Rok-Bujko Paulina
Second Department of Psychiatry, Department of Neuroses, Personality Disorders and Eating Disorders, Institute of Psychiatry and Neurology, Warsaw, Poland.
Postep Psychiatr Neurol. 2021 Mar;30(1):37-44. doi: 10.5114/ppn.2021.106818. Epub 2021 Jun 10.
Psychological trauma is a significant risk factor for physical and mental health development distortion. This paper presents the results of longitudinal epidemiological surveys and naturalistic observations. It also reviews the results of the most important neurobiological findings in the field of impact of early life trauma on cognitive and emotional development, and the structure and functions of the brain.
Trauma is defined as subjective experiences that overwhelm a person's ability to maintain psychophysical integrity. During the stage of neurodevelopment, various life adversities, such as emotional and sensory deprivation, abandonment and neglect by caregivers as well as physical or emotional violence and sexual abuse overwhelm the physiological and mental capacity of a child and impact their cognitive, emotional and social development, adversely influencing adulthood functioning. Symptoms of abused children can evolve and change with time, from moderate signs of distress to more complex symptoms and organized disorders. The most important longitudinal studies, such as the Lives Across Time Study, Minnesota Study, Adverse Childhood Experiences Study, The Great Smoky Mountains Study, and the English and Romanian Adoptee Study are discussed in the paper. The lifelong influences of early adversities on brain structures like the corpus callosum, hippocampus, the amygdaloid nuclei, ventral striatum and cerebral cortex has been described. The variability of the sensitivity of specific brain regions, based on different rates of maturation, has also been discussed.
This review integrates and summarizes the basic knowledge about the impact and neurobiological consequences of early traumatic adversities.
心理创伤是身心健康发展扭曲的一个重要风险因素。本文呈现了纵向流行病学调查和自然观察的结果。它还回顾了早期生活创伤对认知和情感发展以及大脑结构和功能影响领域中最重要的神经生物学研究结果。
创伤被定义为使人的心理生理完整性维持能力不堪重负的主观体验。在神经发育阶段，各种生活逆境，如情感和感觉剥夺、照顾者的遗弃和忽视以及身体或情感暴力和性虐待，会超出儿童的生理和心理承受能力，影响其认知、情感和社会发展，对成年后的功能产生不利影响。受虐儿童的症状会随着时间演变和变化，从中度痛苦迹象发展为更复杂的症状和有组织的障碍。本文讨论了一些最重要的纵向研究，如“跨时生活研究”“明尼苏达研究”“儿童期不良经历研究”“大烟山研究”以及“英国和罗马尼亚领养儿童研究”。文中描述了早期逆境对胼胝体、海马体、杏仁核、腹侧纹状体和大脑皮层等脑结构的终身影响。还讨论了基于不同成熟率的特定脑区敏感性的变异性。
本综述整合并总结了关于早期创伤性逆境的影响及其神经生物学后果的基础知识。
