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Neurocognitive deficits, such as cognitive flexibility impairments, are common in bipolar disorder (BD) and predict poor academic, occupational, and functional outcomes. However, the association between neurocognition and illness trajectory is not well understood, especially across developmental transitions. This study examined cognitive flexibility and subsequent mood symptom and suicidal ideation (SI) course in young adults with childhood-onset BD-I (with distinct mood episodes) vs. BD-not otherwise specified (BD-NOS) vs. typically-developing controls (TDCs). Sample included 93 young adults (ages 18-30) with prospectively verified childhood-onset DSM-IV BD-I (n = 34) or BD-NOS (n = 15) and TDCs (n = 44). Participants completed cross-sectional neuropsychological tasks and clinical measures. Then participants with BD completed longitudinal assessments of mood symptoms and SI at 6-month intervals (M = 39.18 ± 16.57months of follow-up data). Analyses included ANOVAs, independent-samples t tests, chi-square analyses, and multiple linear regressions. Participants with BD-I had significant deficits in cognitive flexibility and executive functioning vs. BD-NOS and TDCs, and impaired spatial working memory vs. TDCs only. Two significant BD subtype-by-cognitive flexibility interactions revealed that cognitive flexibility deficits were associated with subsequent percentage of time depressed and with SI in BD-I but not BD-NOS, regardless of other neurocognitive factors (full-scale IQ, executive functioning, spatial working memory) and clinical factors (current and prior mood and SI symptoms, age of BD onset, global functioning, psychiatric medications, comorbidity). Thus, cognitive flexibility may be an important etiological brain/behavior mechanism, prognostic indicator, and intervention target for childhood-onset BD-I, as this deficit appears to endure into young adulthood and is associated with worse prognosis for subsequent depression and SI.

The purpose of this study was to elucidate possible cognitive mechanisms involved in the intergenerational transmission of trauma from maltreatment-survivor mothers to their toddler/preschool-aged children. This study investigated whether maternal trauma–related cognitions—posttrauma appraisals and disorganized memory for maltreatment—were associated with higher levels of toddler internalizing and externalizing symptoms and more dysfunction in the mother–child relationship. A community sample of mothers with histories of maltreatment and a child between the ages of 2 and 5 years was recruited for a study on maternal attachment, coping, and health ( N = 113). Path analysis results showed that posttrauma appraisals and disorganized memory were significantly related to toddler internalizing symptoms, even with maternal trauma symptoms included in the model. Maternal posttrauma appraisals and disorganized memory were also linked to more dysfunction in the mother–child relationship. These findings provide preliminary evidence in support of maternal trauma–related cognitions as potential mechanisms for the intergenerational transmission of trauma.

The objective of this study was to investigate whether experiences of high betrayal trauma (BT; maltreatment by a parent/caregiver) during mothers' own childhoods may influence the intergenerational transmission of maltreatment and its associated psychopathology from mothers to their children. A prospective, longitudinal design was utilized to assess maternal physical and sexual betrayal trauma in relation to children's own maltreatment experiences, and child mood and behavioral symptoms during pre-adolescence. Data from 706 mothers and children who participated in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) was analyzed, including: mothers' physical and sexual maltreatment histories, child protective services' documented physical and sexual maltreatment during children's first twelve years of life, and mother- and child-reports of child internalizing and externalizing symptoms at age 12. Children of mothers who survived high BT (maltreatment by a caregiver) were 4.52 times more likely to experience maltreatment than children of no BT mothers (mothers whom were not maltreated), and 1.58 times more likely than children whose mothers survived low BT (maltreatment by a non-caregiver). Higher levels of maternal physical BT significantly predicted more internalizing and externalizing symptoms in children at age 12, according to both mother (CBCL) and child (YSR) reports. More incidents of child physical maltreatment partially mediated associations between maternal physical BT and child symptoms. Incidents of sexual maltreatment also partially mediated associations between maternal sexual BT and child internalizing and externalizing symptoms (CBCL only). These findings have implications for understanding the role of betrayal trauma in perpetuating the cycle of maltreatment across generations.