MRC Social, Genetic and Developmental Psychiatry Centre, and Department of Child & Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK.
Physiol Behav. 2012 Apr 12;106(1):29-39. doi: 10.1016/j.physbeh.2011.08.019. Epub 2011 Aug 25.
How do adverse childhood experiences get 'under the skin' and influence health outcomes through the life-course? Research reviewed here suggests that adverse childhood experiences are associated with changes in biological systems responsible for maintaining physiological stability through environmental changes, or allostasis. Children exposed to maltreatment showed smaller volume of the prefrontal cortex, greater activation of the HPA axis, and elevation in inflammation levels compared to non-maltreated children. Adults with a history of childhood maltreatment showed smaller volume of the prefrontal cortex and hippocampus, greater activation of the HPA axis, and elevation in inflammation levels compared to non-maltreated individuals. Despite the clear limitations in making longitudinal claims from cross-sectional studies, work so far suggests that adverse childhood experiences are associated with enduring changes in the nervous, endocrine, and immune systems. These changes are already observable in childhood years and remain apparent in adult life. Adverse childhood experiences induce significant biological changes in children (biological embedding), modifying the maturation and the operating balance of allostatic systems. Their chronic activation can lead to progressive wear and tear, or allostatic load and overload, and, thus, can exert long-term effects on biological aging and health.
不良的童年经历是如何“深入骨髓”并通过整个生命周期影响健康结果的？本文回顾的研究表明，不良的童年经历与负责通过环境变化维持生理稳定性的生物系统的变化（即适应）有关。与未受虐待的儿童相比，遭受虐待的儿童的前额叶皮层体积较小，HPA 轴的活性更高，炎症水平升高。与未受虐待的个体相比，有童年虐待史的成年人的前额叶皮层和海马体体积较小，HPA 轴的活性更高，炎症水平升高。尽管从横断面研究中得出纵向结论存在明显的局限性，但迄今为止的研究工作表明，不良的童年经历与神经系统、内分泌系统和免疫系统的持久变化有关。这些变化在儿童时期就已经可以观察到，并在成年期仍然明显。不良的童年经历会在儿童身上引起显著的生物学变化（生物学嵌入），改变适应系统的成熟和运行平衡。它们的慢性激活会导致渐进性磨损或适应负荷和过载，从而对生物衰老和健康产生长期影响。
