Department of Psychology, Emory University, Atlanta, GA, United States.
Institute of Child Development, University of Minnesota, Minneapolis, MN, United States.
Int Rev Neurobiol. 2020;150:41-76. doi: 10.1016/bs.irn.2019.11.003. Epub 2019 Nov 29.
Adverse experiences during childhood can have long-lasting impacts on physical and mental health. At the heart of most theories of how these effects are transduced into health impacts is the activity of stress-mediating systems, most notably the hypothalamic-pituitary-adrenocortical (HPA) axis. Here we review the anatomy and physiology of the axis, models of stress and development, the development of the axis prenatally through adolescence, the role of experience and sensitive periods in shaping its regulation, the social regulation of the axis at different points in development, and finally conclude with suggestions for future research. We conclude that it is clear that early adversity sculpts the stress system, but we do not understand which dimensions have the most impact and at what points in early development. It is equally clear that secure attachment relationships buffer the developing stress system; however, the mechanisms of social buffering and how these may change with development are not yet clear. Another critical issue that is not understood is when and for whom adversity will result in hypo- vs hyperactivity of stress-mediating systems. These and other issues are important for advancing our understanding of how early adversity "gets under the skin" and shapes human physical and mental health.
儿童时期的不良经历会对身心健康产生持久的影响。在将这些影响转化为健康影响的大多数理论的核心是应激调节系统的活动，其中最主要的是下丘脑-垂体-肾上腺皮质（HPA）轴。在这里，我们回顾了轴的解剖和生理学、应激和发育模型、轴在产前到青春期的发育、经验和敏感时期在其调节中的作用、不同发育阶段轴的社会调节，最后提出了未来研究的建议。我们的结论是，很明显，早期逆境塑造了应激系统，但我们不清楚哪些方面的影响最大，以及在早期发育的哪个阶段。同样清楚的是，安全的依恋关系缓冲了发育中的应激系统；然而，社会缓冲的机制以及这些机制如何随发展而变化尚不清楚。另一个尚未解决的关键问题是，何时以及对于哪些人，逆境会导致应激调节系统的活动过度或活动不足。这些和其他问题对于我们理解早期逆境如何“深入皮肤”并塑造人类身心健康非常重要。
