Bick Johanna, Nelson Charles A
Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
Neuropsychopharmacology. 2016 Jan;41(1):177-96. doi: 10.1038/npp.2015.252. Epub 2015 Sep 3.
Children exposed to various forms of adversity early in life are at increased risk for a broad range of developmental difficulties, affecting both cognitive and emotional adjustment. We review a growing body of evidence suggesting that exposure to adverse circumstances affects the developing brain in ways that increase risk for a myriad of problems. We focus on two forms of adversity, one in which children are exposed to childhood maltreatment in family environments, and another in which children are exposed to extreme psychosocial deprivation in contexts of institutional rearing. We discuss ways in which each of these experiences represent violations of species-expected caregiving conditions, thereby imposing challenges to the developing brain. We also review emerging data pointing to the effectiveness of early intervention in remediating neurodevelopmental consequences associated with maltreatment or institutional rearing. We conclude by discussing implications of this work for public health efforts and highlight important directions for the field.
早年经历各种逆境的儿童面临更广泛发育困难的风险增加,这会影响认知和情绪调节。我们回顾了越来越多的证据,表明接触逆境会以增加各种问题风险的方式影响发育中的大脑。我们关注两种逆境形式,一种是儿童在家庭环境中遭受童年虐待,另一种是儿童在机构养育环境中遭受极端心理社会剥夺。我们讨论了这些经历如何以违背物种预期照料条件的方式呈现,从而给发育中的大脑带来挑战。我们还回顾了新出现的数据,这些数据表明早期干预在补救与虐待或机构养育相关的神经发育后果方面的有效性。我们通过讨论这项工作对公共卫生努力的影响来得出结论,并强调该领域的重要方向。