Washington State University, Pullman, WA 99164-4820, USA.
Dev Psychopathol. 2011 Nov;23(4):975-99. doi: 10.1017/S0954579411000459.
The term allostasis, which is defined as stability through change, has been invoked repeatedly by developmental psychopathologists to describe long-lasting and in some cases permanent functional alterations in limbic-hypothalamic-pituitary-adrenal axis responding following recurrent and/or prolonged exposure to stress. Increasingly, allostatic load models have also been invoked to describe psychological sequelae of abuse, neglect, and other forms of maltreatment. In contrast, neural adaptations to stress, including those incurred by monoamine systems implicated in (a) mood and emotion regulation, (b) behavioral approach, and (c) social affiliation and attachment, are usually not included in models of allostasis. Rather, structural and functional alterations in these systems, which are exquisitely sensitive to prolonged stress exposure, are usually explained as stress mediators, neural plasticity, and/or programming effects. Considering these mechanisms as distinct from allostasis is somewhat artificial given overlapping functions and intricate coregulation of monoamines and the limbic-hypothalamic-pituitary-adrenal axis. It also fractionates literatures that should be mutually informative. In this article, we describe structural and functional alterations in serotonergic, dopaminergic, and noradrenergic neural systems following both acute and prolonged exposure to stress. Through increases in behavioral impulsivity, trait anxiety, mood and emotion dysregulation, and asociality, alterations in monoamine functioning have profound effects on personality, attachment relationships, and the emergence of psychopathology.
术语“适应负荷”（allostasis）的定义为通过变化实现稳定，它被发展心理病理学家反复引用，以描述在反复和/或长期暴露于应激后，边缘-下丘脑-垂体-肾上腺轴（limbic-hypothalamic-pituitary-adrenal axis）反应的持久和在某些情况下是永久性的功能改变。越来越多的适应负荷模型也被用来描述虐待、忽视和其他形式的虐待的心理后果。相比之下，应激的神经适应，包括与（a）情绪和情感调节、（b）行为接近和（c）社会联系和依恋有关的单胺系统所涉及的适应，通常不包括在适应模型中。相反，这些系统的结构和功能改变，对长期的应激暴露极其敏感，通常被解释为应激中介物、神经可塑性和/或编程效应。考虑到这些机制与适应负荷不同，是有些人为的，因为单胺和边缘-下丘脑-垂体-肾上腺轴的功能重叠和核心调节非常复杂。它还将本应相互提供信息的文献割裂开来。在本文中，我们描述了在急性和长期暴露于应激后，5-羟色胺能、多巴胺能和去甲肾上腺素能神经系统的结构和功能改变。通过增加行为冲动性、特质焦虑、情绪和情感调节障碍以及非社会性，单胺功能的改变对个性、依恋关系和精神病理学的出现有深远的影响。
