Les fonctions exécutives chez les enfants exposés au traumatisme familial
DePrince, A., Weinzierl, K., & Combs, M. (2009). Executive function performance and trauma exposure in a community sample of children. Child Abuse & Neglect, 33(6), 353-361.
Les fonctions exécutives (FE) font partie intégrante du comportement orienté vers un but. La recherche a montré l’influence de ces fonctions chez les adultes ayant subi un traumatisme, mais peu de chercheurs se sont penchés sur les FE chez les enfants ayant subi un traumatisme familial (p. ex., violence sexuelle ou physique ou exposition à la violence familiale). En conséquence, cette étude est parmi les premières à examiner la relation entre le traumatisme causé par la famille et les résultats en matière de FE chez les enfants. Les auteurs ont examiné les FE des enfants qui ont été exposés au traumatisme familial, au traumatisme non familial et de ceux qui n’ont pas été exposés. Les analyses indiquent que les premiers avaient de moins bons résultats que les autres en matière de FE. De plus, le nombre de traumatismes familiaux subis a un effet sur les FE des enfants. Ainsi, les résultats démontrent que les enfants qui ont subi un traumatisme familial pourraient être plus à risque que leurs pairs en ce qui a trait à leur capacité d’utiliser pleinement les FE.
This study predicts children who experience some form of familial trauma (n=44) will exhibit poorer EFs than children exposed to non-familial trauma (e.g., natural disaster, vehicle accident; n=38) and children who have not experienced trauma (n=28). The study engaged school-aged children (n=110) for the study through flyers at community agencies, centres, and businesses. The mean age of the child participants was 10 years (Mean: 10.39, SD: 1.19). Both the children and caregivers participated in a two session study where several measures were administered including those assessing children’s memory, inhibition, processing speed, interference control, and auditory attention. The specific tools used were the Wechler Intelligence Scale for Children-Fourth Edition, Gordon Diagnostic System, the Brief Test of Attention, and a Stroop task. Caregivers completed various tools, assessing behaviours of the child and the type of trauma the child experienced, including the UCLA PTSD Index and the Child Dissociative Checklist. Six children were identified from the familial trauma group who had been sexually abused, but the relationship to the perpetrator was not noted. Thus, they were removed from various analyses during the study because it could not be confirmed they experienced trauma within their family unit. Analysis revealed a link between experiencing familial trauma and poorer EFs, even when considering factors such as dissociation, anxiety, socioeconomic status, and traumatic brain injury. Further, the authors found the number of familial incidents played a role in EF variance; this was not the finding in the non-familial trauma group. Additionally, a medium effect size was found when considering the relationship between IQ and EFs.
Impact et limites:
There are limitations within this study. Caregiver’s may have unconsciously provided an elevated level of dissociation for their child, as they were aware of the requirements of participants and that dissociation was being measured in the study. Further, the trauma report relies upon caregivers’ accounts of trauma histories and may include false negatives given concerns about mandatory reporting to child welfare. The study was cross-sectional and examined only one point in time, therefore, cannot establish a causal relationship between EF and familial trauma exposure. Lastly, EF is closely related to other cognitive measures (e.g., language), thus future research designs would benefit from more thorough cognitive assessments. Nonetheless, this study provides some preliminary evidence that EFs may be lowered in children who have experienced familial trauma, and that EFs require careful assessment.