Expansion and commentary on a two generation approach to prenatal opioid exposure - a commentary on Conradt et al. (2023).
Expansion and commentary on a two generation approach to prenatal opioid exposure - a commentary on Conradt et al. (2023).
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对产前阿片类药物暴露的两代方法的扩展和评论 - Conradt 等人的评论。
DOI：
10.1111/jcpp.13770
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Schiff,Davida
中科院分区：
文献类型：
--
作者：
Chaiyachati,BarbaraH;Schiff,Davida
早期儿童神经发育，包括精神病理学，受到无数因素和相互作用的影响。这些因素既有内在的，如遗传学和表观遗传学，也有外在的，如社会环境和丰富。在父母使用药物的家庭中，可能会有更多的复杂性，如Conradt等人（2023）在其题为“产前阿片类药物暴露：儿童精神病理学概念化风险的两代方法”的评论文章中所述。Conradt等人提供了与物质使用相关的许多发现的总体综合，这些发现超出了子宫内暴露到妊娠和幼儿期跨代界面的范围，包括生物敏感性，如遗传易感性，社会风险因素的过度表达，包括照顾者和贫困的早期逆境，以及跨代的代际可持续性。改变的二元相互作用可能与神经行为的联合变化有关，并且不能与婴儿遗传学、表观遗传学和环境的影响隔离开来。产前物质暴露的早期神经发育相关性，包括儿童期精神病理学的风险，是许多不同力量的复合物。这种微妙的现实，被描述为“代际级联”，并不集中父母的物质使用或产前暴露作为一个独特的因果关系的时刻，但它的位置在总的生活经验的生态环境。
Early child neurodevelopment, including psychopathology, is influenced by a myriad of factors and interactions. These factors are both intrinsic to the caregiver–child dyad such as genetics and epigenetics as well as extrinsic such as social environment and enrichment. Additional layers of complexity may be at play within families with parental substance use, as outlined by Conradt et al. (2023) in their review article titled “Prenatal Opioid Exposure: A Two‐Generation Approach to Conceptualizing Risk for Child Psychopathology.”. Conradt et al. provide an overarching synthesis of many findings related to substance use that goes beyond the in utero exposure to the transgenerational interface of pregnancy and early childhood, including biologic sensitivities such as genetic predisposition, overrepresentation of social risk factors including early adversities of caregivers and poverty, and transgenerational interactional susceptibilities. Altered dyadic interactions may relate to joint changes in neurobehavior and are not isolated from the influence of infant genetics, epigenetics, and environment. The early neurodevelopmental correlates of prenatal substance exposure including risks of childhood psychopathology are then a composite of many different forces. This nuanced reality, described as an “inter‐generational cascade,” does not centralize parental substance use or prenatal exposure as a singularly causative moment but positions it within the ecologic milieu of the total lived experience.