Division of Psychology and Language Sciences, University College London, London, UK; Anna Freud National Centre for Children and Families, London, UK.
Division of Psychology and Language Sciences, University College London, London, UK; Anna Freud National Centre for Children and Families, London, UK.
Lancet Psychiatry. 2022 Oct;9(10):828-837. doi: 10.1016/S2215-0366(22)00202-4. Epub 2022 Aug 1.
Childhood maltreatment is associated with significant, enduring risk of psychiatric disorder. In this paper, we review how neurocognitive alterations after maltreatment might indirectly increase the risk of psychiatric disorder via their impact on social functioning. We propose a neurocognitive social transactional model, within which the neurocognitive sequelae of maltreatment are postulated to affect how an individual's social architecture is constructed across development, including the quality and quantity of relationships in an individual's social network. We review extant evidence in two areas in relation to maltreatment: stress generation (a process by which individuals are more likely to experience interpersonal stressor events) and social thinning (an attenuation in the number and quality of relationships over time). We consider how neurocognitive alterations could contribute to these interactive and autocatalytic social processes, which gradually impoverish an individual's actual or potential social environment and ultimately increase psychiatric risk. We conclude by considering the implications of this neurocognitive social transactional model for the prevention of psychiatric disorder after childhood maltreatment.
儿童期虐待与精神障碍的显著和持久风险相关。在本文中,我们回顾了虐待后神经认知改变如何通过对社交功能的影响间接增加精神障碍的风险。我们提出了一个神经认知社会相互作用模型,其中假设虐待的神经认知后果会影响个体在整个发展过程中社会结构的构建方式,包括个体社交网络中的关系的质量和数量。我们回顾了与虐待有关的两个领域的现有证据:应激产生(个体更有可能经历人际应激事件的过程)和社交稀疏(随着时间的推移,关系的数量和质量减弱)。我们考虑了神经认知改变如何促成这些相互作用和自催化的社交过程,这些过程逐渐使个体的实际或潜在社交环境变得贫瘠,并最终增加精神障碍风险。最后,我们考虑了这种神经认知社会相互作用模型对预防儿童期虐待后精神障碍的影响。