Deficits in short-term memory in adult survivors of childhood abuse

“…a history of severe childhood physical and/or sexual abuse, as determined by the Early Trauma Inventory (ETI), and an Axis I psychiatric disorder on the basis of a semistructured interview, the Schedule for Affective Disorders and SchizophreniaLifetime version (SADS-L; Endicott and Spitzer, 1978).”

“1990; Uno et al., 1989) a brain structure that plays an important role in learning and memory (Squire and Zola-Morgan, 1991).”

“(4) The Visual Selective Reminding Procedure (ViSRT; Buschke and Fuld, 1974; Hannay and Levin, 1985) is a task modeled on the verbal selective reminding in which 12 designs are presented one at a time for 3 s each, followed by an opportunity for the subject to draw all from memory.”

“Deficits in verbal short-term memory, as measured by the Wechsler Memory Scale, were associated with decreased right hippocampal volume in these patients (Bremner et al., 1995b).”

“…1988; Swett et al., 1990) dissociation (Putnam et al., 1986; Chu and Dill, 1990; Ross et al., 1991) post- traumatic stress disorder (PTSD) (Greenwald and Leitenberg, 1990), borderline personality disorder (Herman et al., 1989; Ogata et al., 1990) alcohol and substance abuse (Ladwig and Anderson.”

“…between early trauma patients and comparison result in damage to neurons of the hippocampus subjects, it is of interest to note that there were (Sapolsky et al., 1988, 1990; Uno et al., 1989) a some relationships between IQ and abuse in this brain structure that plays an important role in…”

“…from the National Center for PTSD, based on clinical experience, a review of available existing instruments, and a survey of the clinical literature on childhood abuse (Finkelhor, 1979, 1986; Lewis et al., 1979; Herman, 1981; Herman et al., 1986; Russell, 1986; Briere and Runtz, 1987; Wyatt, 1885).”

“Rates of sexual abuse have been estimated from community samples to be from 11% to 62% in women (Russell, 1983; Finkelhor and Hotaling, 1984; Kercher and McShane, 1984; Wyatt, 1985) and from 3% to 39% in men (Finkelhor and Hotaling, 1984; Kercher and McShane, 1984).”

“…from the National Center for PTSD, based on clinical experience, a review of available existing instruments, and a survey of the clinical literature on childhood abuse (Finkelhor, 1979, 1986; Lewis et al., 1979; Herman, 1981; Herman et al., 1986; Russell, 1986; Briere and Runtz, 1987; Wyatt, 1885).”

“…including depression (Briere et al., 1988; Swett et al., 1990), anxiety (Briere et al., 1988; Swett et al., 1990) dissociation (Putnam et al., 1986; Chu and Dill, 1990; Ross et al., 1991) post- traumatic stress disorder (PTSD) (Greenwald and Leitenberg, 1990), borderline personality…”

“Overall severity of abuse, as measured by learning and memory, with associated deficits in the summed abuse severity score, was associated memory (Luine et al., 1994).”

“High levels of glucocorticoids released during stress have been shown to cause damage to neurons in the hippocampus (Sapolsky et al., 1988. 1990; Uno et al., 1989) a brain structure that plays an important role in learning and memory (Squire and Zola-Morgan, 1991).”

“(2) Two subtests of the Wechsler Memory Scale (WMS) were administered according to the Russell revision (Russell, 1975).”

“Although considerable variation exists with regard to the definition of childhood abuse (Kinsey et al., 1953; Finkelhor and Hotaling, 1984; Wyatt, 1985; Briere and Runtz, 1988), there are no empirical bases to justify the use of specific criteria.”

“Considerable evidence supports a relationship between stress and alterations in memory (review- ed in Charney et al., 1993; Bremner et al., 1995a).”

“1989: Brown and Anderson, 1991) and other psychiatric disorders (Green, 1978; Herman, 198 1; Carmen et al., 1984; Bryer et al.. 1987; Bulik et al., 1989; Hall et al., 1989; Palmer et al., 1990).”

“1989: Brown and Anderson, 1991) and other psychiatric disorders (Green, 1978; Herman, 198 1; Carmen et al., 1984; Bryer et al.. 1987; Bulik et al., 1989; Hall et al., 1989; Palmer et al., 1990).”

“Severity of physical abuse was released during stress that facilitate the laying associated with decreased performance IQ down of memory traces (Pitman, 1989; Pitman et (r = -0.50, df = 20, P = 0.022). al., 1993; Bremner et al., 1995a).”

“, 1993) in collaboration with colleagues from the National Center for PTSD, based on clinical experience, a review of available existing instruments, and a survey of the clinical literature on childhood abuse (Finkelhor, 1979, 1986; Lewis et al., 1979; Herman, 1981; Herman et al., 1986; Russell, 1986; Briere and Runtz…”

“Other studies in combat veterans and prisoners of war from World War II and the Vietnam war have documented amnesia and other dis- turbances of memory (Archibald and Tuddenham, 1965; Thygesen et al., 1970; Eitinger, 1980; Goldstein et al., 1987; Bremner et al., 1992, 1993b).”

“, 1993) in collaboration with colleagues from the National Center for PTSD, based on clinical experience, a review of available existing instruments, and a survey of the clinical literature on childhood abuse (Finkelhor, 1979, 1986; Lewis et al., 1979; Herman, 1981; Herman et al., 1986; Russell, 1986; Briere and Runtz…”

“, 1993) in collaboration with colleagues from the National Center for PTSD, based on clinical experience, a review of available existing instruments, and a survey of the clinical literature on childhood abuse (Finkelhor, 1979, 1986; Lewis et al., 1979; Herman, 1981; Herman et al., 1986; Russell, 1986; Briere and Runtz…”

“Other studies in Vietnam combat veterans have shown deficits in new learning and memory using different neuro- psychological tests than the Wechsler Memory Scale (Uddo et al., 1993; Yehuda et al., 1995).”

“Deficits in verbal short-term memory, as measured by the Wechsler Memory Scale, were associated with decreased right hippocampal volume in these patients (Bremner et al., 1995b).”

“Other studies in Vietnam combat veterans have shown deficits in new learning and memory using different neuro- psychological tests than the Wechsler Memory Scale (Uddo et al., 1993; Yehuda et al., 1995).”

“Other studies in combat veterans and prisoners of war from World War II and the Vietnam war have documented amnesia and other dis- turbances of memory (Archibald and Tuddenham, 1965; Thygesen et al., 1970; Eitinger, 1980; Goldstein et al., 1987; Bremner et al., 1992, 1993b).”

“…between early trauma patients and comparison result in damage to neurons of the hippocampus subjects, it is of interest to note that there were (Sapolsky et al., 1988, 1990; Uno et al., 1989) a some relationships between IQ and abuse in this brain structure that plays an important role in…”

“1989: Brown and Anderson, 1991) and other psychiatric disorders (Green, 1978; Herman, 198 1; Carmen et al., 1984; Bryer et al.. 1987; Bulik et al., 1989; Hall et al., 1989; Palmer et al., 1990).”

“, 1990), anxiety (Briere et al., 1988; Swett et al., 1990) dissociation (Putnam et al.”

“Empirical studies of short-term memory have shown deficits in short-term memory, as measured by the Logical component of the Wechsler Memory Scale, in prisoners of war in comparison to combat veterans without a history of containment during the Korean war (Sutker et al., 1988, 1991).”

“1989: Brown and Anderson, 1991) and other psychiatric disorders (Green, 1978; Herman, 198 1; Carmen et al., 1984; Bryer et al.. 1987; Bulik et al., 1989; Hall et al., 1989; Palmer et al., 1990).”

“Rates of sexual abuse have been estimated from community samples to be from 11% to 62% in women (Russell, 1983; Finkelhor and Hotaling, 1984; Kercher and McShane, 1984; Wyatt, 1985) and from 3% to 39% in men (Finkelhor and Hotaling, 1984; Kercher and McShane, 1984).”

“Neurotransmitters and neuropeptides released during stress also have the potential to result in an overconsolidation of memory traces, which may explain the existence of intrusive memories in patients with PTSD (Pit- man, 1989; Pitman et al., 1993; Bremner et al., 1995a).”

“…deficits in short-term verbal memory, as measured by the Logical component of the Wechsler Memory Scale and the Verbal Selective Reminding Test, with no change in IQ, in Vietnam combat veterans with posttraumatic stress disorder (PTSD) in comparison to control subjects (Bremner et al., 1993a).”

“1989: Brown and Anderson, 1991) and other psychiatric disorders (Green, 1978; Herman, 198 1; Carmen et al., 1984; Bryer et al.. 1987; Bulik et al., 1989; Hall et al., 1989; Palmer et al., 1990).”

“, 1990), anxiety (Briere et al., 1988; Swett et al., 1990) dissociation (Putnam et al.”

“Other studies in combat veterans and prisoners of war from World War II and the Vietnam war have documented amnesia and other disturbances of memory (Archibald and Tuddenham, 1965; Thygesen et al., 1970; Eitinger, 1980; Goldstein et al., 1987; Bremner et al., 1992, 1993b).”

“In addition, early treatment interventions may prevent the long-term impairments in memory function, and hence academic performance, that appear to be associated with exposure to high levels of stress as occurs with childhood abuse (Saigh, 1989).”

“Five percent of soldiers in a major campaign in World War II had no memory for events which had just occurred immediately after they had participated as combatants (Torrie, 1944).”

“, 1990) dissociation (Putnam et al., 1986; Chu and Dill, 1990; Ross et al., 1991) posttraumatic stress disorder (PTSD) (Greenwald and Leitenberg, 1990), borderline personality disorder (Herman et al.”

“Empirical studies of short-term memory have shown deficits in short-term memory, as measured by the Logical component of the Wechsler Memory Scale, in prisoners of war in comparison to combat veterans without a history of containment during the Korean war (Sutker et al., 1988, 1991).”

“Consistent with deficits in hippocampal function are deficits in verbal declarative memory (Bremner 1995) and failure of hippocampal hippocampal activation with memory tasks (Bremner 2003a) in adult women with early abuse-related PTSD. Children with PTSD have smaller whole brain and corpus callosum…”

“Favoring this are findings hinting that atrophy is more a correlate of trauma itself, rather than of PTSD.”

“We have previously reported interrater reliability data demonstrating a high level of agreement for hippocampus, temporal lobe, and caudate (Bremner et al 1995b).”

“Bremner et al. (1995b) showed that male combat veterans with PTSD had reduced MRIderived right-sided hippocampal volume compared to control subjects and, moreover, that certain aspects of their memory deficit were correlated with hippocampal volume.”

“Bremner et al. (1997) have reported 12% left hippocampal volume reduction in 17 adult male and female survivors of severe childhood physical and sexual abuse who now suffered PTSD, in comparison with a nonabused group. There was, however, no associated memory impairment. Stein, Koverola, Hanna, Torchia, and Mclarty (1…”

“Encoding of paragraphs was selected as the task for assessment of neural correlates of verbal declarative memory function because prior studies have shown that PTSD patients have deficits on this task (24, 25).”

“Studies of adults who were maltreated as children do not generally report IQ differences relative to controls (Bremner et al., 1995; Twamley et al., 2004), suggesting that if IQ is associated with maltreatment it may normalize with age.”

“Memory problems have often been reported in individuals with maltreatment histories (62, 63).”

“, 2006) and during verbal declarative memory tasks more generally (Bremner et al., 1995; Shin et al., 2004).”

“T GE Electric Signa Camera (General Electric Medical Systems, Milwaukee, Wisconsin) with a protocol previously described (Bremner et al 1995a).”

“Thus, PFC dysfunction might account for working memory deficits of PTSD-patients (Bremner et al., 1993a, 1995a).”

“…smaller hippocampal volume and/or N-acetyl aspartate (NAA, a marker of neuronal integrity) measured with magnetic resonance imaging (MRI) in PTSD (Bremner et al., 1995b, 1997b, 2003c; Stein et al., 1997; Freeman et al., 1998; Schuff et al., 2001; Villarreal et al., 2002; Lindauer et al., 2004;…”

“In particular, we adopted indices which have previously been shown to be affected by acute changes in corticosteroids , including verbal memory (Bremner et al., 1995), selective attention (Lupien et al., 1994) and divided attention (Bohnen et al., 1990).”

“The same group also reported similar results with adult survivors of severe childhood physical or sexual abuse who presented for psychiatric treatment.([51]) Using a modified SPS paradigm, Harvey et al.”

“Patients with PTSD in general show deficits in verbal declarative memory (Bremner et al 1993, 1995a), as well as a preference for remembrance of trauma-related material (McNally et al 1990).”

“R) Bremner et al. (1995) Interpersonal 21 Mixed Non-trauma-exposed Verbal immediate (WMS, SRT) Mild head injury excluded Verbal delayed (WMS, SRT) Visual immediate (WMS, SRT) Visual delayed (WMS, SRT) Bremner et al. (1993) Military 26 Men Non-trauma-exposed Verbal immediate (WMS, SRT) Mild head…”

“Furthermore, it has been shown that patients with PTSD show significant deficits in memory [Bremner et al., 1993, 1995b].”

“Deficits in short-term verbal memory have been observed in adults with childhood sexual abuse.(1) Deficient inhibitory capacity,(2) problems with verbally mediated higher cognitive abilities,(3) and distractibility and impaired sustained attention(4) have been observed in abused children.”

“This may explain, in part, the memory impairment seen in victims of trauma (Bremner et al., 1995; Bremner, Randall, Scott, & Bronen, 1997; Debellis, 1997, 2002).”

“All rights reserved First published online as a Review in Advance on September 16, 2005 STRESSFUL EXPERIENCE AND LEARNING ACROSS THE LIFESPAN”

“A number of investigations have demonstrated associations between childhood maltreatment and poorer cognitive functioning in adulthood, including reduced intellectual and academic functioning (Perez and Widom, 1994), deficits on tasks of verbal learning and memory (Bremner et al., 1995), working memory (Raine et al.”

“…PTSD (Gilbertson et al., 2006, 2001; Buckley et al., 2000; Elzinga and Bremner, 2002; Brewin, 2001; Golier and Yehuda, 1998; Bremner et al., 1993; Bremner et al., 1995; Jenkins et al., 1998; Moradi et al., 1999; Roca and Freeman, 2001; Uddo et al., 1993; Vasterling et al., 1998, 2002; Yehuda et…”

“…hippocampal volume in combat veterans with PTSD and 12% in left hippocampal volume in women with childhood sexual abuse-related PTSD. Magnitude of reduction in hippocampal volume in these studies was associated with magnitude of deficits in short-term verbal memory [Bremner et al., 1995c, 1997b].”

“In a study comparing Vietnam combat veterans with PTSD (N = 26) to healthy date, or amygdala between patients and controls in this study (Bremner et al., 1995a).controls (N = 16) matched for age, race, years of alcohol abuse, years of education, handed- Multiple linear regression including…”

“…Memory Test) found specific deficits in verbal declarative memory function, with a relative sparing of visual memory and IQ (Barrett et al., 1996; Bremner et al., 1993a, 1995a; Gil et al, 1990; Gilbertson et al., 2001; Golier et al., 1997; Jenkins et al., 1998; Moradi et al., 1999; Roca and…”

“These results support arlier studies demonstrating a strong relationship between ippocampal size and cognitive functioning of individuals who ad been exposed to traumatic stress (Bremner et al 1995a, 1997; urvits et al 1996).”

“Isolating specific brain regions with functional imaging, and exploring the effects of their relative activation on emotional and cognitive correlates of PTSD, could shed further light on an integrated neural network in PTSD. CONCLUSIONS Summary of Findings Much of what is known about the neuropsychological deficits a…”

“Thus, PTSD is not associated with degraded retention when the initial formation is controlled for (e.g., Brandes et al., 2002; Bremner et al., 1993, 1995; Jenkins et al., 2000; Vasterling et al., 1998, 2002, 2000).”

“Patients with PTSD secondary to combat [45–49] and childhood abuse [50,51] have been reported to have deficits in verbal declarative memory function based on neuropsychological testing.”

“More importantly, Bremner et al. (1995a) found that these verbal memory deficits were significantly associated with the smaller size of the right hippocampus of the PTSD subjects, suggesting the possibility of a causal relation between the two.”

“, 1997c), with similar deficits in verbal memory as we had seen in combat-related PTSD (Bremner et al., 1995a).”

“For example, dysfunctional short-term memory (STM) processes observed in adults who were regularly exposed to abuse (Bremner et al., 1995) or severe social deprivation (Bos, Fox, Zeanah, & Nelson, 2009) during infancy could be related to reduced volume in their brain structures (hippocampus)…”

“…support for impaired PFC function, as PTSD is associated with elevated catecholamine release in response to stress (reviewed in Charney, Deutch, Krystal, Southwick, & Davis, 1993; Southwick et al., 1999), and patients show deficits in working memory (Bremner et al., 1993; Bremner et al., 1995).”

“Studies show that cognitive impairment may be associated with maltreatment during childhood (Beers & De Bellis, 2002; Bremner et al., 1995; De Bellis, Hooper, Spratt, & Woolley, 2009; Goodman, Quas, & Ogle, 2010; Mezzacappa, Kindlon, & Earls, 2001; Savitz, van der Merwe, Stein, Solms, & Ramesar,…”

“Other studies have similarly found that in other cohorts of individuals with PTSD, difficulties in attention, learning, and verbal memory are also present (Bremner et al., 1995; Marx, Doron-Lamarca, Proctor, & Vasterling, 2009; Samuelson et al., 2006; Vasterling et al., 2002, 2012).”

“Posttraumatic stress disorder (PTSD) in children is associated with numerous negative outcomes including significant social impairment (Berman, Kurtines, Silverman, & Serafini, 1996; Stallard, Velleman, & Baldwin, 1998), cognitive deficits (Bremner et al., 1995), poor academic performance (Reinherz, Gianconia, Lefkowi…”

“Indeed, childhood trauma victims and patients with psychosis show similar areas of cognitive deficits: for example, they both show decline in general cognition,workingmemoryandhippocampus-related memory tests (Bremner et al., 1995; Flashman andGreen, 2004; Lysaker et al., 2001; Perez and Widom, 1994).”

“Two brain-imaging studies of adults with histories of child sexual abuse reported a reduced size of the hippocampus, a part of the brain associated with memory, and in a test of verbal short-term memory, adults who had been abused had lower scores [34-36].”

“Several small clinical studies of women with a history of physical and sexual abuse reported disorders of vigilance, memory and mathematical ability compared to controls (Navalta et al., 2006; Bremner et al., 1995; Bremner et al., 2004) but with no impact on IQ.”

“poorer in adult survivors of childhood physical and sexual abuse.(11) Findings suggested that this stressor is asso-”

“Verbal memory impairments have often been reported in PTSD (Beers and De Bellis 2002; Bremner et al. 1993, 1995b; Gilbertson et al. 1997, 2001; Golier et al. 2002; Horner and Hamner 2002; Vasterling et al. 1998, 2002; Yehuda et al. 1995).”

“Indeed, there is behavioral evidence suggesting decrement in the memory performance of adults who encountered traumatic stress experienced during early development (e.g., Bremner et al., 1995; Golier et al., 2002).”

“Further, because glutamate receptors who suffer PTSD as a result of childhood abuse have been shown to have deficits in and glucocorticoids likely are coinvolved in hippocampal cell death resulting from high verbal, but not in visual short-term memory (Bremner, et al., 1995c).”

“Given recent findings showing deficits in working memory in abused individuals [Bremner et al., 1995] and deficits in executive functions and working memory in violent offenders [Seguin et al.”

“, 2006), memory (Bremner et al., 1995; Raine et al., 2001; Bremner et al., 2004; Navalta et al., 2006) and working memory (Raine et al.”

“In contrast, PTSD has been associated with enduring cognitive symptoms (Bremner et al., 1995; Vasterling et al., 1998, 2002, 2006).”

“The hippocampus integrates different aspects of memory / the left hippocampus more important in verbal memory (106).”

“While Stein et al. (1999) found no evidence of memory impairment among women survivors of childhood sexual abuse, Bremner et al. (1995) found that adult survivors of child abuse manifested significant deficits in verbal memory, dependent on the severity of abuse experienced in childhood.”

“hyperarousal) alterations in the HPA-axis produce neuroanatomical changes including volume changes in the frontal lobe, lower neuronal density in the medial temporal lobe and hippocampal atrophy [37–39] and thereby evoke significant changes in cognitive functioning.”

“For instance, Bremner et al. (1995) found that childhood physical and sexual abuse was associated with longterm deficits in verbal short-term memory.”

“Patients with PTSD display poorer performance on several tests of learning and memory including the Wechsler Memory Scale-Revised WMS-R, California Verbal-Learning Test CVLT, Rey Auditory Verbal-Learning Test AVLT, Selective Reminding Test,([20]) and the Rivermead Behavioral Memory Test.”

“Deficit in memory function was also related to the severity and duration of maltreatment experience (Bremner et al., 1995; Navalta et al., 2006).”