Aktar Evin, Qu Jin, Lawrence Peter J, Tollenaar Marieke S, Elzinga Bernet M, Bögels Susan M
Clinical Psychology Unit, Department of Psychology, Leiden University, Leiden, Netherlands.
Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands.
Front Psychiatry. 2019 Jun 27;10:391. doi: 10.3389/fpsyt.2019.00391. eCollection 2019.
Mental illness is highly prevalent and runs in families. Mental disorders are considered to enhance the risk for the development of psychopathology in the offspring. This heightened risk is related to the separate and joint effects of inherited genetic vulnerabilities for psychopathology and environmental influences. The early years of life are suggested to be a key developmental phase in the intergenerational psychopathology transmission. Available evidence supports the idea that early exposure to parental psychopathology, during the pregnancy and first postpartum year, may be related to child psychological functioning beyond the postpartum period, up to adulthood years. This not only highlights the importance of intervening early to break the chain of intergenerational transmission of psychopathology but also raises the question of whether early interventions targeting parental mental disorders in this period may alleviate these prolonged adverse effects in the infant offspring. The current article focuses on the specific risk of psychopathology conveyed from mentally ill parents to the offspring during the pregnancy and first postpartum year. We first present a summary of the available evidence on the associations of parental perinatal mental illness with infant psychological outcomes at the behavioral, biological, and neurophysiological levels. Next, we address the effects of early interventions and discuss whether these may mitigate the early intergenerational transmission of risk for psychopathology. The summarized evidence supports the idea that psychopathology-related changes in parents' behavior and physiology in the perinatal period are related to behavioral, biological, and neurophysiological correlates of infant psychological functioning in this period. These alterations may constitute risk for later development of child and/or adult forms of psychopathology and thus for intergenerational transmission. Targeting psychopathology or mother-infant interactions in isolation in the postnatal period may not be sufficient to improve outcomes, whereas interventions targeting both maternal psychopathology and mother-infant interactions seem promising in alleviating the risk of early transmission.
精神疾病非常普遍且具有家族遗传性。精神障碍被认为会增加后代发生精神病理学的风险。这种风险的增加与精神病理学的遗传易感性和环境影响的单独及共同作用有关。生命早期被认为是代际精神病理学传播中的一个关键发育阶段。现有证据支持这样一种观点,即在孕期和产后第一年早期接触父母的精神病理学可能与产后时期之外直至成年期的儿童心理功能有关。这不仅凸显了早期干预以打破精神病理学代际传播链条的重要性,还提出了在此期间针对父母精神障碍的早期干预是否可以减轻婴儿后代这些长期不良影响的问题。本文聚焦于在孕期和产后第一年患有精神疾病的父母传给后代的精神病理学的特定风险。我们首先总结现有证据,这些证据涉及父母围产期精神疾病与婴儿在行为、生物学和神经生理学层面心理结果之间的关联。接下来,我们探讨早期干预的效果,并讨论这些干预是否可以减轻精神病理学风险的早期代际传播。总结的证据支持这样一种观点,即围产期父母行为和生理方面与精神病理学相关的变化与这一时期婴儿心理功能的行为、生物学和神经生理学相关因素有关。这些改变可能构成儿童和/或成人形式精神病理学后期发展的风险,从而构成代际传播的风险。在产后单独针对精神病理学或母婴互动可能不足以改善结果,而针对母亲精神病理学和母婴互动的干预似乎有望减轻早期传播的风险。