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积极育儿在邻里社会劣势与青少年大脑发育关联中的作用。

Role of Positive Parenting in the Association Between Neighborhood Social Disadvantage and Brain Development Across Adolescence.

作者信息

Whittle Sarah, Vijayakumar Nandita, Simmons Julian G, Dennison Meg, Schwartz Orli, Pantelis Christos, Sheeber Lisa, Byrne Michelle L, Allen Nicholas B

机构信息

Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia2Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton, Victoria, Australia.

Department of Psychology, University of Oregon, Eugene.

出版信息

JAMA Psychiatry. 2017 Aug 1;74(8):824-832. doi: 10.1001/jamapsychiatry.2017.1558.

Abstract

IMPORTANCE

The negative effects of socioeconomic disadvantage on lifelong functioning are pronounced, with some evidence suggesting that these effects are mediated by changes in brain development. To our knowledge, no research has investigated whether parenting might buffer these negative effects.

OBJECTIVE

To establish whether positive parenting behaviors moderate the effects of socioeconomic disadvantage on brain development and adaptive functioning in adolescents.

DESIGN, SETTING, AND PARTICIPANTS: In this longitudinal study of adolescents from schools in Melbourne, Australia, data were collected at 3 assessments between 2004 and 2012. Data were analyzed between August 2016 and April 2017.

EXPOSURES

Both family (parental income-to-needs, occupation, and education level) and neighborhood measures of socioeconomic disadvantage were assessed. Positive maternal parenting behaviors were observed during interactions in early adolescence.

MAIN OUTCOMES AND MEASURES

Structural magnetic resonance imaging scans at 3 times (early, middle, and late adolescence) from ages 11 to 20 years. Global and academic functioning was assessed during late adolescence. We used linear mixed models to examine the effect of family and neighborhood socioeconomic disadvantage as well as the moderating effect of positive parenting on adolescent brain development. We used mediation models to examine whether brain developmental trajectories predicted functional outcomes during late adolescence.

RESULTS

Of the included 166 adolescents, 86 (51.8%) were male. We found that neighborhood, but not family, socioeconomic disadvantage was associated with altered brain development from early (mean [SD] age, 12.79 [0.425] years) to late (mean [SD] age, 19.08 [0.460] years) adolescence, predominantly in the temporal lobes (temporal cortex: random field theory corrected; left amygdala: B, -0.237; P < .001; right amygdala: B, -0.209; P = .008). Additionally, positive parenting moderated the effects of neighborhood disadvantage on the development of dorsal frontal and lateral orbitofrontal cortices as well as the effects of family disadvantage on the development of the amygdala (occupation: B, 0.382; P = .004; income-to-needs: B, 27.741; P = .004), with some male-specific findings. The pattern of dorsal frontal cortical development in males from disadvantaged neighborhoods exposed to low maternal positivity predicted increased rates of school noncompletion (indirect effect, -0.018; SE, 0.01; 95% CI, -0.053 to -0.001).

CONCLUSIONS AND RELEVANCE

Our findings highlight the importance of neighborhood disadvantage in influencing brain developmental trajectories. Further, to our knowledge, we present the first evidence that positive maternal parenting might ameliorate the negative effects of socioeconomic disadvantage on frontal lobe development (with implications for functioning) during adolescence. Results have relevance for designing interventions for children from socioeconomically disadvantaged backgrounds.

摘要

重要性

社会经济劣势对终身机能的负面影响十分显著,一些证据表明这些影响是由大脑发育的变化介导的。据我们所知,尚无研究调查养育方式是否可以缓冲这些负面影响。

目的

确定积极的养育行为是否能够缓和社会经济劣势对青少年大脑发育和适应性机能的影响。

设计、背景和参与者:在这项针对澳大利亚墨尔本学校青少年的纵向研究中,于2004年至2012年期间进行了3次评估并收集数据。在2016年8月至2017年4月期间对数据进行了分析。

暴露因素

评估了家庭(父母收入需求比、职业和教育水平)和邻里社会经济劣势指标。在青春期早期的互动过程中观察到了积极的母亲养育行为。

主要结局和测量指标

在11至20岁期间进行3次(青春期早期、中期和晚期)结构磁共振成像扫描。在青春期晚期评估整体和学业机能。我们使用线性混合模型来检验家庭和邻里社会经济劣势的影响以及积极养育对青少年大脑发育的调节作用。我们使用中介模型来检验大脑发育轨迹是否预测青春期晚期的机能结局。

结果

纳入的166名青少年中,86名(51.8%)为男性。我们发现,邻里而非家庭的社会经济劣势与从青春期早期(平均[标准差]年龄,12.79[0.425]岁)到晚期(平均[标准差]年龄,19.08[0.460]岁)大脑发育改变有关,主要发生在颞叶(颞叶皮质:经随机场理论校正;左侧杏仁核:B,-0.237;P<0.001;右侧杏仁核:B,-0.209;P = 0.008)。此外,积极养育缓和了邻里劣势对背侧额叶和外侧眶额皮质发育的影响以及家庭劣势对杏仁核发育的影响(职业:B,0.382;P = 0.004;收入需求比:B,27.741;P = 0.004),还有一些特定于男性的发现。来自弱势邻里且母亲积极性较低的男性,其背侧额叶皮质发育模式预示着辍学率增加(间接效应,-0.018;标准误,0.01;95%置信区间,-0.053至-0.001)。

结论及意义

我们的研究结果凸显了邻里劣势在影响大脑发育轨迹方面的重要性。此外,据我们所知,我们首次提供证据表明积极的母亲养育方式可能会改善社会经济劣势对青少年额叶发育(以及对机能的影响)的负面影响。研究结果对于为社会经济弱势背景儿童设计干预措施具有重要意义。

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