How does childhood maltreatment influence ensuing cognitive functioning among people with the exposure of childhood maltreatment? A systematic review of prospective cohort studies

Background: Childhood maltreatment is closely related to normal cognitive development and ensuing adverse mental health outcomes and cognitive dysfunction. Our current comprehensive systematic review examines the relationship between childhood maltreatment and cognitive functioning focusing only on prospective studies, which allow us to draw inferences about the temporal relationships among the constructs and make causal inferences. Methods: The databases, EMBASE, HealthStar, PsychoInfo, Medline, and Cochrane Library, were searched using a systematic methodology to identify prospective studies published up to December, 2017 to explore the relationship between childhood maltreatment and cognitive functioning. Quality assessment of each study was rated using Newcastle-Ottawa-Scale (NOS). Results: 10 articles with 11 studies were included evaluating cognitive development, memory, academic achievement, literacy/verbal comprehension, intelligence, executive function, processing speed, perceptional reasoning, and non-verbal reasoning among children exposed to abuse, neglect or domestic violence either individually or combined. Intelligence and executive function were the most frequently reported cognitive impairments. The findings of this review collectively indicated that nine domains of the cognitive functioning impairments were significantly related to multiple forms of maltreatment and that significance remained in multivariable analyses after controlling for potential confounders. Limitations: A high degree of heterogeneity of various domains of cognitive functioning and different measurements among selected studies precluded the use of meta-analysis. Conclusions: Childhood maltreatment is considered as one of the most consistent factors related to later life cognitive dysfunction. The study outcomes provide direction for future research on children who have experienced child abuse and have implications for the delivery of health and mental health services to develop clinical practice and intervention for maltreated children.