Feldman Ruth
Interdisciplinary Center, Herzliya, Israel.
Yale Child Study Center, University of Yale, New Haven, CT, USA.
World Psychiatry. 2020 Jun;19(2):132-150. doi: 10.1002/wps.20729.
Resilience - a key topic in clinical science and practice - still lacks a clear conceptualization that integrates its evolutionary and human-specific features, refrains from exclusive focus on fear physiology, incorporates a developmental approach, and, most importantly, is not based on the negation (i.e., absence of symptoms following trauma). Building on the initial condition of mammals, whose brain matures in the context of the mother's body and caregiving behavior, we argue that systems and processes that participate in tuning the brain to the social ecology and adapting to its hardships mark the construct of resilience. These include the oxytocin system, the affiliative brain, and biobehavioral synchrony, all characterized by great flexibility across phylogenesis and ontogenesis. Three core features of resilience are outlined: plasticity, sociality and meaning. Mechanisms of sociality by which coordinated action supports diversity, endurance and adaptation are described across animal evolution. Humans' biobehavioral synchrony matures from maternal attuned behavior in the postpartum to adult-adult relationships of empathy, perspective-taking and intimacy, and extends from the mother-child relationship to other affiliative bonds throughout life, charting a fundamental trajectory in the development of resilience. Findings from three high-risk cohorts, each tapping a distinct disruption to maternal-infant bonding (prematurity, maternal depression, and early life stress/trauma), and followed from birth to adolescence/young adulthood, demonstrate how components of the neurobiology of affiliation confer resilience and uniquely shape the social brain.
复原力——临床科学与实践中的一个关键主题——仍然缺乏一个清晰的概念,该概念应整合其进化和人类特有的特征,避免只专注于恐惧生理学,纳入发展方法,并且最重要的是,不以否定(即创伤后无症状)为基础。基于哺乳动物的初始状态,其大脑在母亲的身体和养育行为的背景下成熟,我们认为参与使大脑适应社会生态并适应其艰难困苦的系统和过程标志着复原力的构建。这些包括催产素系统、亲和性大脑和生物行为同步性,所有这些在系统发生和个体发生过程中都具有很大的灵活性。概述了复原力的三个核心特征:可塑性、社会性和意义。描述了在动物进化过程中社会性行为的机制,通过这些机制,协调行动支持多样性、耐力和适应性。人类的生物行为同步性从产后母亲的协调行为发展到成人之间的共情、换位思考和亲密关系,并从母婴关系扩展到一生中的其他亲和关系,描绘了复原力发展的一条基本轨迹。来自三个高危队列的研究结果,每个队列都涉及母婴联结的不同干扰(早产、母亲抑郁和早期生活压力/创伤),并从出生跟踪到青少年期/青年期,证明了亲和神经生物学的组成部分如何赋予复原力并独特地塑造社会大脑。