Essex Marilyn J, Klein Marjorie H, Cho Eunsuk, Kalin Ned H
Department of Psychiatry, Wisconsin Psychiatric Institute and Clinics, University of Wisconsin, 6001 Research Park Boulevard, Madison, WI 53719, USA.
Biol Psychiatry. 2002 Oct 15;52(8):776-84. doi: 10.1016/s0006-3223(02)01553-6.
Preclinical studies demonstrate that the neonatal environment can permanently alter an individual's responses to stress. To demonstrate a similar phenomenon in humans, we prospectively examined the relationships of maternal stress beginning in infancy and concurrent stress on preschoolers' hypothalamic-pituitary-adrenal activity and later mental health symptoms.
Salivary cortisol levels were assessed in 282 4.5-year-old children and 154 of their siblings. Maternal reports of stress were obtained when the children were ages 1, 4, and 12 months, and again at 4.5 years. Children's mental health symptoms were assessed in first grade.
A cross-sectional analysis revealed that preschoolers exposed to high levels of concurrent maternal stress had elevated cortisol levels; however, a longitudinal analysis revealed that concurrently stressed children with elevated cortisol also had a history of high maternal stress exposure in infancy. Importantly, children exposed only to high levels of concurrent or early stress had cortisol levels that did not significantly differ from those never exposed to stress. Further analysis of the components of stress indicated that maternal depression beginning in infancy was the most potent predictor of children's cortisol. We also found that preschoolers with high cortisol levels exhibited greater mental health symptoms in first grade.
These results link the findings of preclinical studies to humans by showing that exposure to early maternal stress may sensitize children's pituitary-adrenal responses to subsequent stress exposure.
临床前研究表明，新生儿环境可永久性改变个体对应激的反应。为了在人类中证明类似现象，我们前瞻性地研究了婴儿期开始的母亲应激以及学龄前儿童下丘脑-垂体-肾上腺活动和后期心理健康症状的并发应激之间的关系。
对282名4.5岁儿童及其154名兄弟姐妹的唾液皮质醇水平进行评估。在儿童1岁、4岁和12个月时，以及4.5岁时再次获取母亲对应激的报告。在一年级时评估儿童的心理健康症状。
横断面分析显示，暴露于高水平并发母亲应激的学龄前儿童皮质醇水平升高；然而，纵向分析显示，皮质醇升高的并发应激儿童在婴儿期也有高母亲应激暴露史。重要的是，仅暴露于高水平并发或早期应激的儿童的皮质醇水平与从未暴露于应激的儿童没有显著差异。对应激成分的进一步分析表明，婴儿期开始的母亲抑郁是儿童皮质醇的最有力预测因素。我们还发现，皮质醇水平高的学龄前儿童在一年级时表现出更严重的心理健康症状。
这些结果通过表明暴露于早期母亲应激可能使儿童的垂体-肾上腺对应激暴露的反应敏感化，将临床前研究的结果与人类联系起来。
