The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology
The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology
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童年时期虐待和相关不良经历的持久影响。
DOI：
10.1111/j.1365-2214.2006.00614_2.x
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发表时间：
2006
影响因子：
1.9
通讯作者：
R. Reading
中科院分区：
文献类型：
--
作者：
R. Reading
童年时期虐待和相关不良经历的持久影响。来自神经生物学和流行病学的证据的融合。
Anda R.F.、Felitti V.J.、Bremner J.D.、Walker J.D.、Whitfield C.、Perry B.D.、Dube S.R. & 贾尔斯·W.H. (2005) 欧洲精神病学和临床神经科学档案，ePub，2005 年 11 月 29 日在线发布。
背景 童年虐待与大脑结构和功能以及压力反应神经生物系统的各种变化有关。流行病学研究记录了儿童虐待对健康和情绪健康的影响。
方法在简要回顾了童年创伤的神经生物学之后，我们使用不良童年经历（ACE）研究作为流行病学“案例”，说明童年创伤影响的流行病学和神经生物学证据之间的趋同。 ACE 研究包括 17,337 名成年 HMO（健康维护组织）成员，评估了八种不良童年经历 (ACE)，包括虐待、目睹家庭暴力和严重的家庭功能障碍。我们使用 ACE 数量（ACE 评分）作为累积童年压力的衡量标准，并假设 ACE 评分与 18 种选定结果以及这些结果总数（合并症）存在“剂量反应”关系。
结果 根据逻辑回归分析，随着 ACE 分数的增加，情感、躯体、药物滥用、记忆、性和攻击相关领域的每种结果的风险都以分级方式增加（P < 0.001）。在 ACE 评分范围内，合并症结果的平均数量增加了两倍。
结论 ACE 评分与多个领域 18 种不同结果的分级关系理论上与发育中的大脑累积暴露于压力反应并导致多种大脑结构和功能受损相一致。
The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology .
Anda R.F., Felitti V.J., Bremner J.D., Walker J.D., Whitfield C., Perry B.D., Dube S.R. & Giles W.H. ( 2005 ) European Archives of Psychiatry and Clinical Neuroscience , ePub, posted online 29 November 2005 .
Background Childhood maltreatment has been linked to a variety of changes in brain structure and function and stress–responsive neurobiological systems. Epidemiological studies have documented the impact of childhood maltreatment on health and emotional well-being.
Methods After a brief review of the neurobiology of childhood trauma, we use the Adverse Childhood Experiences (ACE) Study as an epidemiological ‘case example’ of the convergence between epidemiological and neurobiological evidence of the effects of childhood trauma. The ACE Study included 17 337 adult HMO (Health Maintenance Organization) members and assessed eight adverse childhood experiences (ACEs) including abuse, witnessing domestic violence, and serious household dysfunction. We used the number of ACEs (ACE score) as a measure of cumulative childhood stress and hypothesized a ‘dose–response’ relationship of the ACE score to 18 selected outcomes and to the total number of these outcomes (comorbidity).
Results Based upon logistic regression analysis, the risk of every outcome in the affective, somatic, substance abuse, memory, sexual, and aggression-related domains increased in a graded fashion as the ACE score increased (P < 0.001). The mean number of comorbid outcomes tripled across the range of the ACE score.
Conclusions The graded relationship of the ACE score to 18 different outcomes in multiple domains theoretically parallels the cumulative exposure of the developing brain to the stress response with resulting impairment in multiple brain structures and functions.