Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany.
Department of Addictive Behaviour and Addiction Medicine, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany.
Curr Top Behav Neurosci. 2022;54:417-438. doi: 10.1007/7854_2021_261.
Early social stress, particularly severe but nevertheless frequent forms such as abuse and neglect, are among the major risk factors for the development of mental disorders. However, we only have very limited knowledge of the psychobiological disease mechanisms underlying the influence of early life stress and stress-related disorders during this vulnerable phase of life. Early stress can have long-lasting adverse effects on the brain and other somatic systems, e.g. through influences on brain development. In adulthood, the prior experience of abuse or neglect can result in complex clinical profiles. Besides conditions such as mood and anxiety disorders as well as posttraumatic stress disorder, substance use disorders (SUD) are among the most prevalent sequelae of early social stress. Current social stress further influences the development and maintenance of these disorders, e.g., by increasing the risk of relapses. In this chapter, we will first give an overview of currently used methods to assess the phenomenology and pathophysiology of stress-related disorders and then focus on the phenomenological and neurobiological background of the interaction between early social stress and SUD. We will give an overview of important insights from neuroimaging studies and will also highlight recent findings from studies using digital tools such as ecological momentary assessment or virtual reality to capture the influence of early social stress as well as current social stress in everyday life of persons with SUD.
早期社会压力，特别是严重但却频繁发生的形式，如虐待和忽视，是精神障碍发展的主要风险因素之一。然而，我们对于早期生活压力和与压力相关的障碍在生命脆弱阶段的影响的心理生物学发病机制，只有非常有限的了解。早期压力会对大脑和其他躯体系统产生持久的不良影响，例如通过对大脑发育的影响。在成年期，虐待或忽视的先前经历可能导致复杂的临床特征。除了心境和焦虑障碍以及创伤后应激障碍等情况外，物质使用障碍（SUD）也是早期社会压力的最常见后果之一。当前的社会压力进一步影响这些障碍的发展和维持，例如，增加复发的风险。在这一章中，我们将首先概述目前用于评估与压力相关障碍的现象学和病理生理学的方法，然后重点介绍早期社会压力与 SUD 之间相互作用的现象学和神经生物学背景。我们将概述神经影像学研究的重要发现，并强调使用生态瞬时评估或虚拟现实等数字工具进行的研究的最新发现，以捕捉 SUD 患者日常生活中的早期社会压力和当前社会压力的影响。
