TY - JOUR
T1 - Executive functions in trauma-exposed youth: a meta-analysis
AU - Op den Kelder, R.
AU - Van den Akker, A.L.
AU - Geurts, H.M.
AU - Lindauer, R.J.L.
AU - Overbeek, G.J.
PY - 2018/5/3
Y1 - 2018/5/3
N2 - An earlier meta-analysis and review indicated that trauma exposure may be related to lower levels of executive functioning in youth. Since different developmental trajectories were found for three core executive functions, the present study focused on working memory, inhibition, and cognitive flexibility specifically. We conducted a multi-level meta-analysis on 55 studies and 322 effect sizes published between 2001 and 2017 that were retrieved from MEDLINE, Embase, and PsycINFO. The 8070 participants in selected studies were aged 2–25 years. We investigated whether the association between constructs would be moderated by trauma-specific moderators (onset, duration, and type), and study (age, gender, ethnicity, and socio-economic status) and measurement (quality) characteristics. We found small to medium effect sizes for working memory (d = −0.49), inhibition (d = −0.46), and cognitive flexibility (d = −0.44). Moderator analyses showed that, for working memory, when studies used low-quality measurements the effect size was significantly stronger than when studies used high-quality measurements. Compared to single trauma-exposed youth, violence-exposed/abused and foster care/adopted youth showed more problems in inhibition, and foster care/adopted youth showed more problems in cognitive flexibility. Our findings imply that trauma-exposed youth have lower levels of executive functions. Clinical practice should incorporate problems in executive functioning, especially working memory, inhibition, and cognitive flexibility, in assessment and treatment guidelines.
AB - An earlier meta-analysis and review indicated that trauma exposure may be related to lower levels of executive functioning in youth. Since different developmental trajectories were found for three core executive functions, the present study focused on working memory, inhibition, and cognitive flexibility specifically. We conducted a multi-level meta-analysis on 55 studies and 322 effect sizes published between 2001 and 2017 that were retrieved from MEDLINE, Embase, and PsycINFO. The 8070 participants in selected studies were aged 2–25 years. We investigated whether the association between constructs would be moderated by trauma-specific moderators (onset, duration, and type), and study (age, gender, ethnicity, and socio-economic status) and measurement (quality) characteristics. We found small to medium effect sizes for working memory (d = −0.49), inhibition (d = −0.46), and cognitive flexibility (d = −0.44). Moderator analyses showed that, for working memory, when studies used low-quality measurements the effect size was significantly stronger than when studies used high-quality measurements. Compared to single trauma-exposed youth, violence-exposed/abused and foster care/adopted youth showed more problems in inhibition, and foster care/adopted youth showed more problems in cognitive flexibility. Our findings imply that trauma-exposed youth have lower levels of executive functions. Clinical practice should incorporate problems in executive functioning, especially working memory, inhibition, and cognitive flexibility, in assessment and treatment guidelines.
KW - Psychotrauma
KW - cognitive flexibility
KW - executive functions
KW - inhibition
KW - meta-analysis
KW - post-traumatic stress disorder
KW - working memory
KW - youth
UR - http://www.scopus.com/inward/record.url?scp=85075120121&partnerID=8YFLogxK
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U2 - https://doi.org/10.1080/20008198.2018.1450595
DO - https://doi.org/10.1080/20008198.2018.1450595
M3 - Review article
SN - 2000-8198
VL - 9
JO - European journal of psychotraumatology
JF - European journal of psychotraumatology
IS - 1
M1 - 1450595
ER -