Ewald D Rose, Strack Robert W, Orsini Muhsin Michael
University of North Carolina at Greensboro, Greensboro, NC, USA.
Prevention Strategies, Greensboro, NC, USA.
Glob Pediatr Health. 2019 Jan 23;6:2333794X18821943. doi: 10.1177/2333794X18821943. eCollection 2019.
Addiction is a complex and challenging condition with many contributing factors. Although addictive behaviors appear to be individual choices, behavior alterations cannot be addressed successfully without considering characteristics of the physical and social environments in which individuals live, work, and play. Exposure to chronic psychosocial stressors and the physiological response of individuals to their external environment activates the brain's neuroendocrine hypothalamic-pituitary-adrenal axis, with profound conditioning effects on behavior. This brief synopsis describes the social determinants of health; examines the interconnectedness of the psychosocial environment, behavior, and subsequent health outcomes; discusses the environment's critical influence on brain plasticity, adaptation and functioning; and explores additional factors that complicate adolescent addiction. Because the environment is both a determinant of behavior and an opportunity for intervention, in the context of addictions, it is important to incorporate these factors in the analysis of risk and design of early interventions for prevention and amelioration of addiction.
成瘾是一种复杂且具有挑战性的状况，有许多促成因素。尽管成瘾行为看似是个人选择，但如果不考虑个体生活、工作和娱乐所处的物理及社会环境的特征，行为改变就无法得到成功解决。长期接触心理社会应激源以及个体对外部环境的生理反应会激活大脑的神经内分泌下丘脑 - 垂体 - 肾上腺轴，对行为产生深远的条件作用影响。本简要概述描述了健康的社会决定因素；审视了心理社会环境、行为及后续健康结果之间的相互联系；讨论了环境对大脑可塑性、适应性和功能的关键影响；并探讨了使青少年成瘾问题复杂化的其他因素。由于环境既是行为的决定因素，也是干预的契机，在成瘾问题的背景下，将这些因素纳入成瘾风险分析以及预防和改善成瘾的早期干预设计中非常重要。
