Poverty, early care, and stress reactivity in adolescence: Findings from a prospective, longitudinal study in South Africa
Poverty, early care, and stress reactivity in adolescence: Findings from a prospective, longitudinal study in South Africa
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DOI：
10.1017/s0954579417000104
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发表时间：
2017-05-01
影响因子：
3.3
通讯作者：
Morgan, Barak
中科院分区：
文献类型：
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作者：
Fearon, R. M. Pasco;Tomlinson, Mark;Morgan, Barak
大量证据表明，早期护理可能会影响下丘脑-垂体-肾上腺皮质轴的短期功能和长期发育。尽管如此，迄今为止的大多数研究本质上都是横断面的或仅限于相对短期的纵向随访。更重要的是，关于低收入和中等收入国家的照护作用的研究很少，在这些国家，高质量的照护对于缓冲儿童正在发育的压力调节系统的保护作用可能至关重要。在本文中，我们报告了在南非开普敦的一个贫困城郊定居点进行的纵向研究 (N = 232) 的结果。我们测量了婴儿期的照料敏感性和依恋安全性，并在 13 岁时对儿童进行了随访，当时我们对下丘脑-垂体-肾上腺皮质轴反应性进行了评估，以特里尔社会压力测试期间唾液皮质醇为指标。研究结果表明，不安全的依恋预示着皮质醇对社会压力的反应减少，尤其是男孩，而且依恋状态调节了逆境对压力反应的影响：在高度不利的环境中，有安全感的儿童并没有表现出不安全感儿童所表现出的皮质醇反应迟钝。一些证据发现，婴儿期护理的敏感性也与皮质醇反应性有关，但在这种情况下，不敏感与皮质醇反应性升高有关，而且仅限于女孩。讨论的重点是护理在压力系统的长期校准中的潜在重要作用，以及更好地了解中低收入国家发展中影响压力反应的社会和生物机制的必要性。
A considerable body of evidence suggests that early caregiving may affect the short-term functioning and longer term development of the hypothalamic-pituitary-adrenocortical axis. Despite this, most research to date has been cross-sectional in nature or restricted to relatively short-term longitudinal follow-ups. More important, there is a paucity of research on the role of caregiving in low- and middle-income countries, where the protective effects of high-quality care in buffering the child's developing stress regulation systems may be crucial. In this paper, we report findings from a longitudinal study (N = 232) conducted in an impoverished periurban settlement in Cape Town, South Africa. We measured caregiving sensitivity and security of attachment in infancy and followed children up at age 13 years, when we conducted assessments of hypothalamus-pituitary-adrenocortical axis reactivity, as indexed by salivary cortisol during the Trier Social Stress Test. The findings indicated that insecure attachment was predictive of reduced cortisol responses to social stress, particularly in boys, and that attachment status moderated the impact of contextual adversity on stress responses: secure children in highly adverse circumstances did not show the blunted cortisol response shown by their insecure counterparts. Some evidence was found that sensitivity of care in infancy was also associated with cortisol reactivity, but in this case, insensitivity was associated with heightened cortisol reactivity, and only for girls. The discussion focuses on the potentially important role of caregiving in the long-term calibration of the stress system and the need to better understand the social and biological mechanisms shaping the stress response across development in low- and middle-income countries.