Cognition, Plasticity, and Functioning After Childhood Adversity in Major Depressive Disorder
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Background: There is a compelling association between childhood adversity and Major Depressive Disorder (MDD) in adulthood, including more severe and treatment-resistant presentations of illness. Childhood adversity is also related to deficits in neurocognition, smaller hippocampal volume, and changes in structural and functional brain connectivity. At the same time, neurocognitive impairment accompanies many cases of MDD, but the extent to which childhood adversity accounts for cognitive variance has not been investigated. Furthermore, it is unclear whether adversity is related to plasticity, indicated by response to neurocognitive treatment, and if the relationship between cognition and functioning differs among individuals based on their history of childhood adversity. Objective: The current research sought to clarify how early adversity and select characteristics of illness relate to cognitive differences in MDD, as well as response to Cognitive Remediation (CR), a treatment that promotes neurogenesis and plasticity through cognitive exercise and compensatory strategies. In addition, this project examined the moderating role of adversity in the relationship between cognition and skills required for everyday functioning. Method: Thirty-nine individuals with MDD who previously completed a 10-week CR intervention, as well as neurocognitive and functional skills testing, were re-recruited to engage in a retrospective interview on childhood adversity. Results: More adversity endured as a child and repeated depressive episodes were associated with poorer cognition in adulthood, B = -.45, t(36) = -3.34, p = .002, and B = -.33, t(36) = -2.53, p = .017, together accounting for 37.4% of variance in cognition. Childhood adversity was associated with more improvement following CR, but this relationship was small in magnitude, ∆R2 = .05, ∆F(2, 36) = 4.36, p = .044. A significant association between cognition and functional performance was apparent only among individuals who experienced high levels of adversity, b = .63, SE = .25, p = .018. Conclusions: Our findings highlight childhood adversity and multiple depressive episodes as factors associated with cognitive impairment in MDD. We emphasize early trauma as an important variable to be addressed in neurocognitive treatment and research.
URI for this recordhttp://hdl.handle.net/1974/26467
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