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儿童早期对心理社会应激源的应激反应:科学现状。

Early childhood stress responses to psychosocial stressors: The state of the science.

机构信息

College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA.

College of Nursing, The Ohio State University, Columbus, Ohio, USA.

出版信息

Dev Psychobiol. 2022 Nov;64(7):e22320. doi: 10.1002/dev.22320.

Abstract

The aim of this systematic review was to better understand whether and to what extent psychosocial stressors are associated with hypothalamic-pituitary-adrenal axis or autonomic nervous system stress responses in young children (1-6 years of age). Studies were classified by psychosocial stressors from the ecobiodevelopmental model: social and economic resources, maternal mental health, parent-child relationships, and the physical environment. Of the 2388 identified studies, 32 met full inclusion criteria, including over 9107 children. Child physiologic stress responses were measured as hair and urinary cortisol and cortisone, salivary diurnal and reactive cortisol, salivary reactive alpha-amylase, and respiratory sinus arrhythmia. There were 107 identified relations between psychosocial stressors and physiologic stress responses. Nearly two thirds of these relations suggested that children have dysregulated stress responses as either significantly blunted (n = 27) or increased (n = 37); 43 relations were not significant. Children most consistently had significantly dysregulated stress responses if they experienced postnatal maternal depression or anxiety. Some reasons for the mixed findings may be related to characteristics of the child (i.e., moderators) or stressor, how the stress response or psychosocial stressor was measured, unmeasured variables (e.g., caregiving buffering), researcher degrees of freedom, or publication bias.

摘要

本系统评价的目的是更好地了解心理社会应激源是否以及在何种程度上与幼儿(1-6 岁)的下丘脑-垂体-肾上腺轴或自主神经系统应激反应有关。研究按生态发育模型的心理社会应激源进行分类:社会和经济资源、产妇心理健康、亲子关系和物理环境。在确定的 2388 项研究中,有 32 项符合完全纳入标准,包括 9107 多名儿童。儿童生理应激反应的测量指标有头发和尿液皮质醇和皮质酮、唾液昼夜和反应性皮质醇、唾液反应性α-淀粉酶和呼吸窦性心律失常。心理社会应激源和生理应激反应之间有 107 种已确定的关系。这些关系中近三分之二表明儿童的应激反应失调,表现为明显减弱(n=27)或增强(n=37);43 种关系没有统计学意义。如果儿童经历产后母亲抑郁或焦虑,他们最有可能出现明显失调的应激反应。造成这种混合结果的一些原因可能与儿童的特征(即调节剂)或应激源、应激反应或心理社会应激源的测量方式、未测量的变量(例如,照顾缓冲)、研究人员的自由度或发表偏倚有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/595a/9543576/50590446097a/DEV-64-0-g001.jpg

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