Lean Rachel E, Constantino-Pettit Anna, Gorham Lisa S, Herzberg Max P, Anaya Berenice, Rogers Cynthia E, Luby Joan L
Department of Psychiatry (Child and Adolescent), Washington University School of Medicine, St. Louis, MO, USA.
Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA.
Neuropsychopharmacology. 2025 Jul 16. doi: 10.1038/s41386-025-02169-1.
Social Determinants of Health (SDoH) are defined as the non-biological individual and structural factors that shape the socio-environmental conditions of everyday life. SDoH are major drivers of risk for psychiatric disorders across development. However, what remains less clear are the neurobiological mechanisms by which SDoH confers risk for psychopathology, especially in early childhood. Growing evidence suggests that adverse forms of SDoH begin to impact the developing brain from the earliest points in development, including in-utero. Brain-wide associations have been found for brain structure and function, especially in regions that subserve socioemotional and cognitive functions. While most studies have shown SDoH-related delays in brain development and psychopathology risk, a small collection of studies have also shown that SDoH has been related to accelerated brain maturation. These latter findings potentially suggest adaptive or compensatory mechanisms that enhance resilient mental health outcomes in the context of adversity. Future directions include the need for randomized interventions designed to enhance development that target the modifiable SDoH and related socio-environmental factors during distinct periods of brain plasticity. The recruitment and retention of socially diverse research participants, to more precisely elucidate the impacts of SDoH on the developing brain in children experiencing different environments, are also needed.
健康的社会决定因素(SDoH)被定义为塑造日常生活社会环境条件的非生物个体和结构因素。SDoH是整个发育过程中精神障碍风险的主要驱动因素。然而,SDoH赋予精神病理学风险的神经生物学机制仍不太清楚,尤其是在幼儿期。越来越多的证据表明,不良形式的SDoH从发育的最早阶段开始影响发育中的大脑,包括子宫内。已经发现大脑结构和功能存在全脑关联,特别是在服务于社会情感和认知功能的区域。虽然大多数研究表明SDoH与大脑发育延迟和精神病理学风险有关,但一小部分研究也表明SDoH与大脑加速成熟有关。这些后者的发现可能表明在逆境中增强心理健康恢复力的适应性或补偿性机制。未来的方向包括需要设计随机干预措施,以在大脑可塑性的不同时期针对可改变的SDoH和相关社会环境因素来促进发育。还需要招募和留住社会背景多样的研究参与者,以更准确地阐明SDoH对处于不同环境中的儿童发育中大脑的影响。