Herzog Julia I, Schmahl Christian
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Front Psychiatry. 2018 Sep 4;9:420. doi: 10.3389/fpsyt.2018.00420. eCollection 2018.
Adverse childhood experiences (ACE) such as sexual and physical abuse or neglect are frequent in childhood and constitute a massive stressor with long-lasting adverse effects on the brain, mental and physical health.The aim of this qualitative review is to present a concise overview of the present literature on the impact of ACE on neurobiology, mental and somatic health in later adulthood. The authors reviewed the existing literature on the impact of ACE on neurobiology, mental and somatic health in later adulthood and summarized the results for a concise qualitative overview. In adulthood, the history of ACE can result in complex clinical profiles with several co-occurring mental and somatic disorders such as posttraumatic stress disorder, depression, borderline personality disorder, obesity and diabetes. Although a general stress effect in the development of the disorders and neural alterations can be assumed, the role of type and timing of ACE is of particular interest in terms of prevention and treatment of ACE-related mental and somatic conditions. It has been suggested that during certain vulnerable developmental phases the risk for subsequent ACE-related disorders is increased. Moreover, emerging evidence points to sensitive periods and specificity of ACE-subtypes in the development of neurobiological alterations, e.g., volumetric and functional changes in the amygdala and hippocampus. Longitudinal studies are needed to investigate complex ACE-related characteristics and mechanisms relevant for mental and somatic disorders by integrating knowledge and methods. By identifying and validating psychosocial and somatic risk factors and diagnostic markers one might improve the development of innovative somatic and psychological treatment options for individuals suffering from ACE-related disorders.
童年期不良经历（ACE），如性虐待、身体虐待或忽视，在儿童时期很常见，是一种巨大的压力源，会对大脑、身心健康产生长期的不良影响。本定性综述的目的是简要概述当前关于ACE对成年后期神经生物学、心理和身体健康影响的文献。作者回顾了关于ACE对成年后期神经生物学、心理和身体健康影响的现有文献，并总结结果以进行简要的定性综述。在成年期，ACE史可导致复杂的临床症状，同时出现多种心理和躯体疾病，如创伤后应激障碍、抑郁症、边缘型人格障碍、肥胖症和糖尿病。虽然可以假设这些疾病和神经改变的发展存在一般应激效应，但ACE的类型和发生时间在预防和治疗与ACE相关的心理和躯体疾病方面尤为重要。有人认为，在某些易受影响的发育阶段，后续发生与ACE相关疾病的风险会增加。此外，新出现的证据表明，ACE亚型在神经生物学改变的发展过程中存在敏感期和特异性，例如杏仁核和海马体的体积和功能变化。需要进行纵向研究，通过整合知识和方法来调查与心理和躯体疾病相关的复杂ACE特征和机制。通过识别和验证心理社会和躯体风险因素以及诊断标志物，可能会改善针对患有与ACE相关疾病的个体的创新躯体和心理治疗方案的开发。
