The Role of Stress Phenotypes in Understanding Childhood Adversity as a Transdiagnostic Risk Factor for Psychopathology
The Role of Stress Phenotypes in Understanding Childhood Adversity as a Transdiagnostic Risk Factor for Psychopathology
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DOI：
10.1037/abn0000619
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发表时间：
2023-04-01
期刊：
影响因子：
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通讯作者：
Hastings，Paul D.
中科院分区：
文献类型：
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作者：
Hostinar，Camelia E.;Swartz，Johnna R.;Hastings，Paul D.
童年逆境是精神病理学的一个主要转诊风险因素，估计与31-62%的儿童期发病疾病和23-42%的成人期发病疾病相关（Kessler等人，2010年）。主要的未解决的理论挑战源于童年逆境和精神病理学之间的联系的非特异性和概率性质。这种联系是非特异性的，因为童年逆境通过一系列机制增加了不同形式的精神病理学的风险，并且是概率性的，因为并非所有暴露于童年逆境的个体都会发展出精神病理学。在这篇文章中，我们提出了一条前进的道路，重点是压力表型，定义为生物行为模式激活的压力源，可以破坏未来的功能时，持续（例如，奖励寻求，社会退缩，侵略）。这篇评论集中在越来越多的证据表明，精神病理学似乎更强烈地预测在压力状态下的行为和生物学。基于这一观察结果，我们的理论框架提出，我们可以通过理解压力表型（定义为由压力源引起的行为模式及其相应的生物基质），以更大的特异性和确定性来模拟从童年逆境到精神病理学的途径。这种方法的目的是推进我们的概念化的调解途径，从童年逆境的精神病理学。了解压力表型将使我们更接近“精确心理健康”，这是一种以人为本的方法来识别，预防和治疗精神病理学。
Childhood adversity is a leading transdiagnostic risk factor for psychopathology, being associated with an estimated 31–62% of childhood-onset disorders and 23–42% of adult-onset disorders (Kessler et al., 2010). Major unresolved theoretical challenges stem from the nonspecific and probabilistic nature of the links between childhood adversity and psychopathology. The links are nonspecific because childhood adversity increases risk, through a range of mechanisms, for diverse forms of psychopathology and are probabilistic because not all individuals exposed to childhood adversity develop psychopathology. In this article, we propose a path forward by focusing on stress phenotypes, defined as biobehavioral patterns activated in response to stressors that can disrupt future functioning when persistent (eg, reward seeking, social withdrawal, aggression). This review centers on the accumulating evidence that psychopathology appears to be more strongly predicted by behavior and biology during states of stress. Building on this observation, our theoretical framework proposes that we can model pathways from childhood adversity to psychopathology with greater specificity and certainty by understanding stress phenotypes, defined as patterns of behavior and their corresponding biological substrates that are elicited by stressors. This approach aims to advance our conceptualization of mediating pathways from childhood adversity to psychopathology. Understanding stress phenotypes will bring us closer to “precision mental health,” a person-centered approach to identifying, preventing, and treating psychopathology.