
Anderson P (2002) Assessment and development of executive function (EF) during childhood. Child Neuropsychol 8:71–82. https://doi.org/10.1076/chin.8.2.71.8724
Skowron EA, Cipriano-Essel E, Gatzke-Kopp LM et al (2014) Early adversity, RSA, and inhibitory control: evidence of children’s neurobiological sensitivity to social context. Dev Psychobiol 56:964–978. https://doi.org/10.1002/dev.21175
Hébert M, Langevin R, Oussaïd E (2018) Cumulative childhood trauma, emotion regulation, dissociation, and behavior problems in school-aged sexual abuse victims. J Affect Disord 225:306–312. https://doi.org/10.1016/j.jad.2017.08.044
Lupien SJ, McEwen BS, Gunnar MR, Heim C (2009) Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat Rev Neurosci 10:434–445
Arnsten AF (2015) Stress weakens prefrontal networks: molecular insults to higher cognition. Nat Neurosci 18(10):1376–1385. https://doi.org/10.1038/nn.4087
Danese A, Moffitt TE, Arseneault L et al (2017) The origins of cognitive deficits in victimized children: implications for neuroscientists and clinicians. Am J Psychiatry 174:349–361. https://doi.org/10.1176/appi.ajp.2016.16030333
Richmond JB, Health C, Fisher PA et al (2011) Building the brain’s “air traffic control” system: How early experiences shape the development of executive function. Center on the Developing Child, Harvard University. Working Paper No. 11. http://www.developingchild.harvard.edu
Heck AL, Handa RJ (2019) Sex differences in the hypothalamic–pituitary–adrenal axis’ response to stress: an important role for gonadal hormones. Neuropsychopharmacology 44:45–58. https://doi.org/10.1038/s41386-018-0167-9
Bangasser DA, Eck SR, Ordoñes Sanchez E (2019) Sex differences in stress reactivity in arousal and attention systems. Neuropsychopharmacology 44:129–139. https://doi.org/10.1038/s41386-018-0137-2
Erskine HE, Ferrari AJ, Nelson P et al (2013) Research review: epidemiological modelling of attention-deficit/hyperactivity disorder and conduct disorder for the Global Burden of Disease Study 2010. J Child Psychol Psychiatry Allied Discip 54(12):1263–1274
Demmer DH, Hooley M, Sheen J et al (2017) Sex differences in the prevalence of oppositional defiant disorder during middle childhood: a meta-analysis. J Abnorm Child Psychol 45(2):313–325
Van Der Molen E, Blokland AAJ, Hipwell AE et al (2015) Girls’ childhood trajectories of disruptive behavior predict adjustment problems in early adolescence. J Child Psychol Psychiatry Allied Discip. https://doi.org/10.1111/jcpp.12339
Moffitt TE, Arseneault L, Belsky D et al (2011) A gradient of childhood self-control predicts health, wealth, and public safety. Proc Natl Acad Sci 108:2693–2698. https://doi.org/10.1073/pnas.1010076108
Best JR, Miller PH (2010) A developmental perspective on executive function. Child Dev 81:1641–1660. https://doi.org/10.1111/j.1467-8624.2010.01499.x
Zelazo PD, Craik FIM, Booth L (2004) Executive function across the life span. Acta Psychol (Amst). https://doi.org/10.1016/j.actpsy.2003.12.005
Hill AC, Laird AR, Robinson JL (2014) Gender differences in working memory networks: a BrainMap meta-analysis. Biol Psychol 102:18–29. https://doi.org/10.1016/j.biopsycho.2014.06.008
Spielberg JM, Galarce EM, Ladouceur CD et al (2015) Adolescent development of inhibition as a function of SES and gender: converging evidence from behavior and fMRI. Hum Brain Mapp 36:3194–3203. https://doi.org/10.1002/hbm.22838
Doidge JC, Higgins DJ, Delfabbro P, Segal L (2017) Risk factors for child maltreatment in an Australian population-based birth cohort. Child Abuse Negl 64:47–60. https://doi.org/10.1016/j.chiabu.2016.12.002
Middeldorp CM, Lamb DJ, Vink JM et al (2014) Child care, socio-economic status and problem behavior: a study of gene-environment interaction in young dutch twins. Behav Genet 44:314–325. https://doi.org/10.1007/s10519-014-9660-z
Pluck G, Banda-Cruz DR, Andrade-Guimaraes MV, Trueba AF (2018) Socioeconomic deprivation and the development of neuropsychological functions: a study with “street children” in Ecuador. Child Neuropsychol 24:510–523. https://doi.org/10.1080/09297049.2017.1294150
Delaney-Black V, Covington C, Ondersma SJ et al (2002) Violence exposure, trauma, and IQ and/or reading deficits among urban children. Arch Pediatr Adolesc Med. https://doi.org/10.1001/archpedi.156.3.280
Jaffee SR, Maikovich-Fong AK (2011) Effects of chronic maltreatment and maltreatment timing on children’s behavior and cognitive abilities. J Child Psychol Psychiatry Allied Discip. https://doi.org/10.1111/j.1469-7610.2010.02304.x
Kessler RC, Berglund P, Demler O et al (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 62:593. https://doi.org/10.1001/archpsyc.62.6.593
Salum GA, Gadelha A, Pan PM et al (2015) High risk cohort study for psychiatric disorders in childhood: rationale, design, methods and preliminary results. Int J Methods Psychiatr Res 24:58–73. https://doi.org/10.1002/mpr.1459
Goodman A, Heiervang E, Collishaw S, Goodman R (2011) The “DAWBA bands” as an ordered-categorical measure of child mental health: description and validation in British and Norwegian samples. Soc Psychiatry Psychiatr Epidemiol 46:521–532. https://doi.org/10.1007/s00127-010-0219-x
Fleitlich-Bilyk B, Goodman R (2004) Prevalence of child and adolescent psychiatric disorders in Southeast Brazil. J Am Acad Child Adolesc Psychiatry 43:727–734. https://doi.org/10.1097/01.chi.0000120021.14101.ca
Grassi-Oliveira R, Cogo-Moreira H, Salum GAA et al (2014) Childhood trauma questionnaire (CTQ) in Brazilian samples of different age groups: findings from confirmatory factor analysis. PLoS One 9:e87118. https://doi.org/10.1371/journal.pone.0087118
Bernstein DP, Fink L (1998) Childhood trauma questionnaire: a retrospective self-report: manual. Psychological Corporation, Orlando
Bernstein DP, Stein JA, Newcomb MD et al (2003) Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abus Negl. https://doi.org/10.1016/S0145-2134(02)00541-0
Wechsler D (1991) Wechsler intelligence scale for children, 3rd edn. TX Psychol Corp, San Antonio
Corsi PM (1973) Human memory and the medial temporal region of the brain. Diss Abstr Int 34:891
Strauss EH, Sherman EMS, Spreen O (2006) A compendium of neuropsychological tests: administration, norms, and commentary, 3rd edn. Oxford University Press, USA
Stern RA, Singer EA, Duke LM et al (1994) The boston qualitative scoring system for the rey-osterrieth complex figure: description and interrater reliability. Clin Neuropsychol 8:309–322. https://doi.org/10.1080/13854049408404137
Savage CR, Baer L, Keuthen NJ et al (1999) Organizational strategies mediate nonverbal memory impairment in obsessive-compulsive disorder. Biol Psychiatry 45:905–916. https://doi.org/10.1016/S0006-3223(98)00278-9
Salum GA, DeSousa DA, Manfro GG et al (2016) Measuring child maltreatment using multi-informant survey data: a higher-order confirmatory factor analysis. Trends Psychiatry Psychother 38:23–32. https://doi.org/10.1590/2237-6089-2015-0036
Hayes A (2013) Introduction to mediation, moderation, and conditional process analysis. Guilford, New York, pp 3–4 (978-1-60918-230-4)
Lee V, Hoaken PNS (2007) Cognition, emotion, and neurobiological development: mediating the relation between maltreatment and aggression. Child Maltreat 12:281–298. https://doi.org/10.1177/1077559507303778
Samuelson KW, Krueger CE, Burnett C, Wilson CK (2010) Neuropsychological functioning in children with posttraumatic stress disorder. Child Neuropsychol 16:119–133
Samuelson KW, Krueger CE, Wilson C (2012) Relationships between maternal emotion regulation, parenting, and children’s executive functioning in families exposed to intimate partner violence. J Interpers Violence 27:3532–3550. https://doi.org/10.1177/0886260512445385
DePrince AP, Weinzierl KM, Combs MD (2009) Executive function performance and trauma exposure in a community sample of children. Child Abuse Negl 33:353–361. https://doi.org/10.1016/j.chiabu.2008.08.002(S0145-2134(09)00096-9 [pii]\r)
Malter Cohen M, Jing D, Yang RR et al (2013) Early-life stress has persistent effects on amygdala function and development in mice and humans. Proc Natl Acad Sci USA 110:18274–18278. https://doi.org/10.1073/pnas.1310163110
Bailey S, Whittle N, Farnworth P, Smedley K (2007) A developmental approach to violence, hostile attributions, and paranoid thinking in adolescence. Behav Sci Law 25:913–929. https://doi.org/10.1002/bsl.776
Broidy LM, Nagin DS, Tremblay RE et al (2003) Developmental trajectories of childhood disruptive behaviors and adolescent delinquency: a six-site, cross-national study. Dev Psychol 39:222–245. https://doi.org/10.1037//0012-1649.39.2.222
Hughes C, White A, Sharpen J, Dunn J (2000) Antisocial, angry, and unsympathetic: “Hard-to-manage” preschoolers’ peer problems and possible cognitive influences. J Child Psychol Psychiatry Allied Discip 41:169–179. https://doi.org/10.1017/S0021963099005193
Dolan M, Lennox C (2013) Cool and hot executive function in conduct-disordered adolescents with and without co-morbid attention deficit hyperactivity disorder: relationships with externalizing behaviours. Psychol Med 43:2427–2436. https://doi.org/10.1017/S0033291712003078
Pears K, Fisher PA (2005) Developmental, cognitive, and neuropsychological functioning in preschool-aged foster children: associations with prior maltreatment and placement history. J Dev Behav Pediatr 26:112–122. https://doi.org/10.1097/00004703-200504000-00006
Pollak SD, Tolley-Schell SA (2003) Selective attention to facial emotion in physically abused children. J Abnorm Psychol 112:323–338. https://doi.org/10.1037/0021-843X.112.3.323
Kavanaugh BC, Dupont-Frechette JA, Jerskey BA, Holler KA (2017) Neurocognitive deficits in children and adolescents following maltreatment: neurodevelopmental consequences and neuropsychological implications of traumatic stress. Appl Neuropsychol Child 6:64–78
Butchart A (2008) Epidemiology. The major missing element in the global response to child maltreatment? Am J Prev Med. https://doi.org/10.1016/j.amepre.2008.01.006
Goodman R, Ford T, Richards H et al (2000) The Development and Well-Being Assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psychiatry 41:645–655. https://doi.org/10.1111/j.1469-7610.2000.tb02345.x
Scarborough AA, Lloyd EC, Barth RP (2009) Maltreated infants and toddlers: predictors of developmental delay. J Dev Behav Pediatr 30:489–498. https://doi.org/10.1097/DBP.0b013e3181c35df6
Funding
Coordination for the Improvement of Higher Level -or Education- Personnel (CAPES), Academic Excellence Program (Proex), Grant to Ms. Elisa Teixeira Bernardes. National Council for Scientific and Technological Development (CNPq, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Grant 573974/2008-0) to National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), Sao Paulo, Brazil. São Paulo Research Foundation (FAPESP) Grant 2016/22455-8 and National Council for Scientific and Technological Development (CNPq) Grant 310582/2017-2 to Dr. Polanczyk.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Dr. Polanczyk has served as a consultant to Shire, Medice and Teva. He has served on the speakers’ bureau of Shire. He has received royalties from Editora Manole. Luis Augusto Rohde has received grant or research support from, served as a consultant to, and served on the speakers’ bureau of Eli Lilly and Co., Janssen, Medice, Novartis and Shire. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by Dr. Rohde have received unrestricted educational and research support from the following pharmaceutical companies: Eli Lilly and Co., Janssen, Novartis, and Shire. Dr. Rohde has received authorship royalties from Oxford Press and ArtMed and travel grants from Shire to take part in the 2018 APA annual meeting and from Novartis to take part in the 2012 meeting. Other authors have no biomedical financial interests or potential conflict of interest.
Rights and permissions
About this article
Cite this article
Bernardes, E.T., Manitto, A.M., Miguel, E.C. et al. Relationships between childhood maltreatment, impairment in executive functions and disruptive behavior disorders in a community sample of children. Eur Child Adolesc Psychiatry 29, 969–978 (2020). https://doi.org/10.1007/s00787-019-01408-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00787-019-01408-3