Chronic stress and executive brain functions in conduct disordered adolescents

David Joseph Suscovich (1997)

Recent interest regarding the psychological and the physiological effects of stress on a person's sense of well being has resulted in a growing body of research and theories. Conduct disordered behaviors has been viewed, at times, as a maladaptive coping response to life stressors in children. However, it remains unclear to what extent and what forms, the effects of chronic stress have on the developing child. Of particular note, has been the effects that stress produces on the brain and its functions. The child neuropsychological literature raises many interesting questions regarding the relationship of conduct disorder behavior, brain functioning (particularly executive brain functions), and various aspects of stress. However, there exists no clear theory which joins these bodies of literature together in a cohesive manner. The following study suggests that a strong relationship exists between chronic stress and the families of conduct disordered children based on responses to the Parenting Stress Index (PSI), the Stress Response Scale (SRS), and the Suscovich Brief Self Report Stress Questionnaire. Parents and children were found to produce clinically and statistically high scores on these measures, and protocols consistent with a diagnosis of conduct disordered children. Chronic stress is also shown to exert a strong, negative effect on brain development in these children frequently resulting in impairments in sustained attention, ability to remain on tasks, poor organization and planning skills, and various aspects of short term memory. This study further supports this notion by assessing a homogeneous sample of 30, conduct disordered boys ages 13 to 16 years old. When administered a series of standardized, neuropsychological tests, which are used to assess executive brain functions in children, these boys show significant impairments on all aspects of executive brain functions. Of particular note, are impairments in memory retrieval of auditory, language-based material. These CD boys demonstrated marked improvement in this area when provided additional cues and when helped to organize materials. Implications for clinical treatments and education planning are discussed.