Skip to main content
SpringerLink
Log in

Executive Functioning in Children with Posttraumatic Stress Disorder Symptoms

  • Original Article
  • Published:
Journal of Child & Adolescent Trauma Aims and scope Submit manuscript

Abstract

Posttraumatic stress disorder (PTSD) symptoms have been preliminarily associated with specific areas of neuropsychological functioning impairments in children; however, the relationship between PTSD symptoms and executive functioning in children is not yet well-understood. This study examined PTSD symptoms and executive functioning in a low socioeconomic status (SES), urban dwelling, ethnic minority sample of 55 children aged 8 to 16. Participants completed interviews, self-report measures, and a neuropsychological test battery assessing intellectual functioning, executive functioning, and PTSD symptoms. Results indicated that PTSD symptoms were negatively associated with one dimension of executive functioning after controlling for the effects of SES, intelligence, and prenatal alcohol exposure. Findings suggest that impairment in executive functioning may be a correlate of PTSD symptoms in some children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Achenbach, T. M., & Rescorla, L. A. (2001). Manual for ASEBA school-age forms and profiles. Burlington: University of Vermont, Research Center for Children, Youth, and Families.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington: Author.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Publishing.

    Book  Google Scholar 

  • Artiola i Fortuny, L., & Heaton, R. K. (1996). Standard versus computerized administration of the Wisconsin Card Sorting Test. The Clinical Neuropsychologist, 10(4), 419–424. doi:10.1080/13854049608406702.

    Article  Google Scholar 

  • Axelrod, B. N., Goldman, R. S., & Woodward, J. L. (1992). Interrater reliability in scoring the Wisconsin Card Sorting Test. The Clinical Neuropsychologist, 6(143), 155.

    Google Scholar 

  • Baron, I. S. (2004). Executive function. In I. S. Baron (Ed.), Neuropsychological evaluation of the child (pp. 133–214). New York: Oxford University Press.

    Google Scholar 

  • Beckham, J. C., Crawford, A. L., & Feldman, M. E. (1998). Trail making test performance in Vietnam combat veterans with and without posttraumatic stress disorder. Journal of Traumatic Stress, 11(4), 811–819. doi:10.1023/A:1024409903617.

    Article  PubMed  Google Scholar 

  • Beers, S. R., & De Bellis, M. (2002). Neuropsychological function in children with maltreatment-related posttraumatic stress disorder. American Journal of Psychiatry, 159(3), 483–486. doi:10.1176/appi.ajp.159.3.483.

    Article  PubMed  Google Scholar 

  • Bell, C. C., & Jenkins, E. J. (1998). Community violence and children on Chicago’s southside. Psychiatry, 56, 46–54.

    Google Scholar 

  • Benton, A. L., Hamsher, K., & Sivan, A. B. (1983). Multilingual aphasia examination (3rd ed.). Iowa City: AJA Associates.

    Google Scholar 

  • Berg, E. A. (1948). A simple objective technique for measuring flexibility in thinking. Journal of General Psychology, 39, 15–22. doi:10.1080/00221309.1948.9918159.

    Article  PubMed  Google Scholar 

  • Berry, D. T. R., Allen, R. S., & Schmitt, F. A. (1991). Rey-Osterrieth figure: psychometric characteristics in a geriatric sample. The Clinical Neuropsychologist, 5, 143–153. doi:10.1080/13854049108403298.

    Article  Google Scholar 

  • Brown, S. J., Rourke, B. P., & Cicchetti, D. V. (1989). Reliability of tests and measures used in the neuropsychological assessment of children. The Clinical Neuropsychologist, 3, 353–368. doi:10.1080/13854048908401484.

    Article  Google Scholar 

  • Bruyer, R., & Tuyumbu, B. (1980). Fluence verbale et elsions du cortex cerebrale: performances et types d’erreurs. Encephale, 6, 287–297.

    PubMed  Google Scholar 

  • Buckley, T. C., Blanchard, E. B., & Neill, W. T. (2000). Information processing and PTSD: a review of the empirical literature. Clinical Psychology Review, 28(8), 1041–1065. doi:10.1016/s0272-7358(99)00030-6.

    Article  Google Scholar 

  • Canivez, G. L., Konold, T. R., Collins, J. M., & Wilson, G. (2009). Construct validity of the Wechsler abbreviated scale of intelligence and wide range intelligence test: convergent and structural validity. School Psychology Quarterly, 24(4), 252–265. doi:10.1037/a0018030.

    Article  Google Scholar 

  • De Bellis, M. D., Baum, A. S., Birmaher, B., Keshavan, M. S., Eccard, C. H., Boring, A. M., Jenkins, F. J., & Ryan, N. D. (1999a). Developmental traumatology part I: biological stress symptoms. Biological Psychiatry, 45, 1259–1270. doi:10.1016/s0006-3223(99)00044-x.

    Article  PubMed  Google Scholar 

  • De Bellis, M. D., Hooper, S. R., Spratt, E. G., & Woolley, D. P. (2009). Neuropsychological findings in childhood neglect and their relationships to pediatric PTSD. Journal of the International Neuropsychological Society, 15, 868–878. doi:10.1017/s1355617709990464.

    Article  PubMed Central  Google Scholar 

  • De Bellis, M. D., & Keshavan, M. S. (2003). Sex differences in brain maturation in maltreatment-related pediatric posttraumatic stress disorder. Neuroscience & Biobehavioral Reviews, 27, 103–117. doi:10.1016/s0149-7634(03)00013-7.

    Article  Google Scholar 

  • De Bellis, M. D., Keshavan, M. S., Clark, D., Casey, B. J., Giedd, J. N., Boring, A. M., et al. (1999b). Developmental traumatology part II: brain development. Society of Biological Psychiatry, 45, 1271–1284. doi:10.1016/s0006-3223(99)00045-1.

    Article  Google Scholar 

  • De Bellis, M. D., & Kuchibhatla, M. (2006). Cerebellar volumes in pediatric maltreatment-related posttraumatic stress disorder. Biological Psychiatry, 60, 697–703. doi:10.1016/j.biopsych.2006.04.035.

    Article  PubMed  Google Scholar 

  • De Bellis, M. D., Woolley, D. P., & Hooper, S. R. (2013). Neuropsychological findings in pediatric maltreatment: relationship of PTSD, dissociative symptoms, and abuse/neglect indices to neurocognitive outcomes. Child Maltreatment, 18, 171–183. doi:10.1177/1077559513497420.

    Article  PubMed Central  PubMed  Google Scholar 

  • DePrince, A. P., Weinzierl, K. M., & Combs, M. D. (2009). Executive function performance and trauma exposure in a community sample of children. Child Abuse & Neglect, 33, 353–361. doi:10.1016/j.chiabu.2008.08.002.

    Article  Google Scholar 

  • DesRosiers, G., & Kavanagh, D. (1987). Cognitive assessment in closed head injury: stability, validity and parallel forms for two neuropsychological measures of recovery. International Journal of Clinical Neuropsychology, 9, 162–173.

    Article  Google Scholar 

  • Diamond, T., Muller, R. T., & Rondeau, L. A. (2001). The relationships among PTSD symptomatology and cognitive functioning in adult survivors of child maltreatment. In F. Columbus (Ed.), Advances in psychology research (Vol. V, pp. 253–279). Hauppauge: Nova.

    Google Scholar 

  • Fastenau, P. S., Bennett, J. M., & Denburg, N. L. (1996). Application of psychometric standards to scoring system evaluation: is “new” necessarily “improved”? Journal of Clinical and Experimental Neuropsychology, 18, 462–472. doi:10.1080/01688639608409003.

    Article  PubMed  Google Scholar 

  • Fishbein, D., Warner, T., Krebs, C., Trevarthen, N., Flannery, B., & Hammond, J. (2009). Differential relationships between personal and community stressors and children’s neurocognitive functioning. Child Maltreatment, 14, 299–315. doi:10.1177/1077559508326355.

    Article  PubMed  Google Scholar 

  • Gilbertson, M. W., Gurvits, T. V., Lasko, N. B., Orr, S. P., & Pitman, R. K. (2001). Multivariate assessment of explicit memory function in combat veterans with posttraumatic stress disorder. Journal of Traumatic Stress, 14(2), 413–431. doi:10.1023/A:1011181305501.

    Article  PubMed  Google Scholar 

  • Hays, J., Reas, D., & Shaw, J. (2002). Concurrent validity of the Wechsler Abbreviated Scale of Intelligence and the Kaufman brief intelligence test among psychiatric inpatients. Psychological Reports, 90, 355–359.

    Article  PubMed  Google Scholar 

  • Heaton, R. K., Chelune, G. J., Talley, J. L., Kay, G. G., & Curtis, G. (1993). Wisconsin Card Sorting Test (WCST) manual revised and expanded. Odessa: Psychological Assessment Resources.

    Google Scholar 

  • Helms, J. E. (1992). Why is there no study of cultural equivalence in standardized cognitive ability testing? American Psychologist, 47, 1083–1101. doi:10.1037/0003-066x.47.9.1083.

    Article  Google Scholar 

  • Hollingshead, A. B. (1956). Two factor index of social position. New Haven: Yale University Press.

    Google Scholar 

  • Kempermann, G., Gast, D., & Gage, F. H. (2002). Neuroplasticity in old age: sustained fivefold induction of Hippocampal neurogenesis by long-term environmental enrichment. Annals of Neurology, 52, 135–143. doi:10.1002/ana.10262.

    Article  PubMed  Google Scholar 

  • Kempermann, G., Kuhn, H. G., & Gage, F. H. (1997). More hippocampal neurons in adult mice living in an enriched environment. Nature, 386, 493–495. doi:10.1038/386493a0.

    Article  PubMed  Google Scholar 

  • Koenen, K. C., Driver, K. L., Oscar-Berman, M., Wolfe, J., Folsom, S., Huang, M. T., & Schlesinger, L. (2001). Measures of prefrontal system dysfunction in posttraumatic stress disorder. Brain and Cognition, 45, 64–78. doi:10.1006/brcg.2000.1256.

    Article  PubMed  Google Scholar 

  • Koso, M., & Hansen, S. (2006). Executive function and memory in posttraumatic stress disorder: a study of Bosnian war veterans. European Psychiatry, 21(3), 167–173. doi:10.1016/j.eurpsy.2005.06.004.

    Article  PubMed  Google Scholar 

  • Krystal, J. H., Bennett, A. L., Bremner, J. D., Southwick, S., & Charney, D. S. (1995). A neuropsychological hypothesis explaining posttraumatic stress disorder. In M. J. Friedman, D. S. Charney, & A. Y. Deutsch (Eds.), Neurobiological and clinical consequences of stress: from normal adaptation to PTSD. Philadelphia: Lippincott-Raven.

    Google Scholar 

  • Lezak, M. D. (1983). Neuropsychological assessment (2nd ed.). New York: Oxford University Press.

    Google Scholar 

  • Lezak, M. D. (1995). Neuropsychological assessment (3rd ed.). New York: Oxford University Press.

    Google Scholar 

  • Lonner, W. J. (1981). Psychological tests and intercultural counseling. In P. B. Pederson, J. G. Draguns, W. J. Lonner, & J. E. Trimble (Eds.), Counseling across culture (pp. 275–303). Honolulu: East–west Center and University of Hawaii.

    Google Scholar 

  • Loong, J. W. K. (1990). The Wisconsin Card Sorting Test (IBM version). San Luis Obispo: Wang Neuropsychological Laboratory.

    Google Scholar 

  • Matarazzo, J. D., Wiens, A. M., Matarazzo, R. G., & Goldstein, S. G. (1974). Psychometric and clinical test-retest reliability of the Halstead Impairment Index in a sample of healthy, young, normal men. Journal of Nervous and Mental Disease, 158, 37–49.

    Article  PubMed  Google Scholar 

  • McEwen, B. S., Gould, E. A., & Sakai, R. R. (1992). The vulnerability of the hippocampus to protective and destructive effects of glucocorticoids in relation to stress. The British Journal of Psychiatry, 160(15), 18–23.

    Google Scholar 

  • McNally, R. J., Luedke, D. L., Besyner, J. K., Peterson, R. A., Bohn, K., & Lips, O. J. (1987). Sensitivity to stress relevant stimuli in post-traumatic stress disorder. Journal of Anxiety Disorders, 1, 105–116. doi:10.1016/0887-6185(87)90001-6.

    Article  Google Scholar 

  • Miceli, G., Caltagirone, C., Gainotti, G., Masullo, C., & Silveri, M. C. (1981). Neuropsychological correlates of localized cerebral lesions in non-aphasic brain damaged patients. Journal of Clinical Neuropsychology, 3, 53–63.

    Article  PubMed  Google Scholar 

  • Milner, B. (1963). Effects of different brain lesions on card sorting. Archives of Neurology, 9, 90–100.

    Article  Google Scholar 

  • Moradi, A. R., Neshat Doost, H. T., Taghavi, M. R., Yule, W., & Dalgleish, T. (1999). Everyday memory deficits in children and adolescents with PTSD: performance on the Rivermead behavioural memory test. The Journal of Child Psychiatry, 40(3), 357–361. doi:10.1111/1469-7610.00453.

    Article  Google Scholar 

  • O’Donnell, J. P. (1983). Neuropsychological test findings for normal, learning disabled, and brain damaged young adults. Journal of Counseling and Clinical Psychology, 51, 726–729.

    Article  Google Scholar 

  • Osterrieth, P. A. (1944). Le test de copie d’une figure complex: contribution a l’etude de la perception et de la memoire. Archives de Psychologie, 30, 286–356.

    Google Scholar 

  • Partington, J. E., & Leiter, R. G. (1949). Partington’s pathway test. The Psychological Service Center Bulletin, 1, 9–20.

    Google Scholar 

  • Pynoos, R. S., Frederick, C., Nader, K., Arroyo, W., Steinberg, A., Eth, S., et al. (1987). Life threat and posttraumatic stress in school-age children. Archives of General Psychiatry, 44, 1057–1063. doi:10.1001/archpsyc.1987.01800240031005.

    Article  PubMed  Google Scholar 

  • Rey, A. (1941). L’examen psychologique dans les cas d’encephalopathie traumatique. Archives de Psychologie, 28, 286–340.

    Google Scholar 

  • Rodriguez, N., Steinberg, A. M., & Pynoos, R. S. (1999). UCLA PTSD index for DSM-IV. Los Angeles: University of California at Los Angeles Trauma Psychiatry Service.

    Google Scholar 

  • Rodriguez, N., Steinberg, A. S., Saltzman, W. S., Pynoos, R. S. (2001a). PTSD Index: Psychometric analyses of the adolescent version. Paper presented at the international society for traumatic stress studies. New Orleans.

  • Rodriguez, N., Steinberg, A. S., Saltzman, W. S., Pynoos, R. S. (2001b). PTSD Index: Preliminary psychometric analyses of child and parent versions. Paper presented at the international society for traumatic stress studies. New Orleans.

  • Roussos, A., Goenjian, A. K., Steinberg, A. M., Sotiropoulou, C., Kakaki, M., Kabakos, C., & Manouras, V. (2005). Posttraumatic stress and depressive reactions among children and adolescents after the 1999 earthquake in Ano Liosia, Greece. American Journal of Psychiatry, 162(3), 530–537. doi:10.1176/appi.ajp.162.3.530.

    Article  PubMed  Google Scholar 

  • Samuelson, K. W., Krueger, C. E., Burnett, C., & Wilson, D. K. (2010). Neuropsychological functioning in children with posttraumatic stress disorder. Child Neuropsychology, 16, 119–133. doi:10.1080/09297040903190782.

    Article  PubMed  Google Scholar 

  • Sapolsky, R. M. (2000). Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Archives of General Psychiatry, 57, 925–935. doi:10.1001/archpsyc.57.10.925.

    Article  PubMed  Google Scholar 

  • Sapolsky, R. M., Uno, H., Rebert, C. S., & Finch, C. E. (1990). Hippocampal damage association with prolonged glucocorticoid exposure in primates. The Journal of Neuroscience, 10, 2897–2902.

    PubMed  Google Scholar 

  • Spreen, O., & Strauss, E. (1998). A compendium of neuropsychological tests: administration, norms, and commentary (2nd ed.). New York: Oxford University Press.

    Google Scholar 

  • Strauss, E., & Spreen, O. (1990). A comparison of the Rey and Taylor figures. Archives of Clinical Neuropsychology, 5, 417–420.

    Article  PubMed  Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics (4th ed.). Boston: Allyn and Bacon.

    Google Scholar 

  • Wechsler, D. (1999). Wechsler abbreciated scale of intelligence. San Antonio: Psychological Corporation.

    Google Scholar 

  • Vasterling, J. J., Brailey, K., Constans, J. I., & Sutker, P. B. (1998). Attention and memory dysfunction in posttraumatic stress disorder. Neuropsychology, 12(1), 125–133. doi:10.1037/0894-4105.12.1.125.

    Article  PubMed  Google Scholar 

  • Woolley, C. S., Gould, E., & McEwen, B. S. (1990). Exposure to excess glucocorticoids alters dendritic morphology of adult hippocampal pyramidal neurons. Laboratory of Neuroendocrinology, 531, 225–231. doi:10.1016/0006-8993(90)90778-A.

    Google Scholar 

  • Yasik, A. E., Saigh, P. A., Oberfield, R. A., & Halamandaris, P. V. (2007). Posttraumatic stress disorder: memory and learning performance in children and adolescents. Biological Psychiatry, 61, 382–388. doi:10.1016/j.biopsych.2006.06.005.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, Emmanuel College, 400 The Fenway, Administration 465, Boston, MA, 02115, USA

    Helen Z. MacDonald

  2. Refugee Trauma and Resilience Center, Boston Children’s Hospital, Boston, MA, USA

    B. Heidi Ellis

  3. Department of Psychiatry, Boston Children’s Hospital/Harvard Medical School, Boston, MA, USA

    B. Heidi Ellis

  4. Psychology Assessment Center, Massachusetts General Hospital, Boston, MA, USA

    Margaret B. Pulsifer

  5. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    Margaret B. Pulsifer

  6. Boston University, Boston, MA, USA

    Michael Lyons

Authors
  1. Helen Z. MacDonald
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. Heidi Ellis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Margaret B. Pulsifer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Lyons
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Helen Z. MacDonald.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

MacDonald, H.Z., Ellis, B.H., Pulsifer, M.B. et al. Executive Functioning in Children with Posttraumatic Stress Disorder Symptoms. Journ Child Adol Trauma 8, 1–11 (2015). https://doi.org/10.1007/s40653-015-0037-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40653-015-0037-0

Keywords

Search

Navigation