Strathearn Lane, Mertens Carol E, Mayes Linda, Rutherford Helena, Rajhans Purva, Xu Guifeng, Potenza Marc N, Kim Sohye
Attachment and Neurodevelopment Laboratory, Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, United States.
Center for Disabilities and Development, University of Iowa Stead Family Children's Hospital, Iowa City, IA, United States.
Front Psychiatry. 2019 Nov 8;10:737. doi: 10.3389/fpsyt.2019.00737. eCollection 2019.
Substance use disorders constitute a significant public health problem in North America and worldwide. Specifically, substance addictions in women during pregnancy or in the postpartum period have adverse effects not only on the mother, but also on mother-infant attachment and the child's subsequent development. Additionally, there is growing evidence suggesting that parental addiction may be transmitted intergenerationally, where the child of parents with addiction problems is more likely to experience addiction as an adult. The current review takes a developmental perspective and draws from animal and human studies to examine how compromised early experience, including insecure attachment, early abuse/neglect, and unresolved trauma, may influence the development of neurobiological pathways associated with addictions, ultimately increasing one's susceptibility to addictions later in life. We approach this from three different levels: molecular, neuroendocrine and behavioral; and examine the oxytocin affiliation system, dopamine reward system, and glucocorticoid stress response system in this regard. Increased understanding of these underlying mechanisms may help identify key targets for early prevention efforts and inform needed intervention strategies related to both insecure attachment and addiction.
物质使用障碍在北美乃至全球都是一个重大的公共卫生问题。具体而言,孕期或产后女性的物质成瘾不仅会对母亲产生不利影响,还会影响母婴依恋关系以及孩子随后的发育。此外,越来越多的证据表明,父母的成瘾问题可能会在代际间传递,有成瘾问题的父母的孩子成年后更有可能成瘾。本综述从发育的角度出发,借鉴动物和人类研究,探讨早期经历受损,包括不安全依恋、早期虐待/忽视和未解决的创伤,如何影响与成瘾相关的神经生物学通路的发育,最终增加个体在生命后期成瘾的易感性。我们从三个不同层面进行探讨:分子层面、神经内分泌层面和行为层面;并在这方面研究催产素依恋系统、多巴胺奖赏系统和糖皮质激素应激反应系统。对这些潜在机制的进一步了解可能有助于确定早期预防工作的关键目标,并为与不安全依恋和成瘾相关的必要干预策略提供依据。