Lyons-Ruth Karlen, Todd Manly Jody, Von Klitzing Kai, Tamminen Tuula, Emde Robert, Fitzgerald Hiram, Paul Campbell, Keren Miri, Berg Astrid, Foley Maree, Watanabe Hisako
Harvard Medical School, Cambridge, MA.
University of Rochester, Rochester, NY.
Infant Ment Health J. 2017 Nov;38(6):695-705. doi: 10.1002/imhj.21674. Epub 2017 Oct 31.
Children worldwide experience mental and emotional disorders. Mental disorders occurring among young children, especially infants (birth -3 years), often go unrecognized. Prevalence rates are difficult to determine because of lack of awareness and difficulty assessing and diagnosing young children. Existing data, however, suggest that rates of disorders in young children are comparable to those of older children and adolescents (von Klitzing, Dohnert, Kroll, & Grube, ). The lack of widespread recognition of disorders of infancy is particularly concerning due to the unique positioning of infancy as foundational in the developmental process. Both the brain and behavior are in vulnerable states of development across the first 3 years of life, with potential for enduring deviations to occur in response to early trauma and deprivation. Intervention approaches for young children require sensitivity to their developmental needs within their families. The primacy of infancy as a time of unique foundational risks for disorder, the impact of trauma and violence on young children's development, the impact of family disruption on children's attachment, and existing literature on prevalence rates of early disorders are discussed. Finally, global priorities for addressing these disorders of infancy are highlighted to support prevention and intervention actions that may alleviate suffering among our youngest world citizens.
世界各地的儿童都经历着精神和情绪障碍。幼儿，尤其是婴儿（出生至3岁）中出现的精神障碍往往未被识别。由于缺乏认识以及评估和诊断幼儿存在困难，患病率难以确定。然而，现有数据表明，幼儿的障碍发生率与大龄儿童和青少年相当（冯·克利青、多纳特、克罗尔和格鲁贝，）。由于婴儿期在发育过程中具有基础性的独特地位，对婴儿期障碍缺乏广泛认识尤其令人担忧。在生命的头3年里，大脑和行为都处于脆弱的发育状态，可能会因早期创伤和剥夺而出现持久的偏差。针对幼儿的干预方法需要关注他们在家庭中的发展需求。本文讨论了婴儿期作为疾病独特基础风险期的首要地位、创伤和暴力对幼儿发展的影响、家庭破裂对儿童依恋的影响以及早期疾病患病率的现有文献。最后，强调了应对这些婴儿期障碍的全球优先事项，以支持预防和干预行动，减轻世界上最年幼公民的痛苦。
