Departments of Epidemiology and Pediatrics, Mailman School of Public Health and College of Physicians and Surgeons, Columbia University, 722 West 168 Street Room 1613, New York, New York 10032, USA.
Child Study Center, Department of Epidemiology and Public Health, Department of Psychology, Yale University, 230 South Frontage Road, New Haven, Connecticut 06519, USA.
Nature. 2015 Nov 19;527(7578):S161-6. doi: 10.1038/nature16030.
Globally, there is a crucial need to prioritize research directed at reducing neurological, mental health and substance-use disorders in adolescence, which is a pivotal age for the development of self-control and regulation. In adolescence, behaviour optimally advances towards adaptive long-term goals and suppresses conflicting maladaptive short-lived urges to balance impulsivity, exploration and defiance, while establishing effective societal participation. When self-control fails to develop, violence, injury and neurological, mental health and substance-use disorders can result, further challenging the development of self-regulation and impeding the transition to a productive adulthood. Adolescent outcomes, positive and negative, arise from both a life-course perspective and within a socioecological framework. Little is known about the emergence of self-control and regulation in adolescents in low- and middle-income countries where enormous environmental threats are more common (for example, poverty, war, local conflicts, sex trafficking and slavery, early marriage and/or pregnancy, and the absence of adequate access to education) than in high-income countries and can threaten optimal neurodevelopment. Research must develop or adapt appropriate assessments of adolescent ability and disability, social inclusion and exclusion, normative development, and neurological, mental health and substance-use disorders. Socioecological challenges in low- and middle-income countries require innovative strategies to prevent mental health, neurological and substance-use disorders and develop effective interventions for adolescents at risk, especially those already living with these disorders and the consequent disability.
全球急需优先开展研究，以减少青少年时期的神经、精神健康和物质使用障碍，因为这是自我控制和调节能力发展的关键时期。在青少年时期，行为最佳地朝着适应长期目标发展，并抑制冲动、探索和反抗等短期冲突的不良冲动，同时建立有效的社会参与。如果自我控制能力未能发展，可能会导致暴力、伤害以及神经、精神健康和物质使用障碍，从而进一步挑战自我调节能力的发展，并阻碍向富有成效的成年期过渡。青少年的积极和消极结果，不仅源于生命全程观，也源于社会生态框架。在环境威胁更为常见的低收入和中等收入国家，青少年自我控制和调节能力的出现情况鲜为人知，这些环境威胁（例如贫困、战争、局部冲突、性交易和奴役、早婚和/或怀孕以及缺乏足够的受教育机会）比高收入国家更为常见，可能会威胁到最佳神经发育。研究必须制定或调整适当的青少年能力和残疾、社会包容和排斥、正常发展以及神经、精神健康和物质使用障碍评估方法。低收入和中等收入国家的社会生态挑战需要创新战略，以预防精神健康、神经和物质使用障碍，并为处于风险中的青少年制定有效干预措施，尤其是那些已经患有这些障碍及其导致的残疾的青少年。
