Poster Session 08 Program Schedule
02/16/2024
01:45 pm - 03:00 pm
Room: Majestic Complex (Posters 61-120)
Poster Session 08: Cognition | Cognitive Reserve Variables
Final Abstract #71
The Impact of Trauma on Executive Functioning in End Stage Organ Failure Patients
Kayla Hall, University of Illinois - Chicago, Chicago, United States
Nevin Orleans, University of Illinois - Chicago, Chicago, United States
Devin Ulrich, University of Illinois - Chicago, Chicago, United States
Kyle Jennette, University of Illinois - Chicago, Chicago, United States
Category: Medical/Neurological Disorders/Other (Adult)
Keyword 1: liver disease
Keyword 2: medical disorders/illness
Keyword 3: post-traumatic stress disorder
Objective:
Early life trauma exposure is associated with higher health-risk behaviors and significant illness including end stage organ failure (ESOF). Early life trauma has also been associated with greater risk for cognitive impairment later in life, especially executive functioning (EF), which may further exacerbate the vulnerability of ESOF patients. This study examined the relationship between trauma and EF in a sociodemographically diverse sample of kidney and liver transplant candidates. We posited that exposure to early life trauma would be associated with poorer EF performance.
Participants and Methods:
Retrospective cohort study data were collected from 21 adult kidney and liver transplant candidates in an urban public academic hospital referred for comprehensive neuropsychological evaluation in the context of transplant candidacy. The sample was diverse (42.9% female; 23.8% non-Hispanic White; 52.4% non-Hispanic Black; 23.8% Hispanic) with mean age of 52.7 (SD=11.9) and mean education of 10.9 (SD=2.2). Three 4-level hierarchical regressions were conducted using (1) Adverse Childhood Experiences (ACE); (2) Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5); (3) Childhood Trauma Questionnaire (CTQ) Abuse Scales; and (4) CTQ Neglect Scales to predict performance on the Wisconsin Card Sorting Test Perseverative Errors (WCST), Trail Making Test Part B (TMT), and Stroop Color and Word Test Interference Trial (SCWT).
Results:
When controlling for ACE and PCL-5, the CTQ Emotional Neglect Scale was a significant predictor of TMT Part B performance (B=0.803; p=0.043). CTQ Emotional Abuse was marginally significant (p= 0.073). There were no significant associations between other trauma scales and EF measures.
Conclusions:
Results of this pilot study showed a significant association between childhood emotional neglect and poorer performance on a speeded mental flexibility task in a diverse transplant candidate population when controlling for other forms of early adverse experiences and current trauma-related stress. These findings, in conjunction with the known relationship between trauma and reduced cognitive functioning, present a unique opportunity for meaningful intervention to potentially improve cognitive functioning in a highly vulnerable population. This is particularly relevant as it relates to risk factors for transplant listing and outcomes after surgery. There is a known graded relationship between childhood trauma and the development of health-risk behaviors, such as alcohol and other substance abuse, as one reason for the disparities between patients waiting on organ transplants. Understanding the role of trauma on cognition in this population can provide a target for intervention to potentially improve functional cognitive capacity and increase more equitable access to life-saving intervention that may otherwise be high risk as a function of reduced cognition capacity.
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