True and false recall and dissociation among maltreated children: the role of self-schema

The Relationship between Suggestibility, Fabrication, Distortion, and Trauma in Suspected Sexually Abused Children

Being a victim of abuse in childhood can lead to the development of trauma-related psychopathology, which could affect the testimony of the child victim. Post-traumatic stress disorder (PTSD) is a factor that can increase both the levels of suggestibility and the production of memory errors, such as confabulations, which can be identified in distortions and fabrications. No studies have analyzed the relationship between suggestibility, fabrications, distortions, and PTSD on samples of children and adolescents suspected of being sexually abused. This study aims to verify in a sample of 221 sexually abused children and adolescents the effect of PTSD, measured by Trauma Symptoms Checklist for Children, in increasing the levels of immediate and delayed suggestibility and the production of fabrications and distortions in immediate and delayed memory tasks, obtained by Gudjonsson Suggestibility Scale 2, controlling age and non-verbal intelligence. Our results show that PTSD increases the levels of immediate and delayed suggestibility, but it has no effect on memory recall in immediate recall tasks. Moreover, PTSD leads to a greater number of distorted and fabricated information inserted in delayed memory. Forensic implications of PTSD consequences on memory tasks and suggestibility levels of sexually abused children are discussed.

What Drives False Memories in Psychopathology? A Case for Associative Activation

In clinical and court settings, it is imperative to know whether posttraumatic stress disorder (PTSD) and depression may make people susceptible to false memories. We conducted a review of the literature on false memory effects in participants with PTSD, a history of trauma, or depression. When emotional associative material was presented to these groups, their levels of false memory were raised relative to those in relevant comparison groups. This difference did not consistently emerge when neutral or nonassociative material was presented. Our conclusion is supported by a quantitative comparison of effect sizes between studies using emotional associative or neutral, nonassociative material. Our review suggests that individuals with PTSD, a history of trauma, or depression are at risk for producing false memories when they are exposed to information that is related to their knowledge base.

The interactive effects of child maltreatment and the FK506 binding protein 5 gene (FKBP5) on dissociative symptoms in adolescence

The FK506 binding protein 5 gene (FKBP5) has been associated with susceptibility to pathogenic effects of childhood trauma including dissociative symptoms. This study examines the impact of maltreatment on dissociative tendencies in adolescence as moderated by the FKBP5 gene. Dissociative symptoms and variation within FKBP5 were assessed in a high-risk, low socioeconomic status community sample of 279 maltreated and 171 nonmaltreated adolescents. Following the assignment of haplotypes across four single nucleotide polymorphisms (rs3800373, rs9296158, rs1360780, and rs9470080), individuals with one or more copies of the CATT haplotype (N = 230) were grouped together and compared to individuals with zero copies of this haplotype (N = 185). Analyses of covariance were conducted to test hypotheses regarding the effects of developmental timing and the chronicity of maltreatment and the CATT haplotype. We found a significant interactive effect of timing/chronicity of maltreatment and the CATT haplotype on dissociative symptoms. Among adolescents who had no copies of the CATT haplotype, dissociative symptoms were higher for chronically maltreated adolescents who had an infancy onset compared to those who were not maltreated or whose maltreatment experience was either relatively less chronic or not started in infancy. The groups did not differ significantly among subjects who carry one or more copies of the CATT haplotype.

A systematic review of the emotional, behavioural and cognitive features exhibited by school-aged children experiencing neglect or emotional abuse

BACKGROUND

Interventions to minimize the long-term consequences of neglect or emotional abuse rely on prompt identification of these children. This systematic review of world literature (1947-2012) identifies features that children aged 5-14 years experiencing neglect or emotional abuse, as opposed to physical or sexual abuse, may exhibit.

METHODS

Searching 18 databases, utilizing over 100 keywords, supplemented by hand searching, 13,210 articles were identified and 111 underwent full critical appraisal by two independent trained reviewers.

RESULTS

The 30 included studies highlighted behavioural features (15 studies), externalizing features being the most prominent (8/9 studies) and internalizing features noted in 4/6 studies. Four studies identified attention deficit hyperactivity disorder (ADHD) associated features: impulsivity, inattention or hyperactivity. Child difficulties in initiating or developing friendships were noted in seven studies. Of 13 studies addressing emotional well-being, three highlighted low self-esteem, with a perception of external control (1), or depression (6) including suicidality (1). A negative internal working model of the mother increased the likelihood of depression (1). In assessing cognition or academic performance, lower general intelligence (3/4) and reduced literacy and numeracy (2) were reported, but no observable effect on memory (3).

CONCLUSIONS

School-aged children presenting with poor academic performance, ADHD symptomatology or abnormal behaviours warrant assessment of neglect or emotional abuse as a potential underlying cause.

Understanding interpersonal trauma in children: why we need a developmentally appropriate trauma diagnosis

Childhood exposure to victimization is prevalent and has been shown to contribute to significant immediate and long-term psychological distress and functional impairment. Children exposed to interpersonal victimization often meet criteria for psychiatric disorders other than posttraumatic stress disorder (PTSD). Therefore, this article summarizes research that suggests directions for broadening current diagnostic conceptualizations for victimized children, focusing on findings regarding victimization, the prevalence of a variety of psychiatric symptoms related to affect and behavior dysregulation, disturbances of consciousness and cognition, alterations in attribution and schema, and interpersonal impairment. A wide range of symptoms is common in victimized children. As a result, in the current psychiatric nosology, multiple comorbid diagnoses are necessary-but not necessarily accurate-to describe many victimized children, potentially leading to both undertreatment and overtreatment. Related findings regarding biological correlates of childhood victimization and the treatment outcome literature are also reviewed. Recommendations for future research aimed at enhancing diagnosis and treatment of victimized children are provided.

Exposure to interpersonal violence and risk for PTSD, depression, delinquency, and binge drinking among adolescents: data from the NSA-R

Interpersonal violence (IPV) is associated with a range of subsequent negative outcomes; however, research has yet to test whether IPV operates as a specific risk factor for separate psychopathology outcomes, such as posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, delinquent acts, or binge drinking. To address this, cumulative exposure to IPV and non-IPV-related traumatic events, PTSD symptoms, depressive symptoms, delinquent acts, and binge drinking were measured 3 times over approximately 3 years among a nationally representative sample of adolescents aged 12-17 (N = 3,614 at Wave 1). Results demonstrated that cumulative IPV exposure predicted subsequent PTSD, depression, delinquency, and binge drinking (βs = .07, .12, .10, and .09, respectively; all ps < .01) when all cross-relationships (e.g., the effect of delinquency on future binge drinking) were in the model. Exposure to non-IPV traumatic events generally did not confer vulnerability to subsequent psychopathology outcomes. Overall, findings from this study advance the literature in this area by exploring consequences for adolescents following cumulative IPV exposure.

Can maltreated children inhibit true and false memories for emotional information?

The authors examined 284 maltreated and nonmaltreated children's (6- to 12-year-olds) ability to inhibit true and false memories for neutral and emotional information using the Deese/Roediger-McDermott (DRM) paradigm. Children studied either emotional or neutral DRM lists in a control condition or were given directed-remembering or directed-forgetting instructions. The findings indicated that children, regardless of age and maltreatment status, could inhibit the output of true and false emotional information, although they did so less effectively than when they were inhibiting the output of neutral material. Verbal IQ was related to memory, but dissociative symptoms were not related to children's recollective ability. These findings add to the growing literature that shows more similarities among, than differences between, maltreated and nonmaltreated children's basic memory processes.

Can maltreated children inhibit true and false memories for emotional information?

The authors examined 284 maltreated and nonmaltreated children's (6- to 12-year-olds) ability to inhibit true and false memories for neutral and emotional information using the Deese/Roediger-McDermott (DRM) paradigm. Children studied either emotional or neutral DRM lists in a control condition or were given directed-remembering or directed-forgetting instructions. The findings indicated that children, regardless of age and maltreatment status, could inhibit the output of true and false emotional information, although they did so less effectively than when they were inhibiting the output of neutral material. Verbal IQ was related to memory, but dissociative symptoms were not related to children's recollective ability. These findings add to the growing literature that shows more similarities among, than differences between, maltreated and nonmaltreated children's basic memory processes.

The effects of maltreatment and neuroendocrine regulation on memory performance

This investigation examined basic memory processes, cortisol, and dissociation in maltreated children. School-aged children (age range=6-13), 143 maltreated and 174 non-maltreated, were administered the California Verbal Learning Test-Children (D. C. Delis, J. H. Kramer, E. Kaplan, & B. A. Ober, 1994) in a week-long camp setting, daily morning cortisol levels were assessed throughout the duration of camp, and behavioral symptoms were evaluated. Maltreatment and cortisol regulation were not related to short- or long-delay recall or recognition memory. However, children experiencing neglect and/or emotional maltreatment and low cortisol evinced heightened false recognition memory. Dissociative symptoms were higher in maltreated children; however, high dissociation was related to recognition inaccuracy only among non-maltreated children. Results highlight the interplay between maltreatment and hypocortisolism in children's recognition memory errors.

Understanding the "ghosts in the nursery" of pregnant women experiencing domestic violence: Prenatal maternal representations and histories of childhood maltreatment

Selma Fraiberg and colleagues (1975) conceptualized the "ghosts in the nursery" as experiences from a mother's past that influenced her ability to form a warm and attuned relationship with her child. Contemporary infant mental health interventions often ask the mother to reflect on her own history of attachment relationships to gain insight into as well as to strengthen her developing relationship with her child. This study investigated the association between a mother's history of childhood maltreatment (CM) and her subsequent prenatal maternal representation during the third trimester of pregnancy. Controlling for domestic violence (DV), distorted prenatal representations were associated with higher rates of self-reported childhood physical neglect. In addition, DV moderated the relationship between representations and CM, such that women who were exposed to DV during pregnancy and had distorted prenatal representations were least likely to report childhood physical and sexual abuse. Implications are discussed in relation to infant mental health interventions which rely on a parent's ability to psychologically access and reflect on childhood histories to more sensitively parent her own child.

Cognitive processes in dissociation: comment on Giesbrecht et al. (2008)

In their recent review "Cognitive Processes in Dissociation: An Analysis of Core Theoretical Assumptions," published in Psychological Bulletin, Giesbrecht, Lynn, Lilienfeld, and Merckelbach have challenged the widely accepted trauma theory of dissociation, which holds that dissociative symptoms are caused by traumatic stress. In doing so, the authors have outlined a series of links between various constructs--such as fantasy proneness, cognitive failures, absorption, suggestibility, altered information-processing, dissociation, and amnesia--claiming that these linkages lead to the false conclusion that trauma causes dissociation. A review of the literature, however, shows that these are not necessarily related constructs. Careful examination of their arguments reveals no basis for the conclusion that there is no association between trauma and dissociation. The current comment offers a critical review and rebuttal of Giesbrecht et al.'s argument that there is no relationship between trauma and dissociation.

Abuse-specific self-schemas and self-functioning: a prospective study of sexually abused youth

Potential pathways from childhood sexual abuse (CSA) to negative self-schemas to subsequent dissociative symptoms and low global self-esteem were examined in a prospective longitudinal study of 160 ethnically diverse youth with confirmed CSA histories. Participants were interviewed at the time of abuse discovery, when they were 8 to 15 years of age, and again 1 and 6 years later. Abuse-specific indicators of stigmatization, in particular the combination of shame and self-blame more than general self-blame attributions for everyday events, explained which youth with CSA histories experienced more dissociative symptoms and clinically significant levels of dissociation. Abuse-specific stigmatization was found to operate as a prospective mechanism for subsequent dissociative symptoms but not self-esteem.

Autobiographical memory functioning among abused, neglected, and nonmaltreated children: the overgeneral memory effect

BACKGROUND

This investigation addresses whether there are differences in the form and content of autobiographical memory recall as a function of maltreatment, and examines the roles of self-system functioning and psychopathology in autobiographical memory processes.

METHODS

Autobiographical memory for positive and negative nontraumatic events was evaluated among abused, neglected, and nonmaltreated school-aged children.

RESULTS

Abused children's memories were more overgeneral and contained more negative self-representations than did those of the nonmaltreated children. Negative self-representations and depression were significantly related to overgeneral memory, but did not mediate the relation between abuse and overgeneral memory.

CONCLUSIONS

The meaning of these findings for models of memory and for the development of overgenerality is emphasized. Moreover, the clinical implications of the current research are discussed.

Memory, maternal representations, and internalizing symptomatology among abused, neglected, and nonmaltreated children

A depth-of-processing incidental recall task for maternal-referent stimuli was utilized to assess basic memory processes and the affective valence of maternal representations among abused (N = 63), neglected (N = 33), and nonmaltreated (N = 128) school-aged children (ages 8-13.5 years old). Self-reported and observer-rated indices of internalizing symptoms were also assessed. Abused children demonstrated impairments in recall compared to neglected and nonmaltreated children. Although abused, neglected, and nonmaltreated children did not differ in valence of maternal representations, positive and negative maternal schemas related to internalizing symptoms differently among subgroups of maltreated children. Valence of maternal schema was critical in differentiating those with high and low internalizing symptomatology among the neglected children only. Implications for clinical intervention and prevention efforts are underscored.