Kuhn Manuel, Scharfenort Robert, Schümann Dirk, Schiele Miriam A, Münsterkötter Anna L, Deckert Jürgen, Domschke Katharina, Haaker Jan, Kalisch Raffael, Pauli Paul, Reif Andreas, Romanos Marcel, Zwanzger Peter, Lonsdorf Tina B
Department of Systems Neuroscience, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Department of Psychiatry, Psychosomatics, and Psychotherapy and Department of Psychology I, Biological Psychology, Clinical Psychology und Psychotherapy, University of Würzburg, Würzburg, Germany.
Soc Cogn Affect Neurosci. 2016 Apr;11(4):537-47. doi: 10.1093/scan/nsv137. Epub 2015 Nov 13.
Traditionally, adversity was defined as the accumulation of environmental events (allostatic load). Recently however, a mismatch between the early and the later (adult) environment (mismatch) has been hypothesized to be critical for disease development, a hypothesis that has not yet been tested explicitly in humans. We explored the impact of timing of life adversity (childhood and past year) on anxiety and depression levels (N = 833) and brain morphology (N = 129). Both remote (childhood) and proximal (recent) adversities were differentially mirrored in morphometric changes in areas critically involved in emotional processing (i.e. amygdala/hippocampus, dorsal anterior cingulate cortex, respectively). The effect of adversity on affect acted in an additive way with no evidence for interactions (mismatch). Structural equation modeling demonstrated a direct effect of adversity on morphometric estimates and anxiety/depression without evidence of brain morphology functioning as a mediator. Our results highlight that adversity manifests as pronounced changes in brain morphometric and affective temperament even though these seem to represent distinct mechanistic pathways. A major goal of future studies should be to define critical time periods for the impact of adversity and strategies for intervening to prevent or reverse the effects of adverse childhood life experiences.
传统上，逆境被定义为环境事件的累积（应激负荷）。然而最近，有人提出早期（儿童期）与后期（成年期）环境之间的不匹配（错配）对疾病发展至关重要，这一假设尚未在人类中得到明确验证。我们探讨了生活逆境发生时间（童年期和过去一年）对焦虑和抑郁水平（N = 833）以及脑形态（N = 129）的影响。远期（童年期）和近期（最近）逆境在情感处理关键区域（即杏仁核/海马体、背侧前扣带回皮质）的形态计量学变化中均有不同程度的反映。逆境对情感的影响呈累加作用，没有相互作用（错配）的证据。结构方程模型表明，逆境对形态计量学估计值以及焦虑/抑郁有直接影响，没有证据表明脑形态起中介作用。我们的结果表明，尽管逆境对脑形态计量学和情感气质的影响似乎代表不同的机制途径，但逆境会表现为脑形态计量学和情感气质的显著变化。未来研究的一个主要目标应该是确定逆境影响的关键时期以及干预策略，以预防或逆转童年不良生活经历的影响。
