Depression & Anxiety Division, McLean Hospital, Mass General Brigham, Belmont, MA, United States of America.
Depression & Anxiety Division, McLean Hospital, Mass General Brigham, Belmont, MA, United States of America; Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.
Pharmacol Biochem Behav. 2021 Nov;210:173271. doi: 10.1016/j.pbb.2021.173271. Epub 2021 Sep 9.
Childhood maltreatment, occurring in up to 20-30% of the population, remains far too common, and incorporates a range of active and passive factors, from abuse, to neglect, to the impacts of broader structural and systemic adversity. Despite the effects of childhood maltreatment and adversity on a wide range of adult physical and psychological negative outcomes, not all individuals respond similarly. Understanding the differential biological mechanisms contributing to risk vs. resilience in the face of developmental adversity is critical to improving preventions, treatments, and policy recommendations. This review begins by providing an overview of childhood abuse, neglect, maltreatment, threat, and toxic stress, and the effects of these forms of adversity on the developing body, brain, and behavior. It then examines examples from the current literature of genomic, epigenomic, transcriptomic, and proteomic discoveries and biomarkers that may help to understand risk and resilience in the aftermath of trauma, predictors of traumatic exposure risk, and potential targets for intervention and prevention. While the majority of genetic, epigenetic, and gene expression analyses to date have focused on targeted genes and hypotheses, large-scale consortia are now well-positioned to better understand interactions of environment and biology with much more statistical power. Ongoing and future work aimed at understanding the biology of childhood adversity and its effects will help to provide targets for intervention and prevention, as well as identify paths for how science, health care, and policy can combine efforts to protect and promote the psychological and physiological wellbeing of future generations.
儿童虐待在人群中的发生率高达 20-30%，仍然非常普遍，它包含了一系列积极和消极的因素，从虐待、忽视到更广泛的结构性和系统性逆境的影响。尽管儿童虐待和逆境对广泛的成年生理和心理负面后果有影响，但并非所有个体的反应都相同。了解导致在面对发展逆境时出现风险和弹性的不同生物学机制对于改善预防、治疗和政策建议至关重要。这篇综述首先概述了儿童期虐待、忽视、虐待、威胁和毒性应激，以及这些形式的逆境对发育中身体、大脑和行为的影响。然后，它检查了当前文献中关于基因组、表观基因组、转录组和蛋白质组学发现和生物标志物的例子，这些发现和生物标志物可能有助于理解创伤后的风险和弹性、创伤暴露风险的预测因素以及干预和预防的潜在目标。虽然迄今为止大多数遗传、表观遗传和基因表达分析都集中在靶向基因和假设上，但大型联盟现在有更好的位置来更好地理解环境和生物学的相互作用，具有更大的统计能力。正在进行和未来旨在了解儿童逆境生物学及其影响的工作将有助于为干预和预防提供目标，并确定科学、医疗保健和政策如何结合努力保护和促进后代的心理和生理健康的途径。
