Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, Massachusetts 02215, USA.
Developmental Biopsychiatry Research Program, McLean Hospital, 115 Mill Street, Belmont, Massachusetts 02478, USA.
Nat Rev Neurosci. 2016 Sep 19;17(10):652-66. doi: 10.1038/nrn.2016.111.
Maltreatment-related childhood adversity is the leading preventable risk factor for mental illness and substance abuse. Although the association between maltreatment and psychopathology is compelling, there is a pressing need to understand how maltreatment increases the risk of psychiatric disorders. Emerging evidence suggests that maltreatment alters trajectories of brain development to affect sensory systems, network architecture and circuits involved in threat detection, emotional regulation and reward anticipation. This Review explores whether these alterations reflect toxic effects of early-life stress or potentially adaptive modifications, the relationship between psychopathology and brain changes, and the distinction between resilience, susceptibility and compensation.
虐待相关的儿童逆境是导致精神疾病和药物滥用的主要可预防风险因素。尽管虐待与精神病理学之间存在关联，但迫切需要了解虐待如何增加精神疾病的风险。新出现的证据表明，虐待会改变大脑发育轨迹，从而影响涉及威胁检测、情绪调节和奖励预期的感觉系统、网络架构和回路。本综述探讨了这些改变是反映了早期生活压力的毒性作用还是潜在的适应性改变，精神病理学与大脑变化之间的关系，以及韧性、易感性和补偿之间的区别。
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