ISSN 1671-3710
CN 11-4766/R
主办:中国科学院心理研究所
出版:科学出版社

心理科学进展, 2018, 26(7): 1193-1203 doi: 10.3724/SP.J.1042.2018.01193

研究前沿

早期应激对情绪调节的影响及其神经机制

张慧会, 张亮,

中国科学院大学心理学系, 北京 100049

The effects of early life stress on emotion regulation and the underlying mechanisms

ZHANG Huihui, ZHANG Liang,

Department of Psychology, University of Chinese Academy of Sciences, Beijing 10049, China

通讯作者: 张亮, E-mail:zhangl@psych.ac.cn

收稿日期: 2016-09-12   网络出版日期: 2018-07-15

基金资助: 国家自然科学基金通用技术基础研究联合基金重点支持项目《基于脑机接口的情绪识别与交互技术》(U1736220)
国家自然科学基金项目(U1736220)
中国科学院战略性先导科技专项(XDA06030800)
国家重点研究计划(2016YFB1001201)

Received: 2016-09-12   Online: 2018-07-15

Fund supported: (U1736220)
(U1736220)
(XDA06030800)
(2016YFB1001201)

摘要

在个体生命早期遭遇的长期或重大的应激经历会显著增加个体罹患抑郁、焦虑等心理疾患的风险, 而情绪调节能力的损伤是引发这些心理疾患的重要因素之一。以人类为对象的行为实验和调查研究表明, 早期应激不仅会影响日常生活中情绪调节策略的使用, 还会对情绪调节能力造成影响, 其影响方向可能与早期应激的严重程度有关。目前, 大部分研究表明严重的早期应激会损伤情绪调节能力, 但中度的早期应激也可能提高情绪调节能力。更为整合性的研究表明情绪调节能力中介了早期应激和各类疾患之间的关系。进一步, 我们从神经层面上阐述了早期应激对情绪调节相关脑区和神经环路的影响。未来研究应当注意控制无关变量, 进一步探究不同早期应激对于情绪调节的影响。

关键词: 早期应激; 情绪调节; 认知重评; 前额叶; 杏仁核

Abstract

Individuals experiencing early life stress (ELS) are at a higher risk of mental/behavioral disorders such as depression and violence, the difficulties of emotion regulation might be one of the underlying mechanisms. ELS individuals use maladaptive strategies (such as avoidance and rumination) more frequently than normal individuals. And most of the studies found that ELS impaired the ability of emotion regulation. However, moderate ELS may enhance the ability of emotion regulation. Besides, emotion regulation moderated the relationship between ELS and mental/behavior disorders. Furthermore, we explored the neural mechanisms of how ELS influences emotion regulation. Finally, we made a summary and pointed out future directions.

Keywords: early life stress; emotion regulation; reappraisal; prefrontal cortex; amygdala

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本文引用格式

张慧会, 张亮. 早期应激对情绪调节的影响及其神经机制 . 心理科学进展, 2018, 26(7): 1193-1203 doi:10.3724/SP.J.1042.2018.01193

ZHANG Huihui, ZHANG Liang. The effects of early life stress on emotion regulation and the underlying mechanisms. Advances in Psychological Science, 2018, 26(7): 1193-1203 doi:10.3724/SP.J.1042.2018.01193

1 引言

早期应激属于慢性应激的一种, 它一般是指发生在个体16岁之前的不良生活经历(Bernstein et al., 2003)。尽管不同研究者对早期应激的定义给出了不同的阐述(Cohen et al., 2006; Enoch, 2011; Heim & Binder, 2012; Philip et al., 2013), 但归结来讲, 这些定义都有两个关键特征:第一, 早期应激发生在个体成年之前, 此阶段为前额叶、杏仁核、海马等脑结构发育的关键时期; 第二, 早期应激是指那些对个体成长造成长期影响的经历(Pechtel & Pizzagalli, 2011), 这主要两类, 一类是在一段时间内持续存在的应激经历, 如虐待、忽视、家庭贫困、家庭成员的冲突等, 另一类是短暂发生但影响重大的创伤事件, 如亲人逝去、遭遇暴力事件、重大事故等。

根据我国2013年第六次人口普查的结果, 我国现有留守儿童近7000万名, 占到儿童总数的1/4 (段成荣, 吕利丹, 郭静, 王宗萍, 2013)。这些儿童普遍面临着不同程度的亲子分离焦虑、物质或情感上的缺失等情况, 这些生理或心理上的应激事件给他们的成长造成了一系列影响(Fan, Su, Gill, & Birmaher, 2010)。更令人担忧的是, 早期的应激经历对个体身心的影响不仅局限于儿童或青少年时期, 它甚至会延续个体的一生(Miller, Chen, & Parker, 2011; Shonkoff et al., 2012)。

大量研究表明, 早期应激是诸多心理、行为疾患的风险因素之一, 它能够在一定程度上预测成年后的抑郁、焦虑、暴力行为等问题(Heim & Nemeroff, 2001; Schilling, Aseltine, & Gore, 2007; Shonkoff et al., 2012)。但是, 早期应激通过何种途径或机制对这些疾患的发病产生长期的影响, 目前尚不清楚。从心理层面来讲, 这一机制主要从执行功能和情绪调节两个方面进行研究, 在本文中将焦点聚焦在后者。近年来的研究发现, 早期应激会损伤个体的情绪调节能力(Chen & Baram, 2016; Krugers & Joëls, 2014; Malter Cohen et al., 2013; Pollak, 2008; Pollak & Tolley-Schell, 2003) , 而情绪调节方面的缺陷和障碍是诱发心理疾患的一个重要因素(Aldao, Nolen-Hoeksema, & Schweizer, 2010; Silvers, Buhle et al., 2014)。因此, 为了预防心理疾患的发生, 降低早期应激的不良影响, 本文从情绪调节的角度出发, 总结并分析了相关的研究成果, 探讨了早期应激对人类行为和脑功能的长期影响。以下将从四个部分展开综述:第一部分总结了早期应激对情绪调节的能力和策略会产生怎样的影响; 在第二部分, 探讨了这些影响背后的神经机制; 在第三部分, 总结了主要的研究发现, 并从应激源特征、研究方法、个体差异等方面对未来研究的方向进行了展望。

2 早期应激对情绪调节的影响

在这一部分, 我们总结了在近20年间围绕早期应激和情绪调节开展的研究。这些研究大致包含两类, 第一类关注的是早期应激是否损伤/促进了个体调节自身情绪的能力, 这些结果多来自于实验室研究; 第二类研究关注的是, 经历和未经历过早期应激的个体, 他们在生活中习惯采用的情绪调节策略有什么不同, 这些结果多来自于大规模的问卷调查。以下, 我们将从这两个方面分别进行回顾。在回顾这些研究之前, 我们首先对如何测量和界定早期应激与情绪调节做以说明。

2.1 早期应激与情绪调节的测量和界定

前文已经提到, 早期应激是指发生在个体生命早期(一般是指16岁之前)的不良生活经历。从研究的时间点上来说, 这可以分为追踪研究和回溯研究两种。在追踪研究中, 研究者会从个体的婴幼儿、童年或青少年时期开始, 通过对个体自身或监护人(如父母、孤儿院的老师等)的调查和访谈对个体的早期经历进行记录, 并追踪研究这些应激经历对个体日后的发展有何影响, 这一研究的优点是采集到的早期经历比较准确和全面, 缺点是耗时长、需要花费巨大的人力和物力。因此, 这类研究的数量相对较少, 追踪时间比较短。即使有大量科研基金的支持, 也很难从童年时期追踪到其成年阶段。所以, 关于早期应激对成年时期影响的研究均来自于后一类研究, 即回溯研究。这类研究一般采用回溯性问卷的方式对个体童年或青少年时期遭遇的应激经历或创伤事件进行调查。目前应用最广泛的早期应激或创伤问卷包括, 最常见的儿童期创伤问卷(Childhood Trauma Questionnaire, Bernstein et al., 2003)、早期创伤事件量表(Early Trauma Inventory, ETI, Bremner, Bolus, & Mayer, 2007)等。这些问卷不仅可以评定出应激或创伤的水平, 还可以区分不同的应激类型, 如生理上的虐待和忽视、情感上的虐待和忽视、以及性虐待等。此外, 福利机构的成长经历、家庭的经济水平和家庭矛盾等也是目前文献中较多提及的早期应激源。

关于情绪调节(Emotion regulation)的含义, 最经典的定义来自于Gross, 他认为, 情绪调节是指个体对具有什么情绪, 什么时候产生这些情绪, 以及如何体验和表达这些情绪施加影响的过程(Gross, 1998)。常见的情绪调节策略包括认知重评、注意转换、表达抑制、回避、反刍等。根据是否需要认知努力, 可以将情绪调节分为内隐的情绪调节和外显的情绪调节, 在下文中我们会进一步介绍。而对情绪调节的测量通常体现在两个方面, 第一是通过实验设置考察个体采用某种情绪调节策略(如情绪冲突调节、认知重评等)对自身的情绪状态进行调节的能力如何, 第二是调查个体在日常生活中习惯采用何种情绪策略, 是否存在调节上的困难等。下面我们就从这两方面来阐述早期应激对情绪调节的影响。

2.2 早期应激对情绪调节能力的影响

2.2.1 早期应激对内隐情绪调节的影响

内隐情绪调节, 即不需要意识努力, 能够在意识下自动化完成的情绪调节策略。情绪冲突调节(Emotional Conflict Regulation Task) (Etkin, Egner, Peraza, Kandel, & Hirsch, 2006)是内隐情绪调节中的一种, 一般采用情绪Stroop任务, 在情绪面孔上同时呈现情绪性词语, 要求被试忽视词语, 只对面孔的情绪进行反应。如果被试在一次冲突试次(即面孔与词语的情绪不一致)出现后, 对紧接着出现的第二个冲突试次的反应时间变快了, 那就说明他成功地调节了这种情绪冲突。

研究表明, 早期应激损伤了成年个体的内隐情绪调节能力(Marusak, Martin, Etkin, & Thomason, 2015; Powers, Etkin, Gyurak, Bradley, & Jovanovic, 2015)。Marusak等人(2015)探索了儿童期创伤对情绪冲突调节的影响。在研究中发现, 早期应激组的内隐情绪调节能力显著弱于控制组。具体来说, 经历过儿童期创伤的被试在第二个冲突试次的反应时没有显著变化, 但控制组在第二个冲突试次的反应时显著快于第一个冲突试次的反应时。Powers等人(2015)也发现了和Marusak等一致的结果。不仅如此, 他们还发现, 儿童期创伤对于内隐情绪调节的影响独立于被试当前的PTSD症状、抑郁状况和成年创伤等因素。

另外, Tottenham等人(2010)对比了在孤儿院成长过的成年被试(实验组)和正常被试(对照组)在情绪冲突任务中的表现, 结果发现实验组在情绪go/nogo任务中更容易受到负性刺激的影响, 表现为当负性面孔出现时, 实验组所需要的反应时更长, 错误率也更高。研究者认为这可能是因为负性刺激占用了他们过多的认知资源, 导致了其在完成任务时调节能力的下降(Tottenham et al., 2010)。

2.2.2 早期应激对外显情绪调节的影响

外显情绪调节, 即需要意识努力的情绪调节策略。认知重评(reappraisal), 即情绪性体验的认知改变(Ochsner, Bunge, Gross, & Gabrieli, 2002), 是近10年研究中较为关注的一种情绪调节策略, 在日常生活中有着广泛的应用。研究发现, 早期应激能够影响个体的认知重评能力, 但影响的方向因应激类型和程度的不同而变化。

Kim等人(2013)研究了被试9岁时的家庭经济状况与其24岁时使用认知重评的关系, 他们比较了被试被动观看负性情绪图片(不进行调节), 和使用认知重评策略调节图片引发的情绪这两种条件下的情绪反应。虽然主观报告结果没有发现显著的不同, 但在神经层面却发现贫困程度越深, 情绪调节时VLPFC/DLPFC激活越小, 杏仁核激活越大。而在认知重评调节情绪过程中, 杏仁核较强的激活往往标志着调节的失败, 因此该结果也说明儿童期越贫困, 成年后认知重评的表现也越差。但是, 最近的一篇研究发现, 中等程度的早期应激也可以提高外显情绪调节能力。Schweizer等人(2016)将中等程度的早期应激定义为有明显的家庭不和, 家庭成员之间有偶然的身体暴力, 缺少温暖和交流, 但是被试没有受到身体或性虐待。实验要求被试被动观看或者使用认知重评调节实验刺激引起的情绪。研究人员将两种条件下的引起的主观情绪效价评分进行对比, 得到的调节量越大, 代表情绪调节能力越强。这项研究发现, 早期应激组的调节量显著大于控制组, 说明中等程度的早期应激促进了认知重评能力的发展。此前的一些研究也支持了Schweizer等人的研究结果, 例如, Parker和Maestripieri (2011)发现中等程度的早期应激能够提高心理韧性, Edge等人(2009)也发现相对于较低程度和较高程度的早期应激, 经历中等程度早期应激的个体成年后的焦虑水平更低。

上述研究表明, 早期应激对不需要意识努力的内隐情绪调节, 和需要意识努力的外显情绪调节都产生了影响(Gyurak, Gross, & Etkin, 2011)。但是, 早期应激的类型和程度不同, 其影响的方向可能不同。对于那些远远超出儿童应对能力范围的应激, 如家庭贫困, 创伤事件等, 早期应激的影响往往是负面的, 经历过这些早期应激的儿童其情绪调节的发展受到了不良影响, 而对于那些尚在儿童应对能力范围之内的应激, 如家庭内部的纠纷, 这些早期应激经历可能会促使儿童更加频繁得使用一些情绪调节策略, 以缓解自身或家庭成员的不良情绪, 因而这些早期应激反而对儿童情绪调节能力的发展起到了一定的促进作用。

2.3 早期应激对情绪调节策略的影响

早期应激能够影响个体对情绪请调节策略的选择, 早期应激越严重的个体, 往往在日常生活中越倾向于使用抑制、回避和反刍等消极的调节策略。情绪调节的策略有很多种, 如问题解决, 认知重评, 接受, 回避, 反刍, 抑制等。其中问题解决、认知重评、接受三种策略被认为是积极的、适应性的(adaptive)情绪调节策略, 这三种策略的使用和抑郁、焦虑等心理疾患负相关; 而回避、反刍和抑制则被认为是消极的、适应不良(maladaptive)的调节策略, 这三种策略的使用与抑郁、焦虑等心理疾患存在较强的正相关(Aldao et al., 2010)。研究发现, 对于那些经历了早期应激的被试, 他们在遇到应激事件的时候, 会更多的选择回避这样的情景; 在产生了负性情绪之后会更多采取抑制情绪表达的方式; 而且在随后的过程中会有更多的反刍行为, 即不断反复体验自己产生的负性情绪。例如, 对于经历过童年虐待或忽视的个体, 在发生应激事件时也更容易选择回避, 来逃避未来可能产生的负性情绪(Gratz, Bornovalova, Delany- Brumsey, Nick, & Lejuez, 2007; Rosenthal, Rasmussen Hall, Palm, Batten, & Follette, 2005)。同样的, 儿童期存在情感虐待的被试, 在成年后会更多地选择去抑制自己的情绪表达(Krause, Mendelson, & Lynch, 2003)。而且儿童期受到的虐待越严重, 越容易在悲伤时使用反刍的策略(Conway, Mendelson, Giannopoulos, Csank, & Holm, 2004)。在O'Mahen, Karl, Moberly和Fedock (2015)的研究中, 他们考察了不同创伤类型与沉思、回避的关系, 发现儿童期情感忽视与回避有关, 儿童期情感虐待与沉思有关, 然而生理上的虐待或忽视不存在与情绪调节策略之间的显著关系, 说明了不同的早期应激类型和特定的情绪调节策略之间具有一定的对应关系。

还有研究者运用情绪调节困难量表(Difficulties in Emotion Regulation Scale, DERS) (Gratz & Roemer, 2004)来研究早期应激类型和情绪调节之间的关系, 发现早期应激越严重, 存在的情绪调节困难越多。一项研究中研究了616名被试, 这些被试在不同的年龄段经历了创伤事件, 在控制了PTSD症状之后, 发现那些在年龄越小的时候经历创伤事件的被试, 在情绪的清晰认知(例如“我对自己的感受有些迷惑”), 以及完成任务时容易受到情绪的影响(例如“当我沮丧时, 我很难去完成我的目标任务”)这两个方面有更大的障碍(Ehring & Quack, 2010)。另一方面, 不同的早期应激类型产生的影响可能是不同的。Carvalho Fernando等人(2014)分析了不同类型的早期应激对情绪调节的影响, 结果发现儿童期情感虐待、情感忽视正向预测了成年期的情绪调节困难, 即儿童期情感虐待和情感忽视越严重, 情绪调节存在的困难就越多, 但生理虐待或忽视对成年期的情绪调节困难没有预测作用。因此, 早期应激会长久地改变个体调节自身情绪的习惯和策略。并且, 这种改变和早期应激的类型具有一定的对应关系, 情感方面的早期应激对个体情绪调节的习惯影响较大。

2.4 早期应激与心理疾患——情绪调节的中介作用

情绪调节方面的问题与抑郁症、焦虑症等心理障碍之间存在着密切的相关(Aldao et al., 2010; Silvers et al., 2013)。处于早期应激环境中的个体, 由于他们不能够得到环境有效的反馈, 因此往往对于自己的情绪不能有清晰的认知, 在选择应对策略时倾向于使用回避、反刍等适应不良的策略(Conway et al., 2004; O'Mahen et al., 2015), 而且更不易接受或控制自己的情绪与行为(Carvalho Fernando et al., 2014), 这些因素会导致他们感到更多负面的情绪(Pechtel & Pizzagalli, 2011), 从而可能引发抑郁、焦虑等疾病(Krause et al., 2003)。Hopfinger, Berking, Bockting和Ebert (2016)分析了269名成年抑郁症患者, 结果发现, 特定的情绪调节能力, 例如对负性情绪的接受和忍耐能力在早期应激和当前抑郁程度的关系中起到了中介作用。具体来说, 早期经历较严重创伤的个体, 情绪调节能力更弱, 从而抑郁情况更加严重; 在一项对3902名非裔美国人进行的调查中, 也发现了类似的结果(Crow, Cross, Powers, & Bradley, 2014)。另外, Carvalho Fernando等人(2014)研究了情绪调节障碍、儿童期情感虐待\忽视与边缘人格障碍之间的关系。结果发现, 儿童期经历的情感虐待与情感忽视越严重, 成年后情绪调节的问题就越严重, 进而导致的边缘人格障碍症状也越严重。

除此之外, 也有研究者将情绪调节视为帮助个体应对应激事件的缓冲因素, 例如采用认知重评进行情绪调节可以帮助个体应对应激事件。当个体处于应激的情境中时, 认知重评帮助个体从更为积极的角度去诠释当前情境, 使其情绪反应更为正面和平和, 从而更好地应对应激源(Troy & Mauss, 2011)。因此, 情绪调节是早期应激能否导致心理疾患的关键因素之一, 这对于心理疾病的治疗有重要价值。

2.5 早期应激和暴力行为——情绪调节的中介作用

以往的研究发现, 早期应激也是暴力/攻击行为的重要风险因素之一(Haller, Harold, Sandi, & Neumann, 2014; Lake et al., 2015; Manly, Kim, Rogosch, & Cicchetti, 2001)。那些经历了生理虐待/心理虐待/性虐待的人, 会更可能有暴力/攻击行为, 也更容易成为暴力/攻击行为的对象, 被称之为“暴力的循环” (Widom, 1989)。那么这是为什么呢?在对攻击行为的研究中, 情绪认知和情绪调节能力的失调往往被视为攻击行为的重要原因(Roberton, Daffern, & Bucks, 2012)。研究者指出容易发生暴力行为的人产生负性情绪的阈值往往较低, 即很容易被激怒, 或容易产生负性情绪(Davidson, Putnam, & Larson, 2000)。核磁研究也表明了儿童期受到过情感虐待的被试在加工负性面孔或词语时出现了杏仁核激活的增强, 表现出对负性刺激过度反应(Fonzo et al., 2016; van Harmelen et al., 2013, 2014)。

正如我们所感受的那样, 暴力/攻击行为往往伴随着较高的负性情绪反应, 以及较差的情绪稳定性, 以及较差的抑制能力等。而那些经历早期应激的被试, 如果他们长期处于被虐待、被忽视的情况, 对于环境中威胁性信息有更加敏感的认知, 就会导致在以后面对此类场景时, 产生注意偏向, 从而导致负性情绪的过强激活, 这时候如果情绪调节能力存在损伤, 无法抑制自己的行为, 就会做出暴力和攻击行为(Lee & Hoaken, 2007)。在Shields等人的两篇研究中, 确实发现情绪调节中介了虐待和反应性攻击行为, 儿童期生理虐待/性虐待的个体更容易去欺凌别人, 而且也很容易成为被欺凌的对象, 同时这些个体的情绪调节能力也较差, 起到了中介的作用 (Shields & Cicchetti, 1998, 2001)。

由此可知, 从情绪调节的角度去预防和治疗早期应激引发的暴力行为是非常有启发性的工作。当前关于早期应激和暴力行为, 以及情绪调节和暴力行为的研究众多, 但结合早期应激, 来进行情绪调节和暴力行为关系的研究还很少, 此类研究能够更加深入、完整的了解帮助我们进行干预和治疗, 有着重要的实际意义。

3 早期应激影响情绪调节的神经机制

早期应激是如何对情绪调节产生影响的?在神经层面上, 杏仁核和前额叶在情绪调节中扮演着重要的角色。在情绪加工和调节的过程中, 杏仁核感知和编码与情绪相关的刺激, 它对高唤醒度或者威胁性的刺激非常敏感。成功的情绪调节往往伴随着杏仁核激活的降低(Buhle et al., 2014; DÖrfel et al., 2014; Kohn et al., 2014; Ochsner, Silvers, & Buhle, 2012; Shonkoff et al., 2012)。而前额叶的不同区域会分别参与不同的情绪调节任务, 例如腹内侧前额叶(vmPFC)整合来自于其他脑区如杏仁核、腹侧纹状体和颞叶的信息, 并根据当前环境和行动的目标做出评估; 腹外侧前额叶(vlPFC)可以抑制与目标不匹配的反应; 背外侧前额叶(dlPFC)和工作记忆以及选择性注意有关(Ochsner et al., 2012; Shonkoff et al., 2012)。这些区域会在不同的情绪调节任务中被激活(DÖrfel et al., 2014; Goldin, McRae, Ramel, & Gross, 2008; Ochsner et al., 2002)。研究表明, 早期应激对杏仁核和前额叶的结构和功能都有着长期的影响(Bick & Nelson, 2016; Hart & Rubia, 2012; Lupien, McEwen, Gunnar, & Heim, 2009; Malter Cohen et al., 2013)。在下文中, 我们从结构和功能这两方面梳理了早期应激对杏仁核和前额的影响。

3.1 早期应激对脑结构的影响

在结构方面, 研究发现早期应激者的杏仁核和前额叶体积同正常被试存在显著差异, 但具体影响因应激类型和程度的不同而不同(Bick & Nelson, 2016; Fareri & Tottenham, 2016)。对于杏仁核来说, Tottenham等人(2010)发现相对于正常被试, 在孤儿院成长过的被试杏仁核体积更大, 并且杏仁核体积越大, 焦虑水平越高。然而, Hanson等人在最近的一项研究中考察了三种不同应激类型(生理虐待、忽视和贫困)的儿童, 结果显示相对于控制组, 无论经历哪种应激, 实验组儿童的杏仁核体积均偏小(Hanson et al., 2015)。近期的一篇综述也指出, 早期应激对于杏仁核体积大小的影响尚没有得到一致的结论, 这可能是由于不同研究中早期应激类型、开始和持续时间等因素不同所造成的(Hart & Rubia, 2012)。

对于前额叶结构的变化, van Harmelen等人(2010)的研究发现在16岁之前经历过情感虐待的成年被试, 内侧前额叶皮层的体积显著小于没有都经历过情感虐待的被试, 而且这一结果不受性别和当前精神状态等因素的影响。Hanson等人(2010)发现, 经历过生理虐待的儿童其眶额皮层体积比正常儿童小。另外, Hodel等人(2015)也发现与正常儿童相比, 在孤儿院成长过的儿童其右侧前额叶体积更小。可见, 目前这些研究都倾向于认为早期应激影响了前额叶的发育, 导致前额叶体积变小, 但不同的应激类型可能影响到前额叶的不同部分。

3.2 早期应激对脑功能的影响

当个体使用不同的策略对自身情绪进行调节时, 涉及的神经通路也不尽相同。但目前的研究结果表明, 早期应激至少在两方面对情绪调节产生影响, 一是增加了个体对负性信息的敏感性, 使其杏仁核活动异常, 增加了调节的难度; 二是影响前额叶功能, 改变了前额叶的调节作用(变弱或变强), 从而改变了情绪调节功能。

Dannlowski等人(2013)研究发现, 儿童期有过虐待经历的被试在观看阈下呈现的悲伤面孔时, 杏仁核的激活程度会显著增强, 表明早期应激增强了杏仁核对情绪的自动加工。类似的, 研究者还发现, 儿童期受到过情感虐待的被试在加工负性面孔或词语时也出现了杏仁核激活的增强, 同时, 还表现出前额叶激活减弱表明其边缘系统对负性刺激过度反应, 而前额叶对杏仁核的调节可能存在问题(Fonzo et al., 2016; van Harmelen et al., 2013, 2014)。研究还发现, 在贫困或充满冲突的家庭中长大的个体, 对于外界的威胁性刺激往往在感知觉以及反应阶段与控制组存在差异, 同时会表现出前额叶和杏仁核之间的连接异常(Javanbakht et al., 2015; Taylor, Lehman, Kiefe, & Seeman, 2006; Teicher, Samson, Anderson, & Ohashi, 2016)。

最近, 有几项研究直接使用fMRI技术考察了早期应激者在完成情绪调节任务时的神经活动。在情绪调节任务中, 前额叶作为控制系统来调节杏仁核的激活(Eden et al., 2015; Etkin, Büchel, & Gross, 2015; Ochsner et al., 2012)。例如, 当被试进行认知重评时, 在调节成功的情况下, 杏仁核激活会减弱, 前额叶激活会增强(Buhle et al., 2014; Frank et al., 2014; Goldin et al., 2008)。Kim等人(2013)测量了成年被试在完成认知重评任务时的脑功能成像, 他们发现儿童期家庭经济条件较差的被试在认知重评时表现出更弱的vlPFC/dlPFC激活, 以及更强的杏仁核激活, 表明童年早期的贫困可能对个体的情绪调节能力产生了长久的损伤; 而Schweizer等人(2016)发现, 经历过中等程度早期应激的被试, 杏仁核激活和前额叶激活都相对较弱, 行为上也表现为更好的情绪调节能力。Schweizer等提出, 这可能是由于早期的应激经历, 如家庭矛盾等, 给了这些人更多调节自身情绪的机会, 因此他们无需调动过多的资源就能够成功调节杏仁核的活动。此外, Marusak等人(2015)采用内隐的情绪冲突调节任务, 他们发现相对于正常被试, 经历过创伤的被试在情绪冲突调节时表现出较强的dlPFC激活, 并在行为上表现出更差的调节能力。研究者提出, 较强的dlPFC激活说明了其进行调节的努力, 但这种努力是无效的。这几项研究结果均表明, 早期应激会通过影响前额叶功能对个体的情绪调节能力产生持久的影响。

在一项整合了早期应激、情绪加工和焦虑症的研究中, 研究者发现在加工负性表情时, 早期经历的情感虐待程度越重, 其成年后杏仁核、右后侧脑岛和腹侧前扣带回的激活越强, 但背外侧前额叶和背侧前扣带回的激活越弱, 同时这些个体的焦虑程度也越高。统计结果表明, 对负性情绪的神经反应强度中介了情感虐待与焦虑之间的关系(Fonzo et al., 2016)。之前的研究还发现, 在经历了早期应激的女性中, 儿童期皮质醇反应能够预测个体在18岁时的杏仁核-腹内侧前额叶的功能连接, 而这一连接能够显著预测18岁的抑郁水平和焦虑水平(Burghy et al., 2012)。这些研究给我们提供了一个更为完整的视角来理解各种因素之间的关系。但是综合来看, 直接探讨早期应激如何影响情绪调节神经环路的研究还比较少, 具体机制尚不清楚。正如Nemeroff在2016年发表的一篇综述中指出, 有关早期应激对中央神经系统的影响的研究还处于早期阶段, 是一个有待探索的广阔领域。

4 总结和展望

回顾这些研究成果, 我们发现早期应激对于外显和内隐的情绪调节能力都存在影响, 多数研究表明早期应激会损伤情绪调节能力, 但最近也有研究发现, 中等程度的早期应激提高了情绪调节能力。不仅如此, 早期应激还能够影响日常生活中情绪调节策略的选择, 经历应激的个体可能更多选择适应不良的策略, 并且存在更多调节障碍, 从而引发抑郁、边缘性人格障碍等多种心理疾患。

在神经层面上, 早期应激影响了脑的发育, 从而对情绪调节的神经基础, 如杏仁核和前额叶等脑区的结构和功能产生了长期的影响。一方面, 早期应激增强了个体对情绪性刺激尤其是负性情绪刺激的反应, 表现为杏仁核的活动增强, 导致情绪调节的难度增加; 另一方面, 早期应激影响了前额叶功能并改变了前额叶和杏仁核的连接, 从而改变了情绪调节能力。但是情绪调节的不同策略涉及很多不同的神经环路, 早期应激究竟如何影响这些神经环路, 尚有很多问题有待研究。

迄今为止, 从情绪调节角度来探讨早期应激影响的研究还不充分, 在国内更是鲜有研究。针对已有的研究成果, 我们对未来的研究提出了几点建议。

首先, 早期应激的概念是比较广泛的。但早期应激的影响与应激的类型、持续时间、发生频率、发生的年龄段、是否可控等特征有很大的关系 (Parihar, Hattiangady, Kuruba, Shuai, & Shetty, 2011; Parker & Maestripieri, 2011)。例如, 常见的家庭矛盾给儿童带来的应激程度比较缓和, 对儿童来说具有一定的可控性, 因此反而有可能锻炼了儿童的情绪调节能力; 但是家庭贫困、父母离异、虐待等事件给儿童造成的应激是非常强烈的, 而且对儿童自身来说是不可控的, 即他们无法通过自身的努力来改变现状, 因此可能给个体带来负面的且长久的影响。由于目前的研究源于各个不同类型、不同程度的早期应激源, 因而给文献之间的比较造成了一定的困难。未来的研究应注重对应激性质和应激程度的操纵或区分, 可以加入一些其他控制变量, 如控制感、社会支持等量表, 进一步细分早期应激的作用。

其次, 情绪调节涉及到不同的策略, 在实验室测量中, 一般要求被试使用特定的情绪策略完成特定的调节任务, 更偏重调节能力的测量; 而在日常生活中, 个体情绪调节的表现往往和实验室测得的结果存在出入, 因为在日常生活中个体会自主选择不同的策略进行情绪调节, 这时候使用问卷测量是一个很好的选择。因此, 未来对情绪调节的测量可以结合实验和问卷进行全面的考虑。

再次, 虽然早期应激是引发情绪性障碍的因素之一, 而且往往被认为是今后罹患各类疾患的风险因素, 但是不可忽视的是依然有很多个体经历了早期不良经历之后, 能够从中恢复, 健康的生活。这其中个体差异是一个不可忽视的因素, 其中基因就是其中重要的一点。研究表明对于同样经历了应激的被试, 5-羟色胺转运体基因表现为s/s, s/l型的个体, 相对于l/l型的个体, 更容易患有抑郁(Caspi et al., 2003; Karg, Burmeister, Shedden, & Sen, 2011; Kendler, Kuhn, Vittum, Prescott, & Riley, 2005; Rocha et al., 2015)。在神经层面上, 高应激且5-HTTLPR为s/s型的被试相比于其他应激程度和基因型的被试, 面对恐惧情绪时杏仁核有更强的激活(Alexander et al., 2012; Hariri et al., 2002; Heinz et al., 2005; Hermann et al., 2012)。近些年关于早期应激表观遗传学的研究也不断增多, 即早期应激通过改变基因的表达过程从而影响大脑的功能(Hermann et al., 2012; Provencal & Binder, 2015), 这方面的研究让我们更明确地了解早期应激是如何产生长久影响的。除此之外, 对基因的研究还能帮助我们在临床上进行疾病预防、诊断和治疗, 因此这方面的研究不可或缺。

最后, 在本文中, 我们总结早期应激导致抑郁、焦虑等心理疾患的问题, 经历早期应激的个体还会出现暴力、攻击性和冲动行为等很多行为问题(Lake et al., 2015; Macinnes, Macpherson, Austin, & Schwannauer, 2016; Veenema, Blume, Niederle, Buwalda, & Neumann, 2006), 而对愤怒等情绪的调节失败可能是导致这些行为问题的重要原因。Lovallo (2013)在研究中提出了的一项早期应激的行为模型, 他提出早期应激会通过影响情绪信息的加工从而对个体的冲动行为产生影响。但迄今为止, 我们还没有发现整合了早期应激、情绪调节与行为问题的相关研究, 这是未来研究值得关注的一个领域。

总之, 早期应激对情绪调节的影响及其机制是一个值得探讨的课题, 它不仅能从理论上丰富情绪调节的发展理论, 更具有实际的临床意义。鉴于我国当前巨大的社会需求和现实问题, 这方面的研究也逐渐引起了国内研究者的注意。未来的研究应注意区分应激的性质, 全面测量其他相关因素, 采用多种研究手段结合的方式, 在更多元的社会文化背景下展开研究。

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Emotions are an indispensable part of our mental life. The term emotion regulation refers to those processes that influence the generation, the experience and the expression of emotions. There is a great variety of strategies to regulate emotions efficiently, which are used in daily life and that have been investigated by cognitive neuroscience. Distraction guides attention to a secondary task. Reinterpretation , a variant of cognitive reappraisal, works by changing the meaning of an emotional stimulus. Detachment , another reappraisal strategy, refers to distancing oneself from an emotional stimulus, thereby reducing its personal relevance. Expressive Suppression modifies the behavioral or physiological response to an emotional stimulus. These four strategies are not equally effective in terms of emotion regulation success and have been shown to partly rely on different neuronal systems. Here, we compare for the first time the neural mechanisms of these typical strategies directly in a common functional magnetic resonance imaging (fMRI) paradigm of downregulation of negative emotions. Our results indicate that three of those strategies (Detachment, Expressive Suppression and Distraction) conjointly increase brain activation in a right prefronto-parietal regulation network and significantly reduce activation of the left amygdala. Compared to the other regulation strategies, Reinterpretation specifically recruited a different control network comprising left ventrolateral prefrontal cortex and orbitofrontal gyrus and was not effective in downregulation of the amygdala. We conclude that Detachment, Distraction and Expressive Suppression recruit very similar emotion regulation networks, whereas Reinterpretation is associated with activation of a qualitatively different network, making this regulation strategy a special one. Notably, Reinterpretation also proved to be the least effective strategy in neural terms, as measured by downregulation of amygdala activation.

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Emotion regulation and trait anxiety are predicted by the microstructure of fibers between amygdala and prefrontal cortex

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Diffusion tensor imaging revealed that trait anxiety predicts the microstructural properties of a prespecified fiber tract between the amygdala and the perigenual anterior cingulate cortex. Besides this particular pathway, it is likely that other pathways are also affected. We investigated white matter differences in persons featuring an anxious or a nonanxious personality, taking into account all potential pathway connections between amygdala and anxiety-related regions of the prefrontal cortex (PFC). Diffusion-weighted images, measures of trait anxiety and of reappraisal use (an effective emotion-regulation style), were collected in 48 females. With probabilistic tractography, pathways between the amygdala and the dorsolateral PFC, dorsomedial PFC, ventromedial PFC, and orbitofrontal cortex (OFC) were delineated. The resulting network showed a direct ventral connection between amygdala and PFC and a second limbic connection following the fornix and the anterior limb of the internal capsule. Reappraisal use predicted the microstructure of pathways to all calculated PFC regions in the left hemisphere, indicating stronger pathways for persons with high reappraisal use. Trait anxiety predicted the microstructure in pathways to the ventromedial PFC and OFC, indexing weaker connections in trait-anxious persons. These effects appeared in the right hemisphere, supporting lateralization and top-down inhibition theories of emotion processing. Whereas a specific microstructure is associated with an anxious personality, a different structure subserves emotion regulation. Both are part of a broad fiber tract network between amygdala and PFC.

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Severe early life stress (ELS) is associated with negative outcomes. It is not clear, however, what impact moderate ELS has. A growing stress inoculation literature suggests that moderate (vs. low or high) ELS is associated with diminished behavioral and physiological anxiety responses. At the same time, studies of trait anxiety suggest that moderate (vs. low) ELS is associated with greater self-reported anxiety. This study tested the hypothesis that stress inoculation effects are evident for implicit (nonconscious) but not explicit (conscious) aspects of anxiety.Ninety-seven healthy women were assessed for ELS and explicit anxiety using questionnaires and assessed for implicit anxiety using a version of the Implicit Association Test.Results indicated a quadratic relation between ELS and implicit anxiety, such that moderate ELS was associated with lower implicit anxiety levels than low or high ELS. By contrast, the relation between ELS and explicit anxiety was linear.These findings support the stress inoculation hypothesis and suggest that stress inoculation applies for implicit but not explicit aspects of anxiety.

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Emotion regulation difficulties in trauma survivors: The role of trauma type and PTSD symptom severity

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Two different hypotheses regarding the relationship between emotion regulation and PTSD are described in the literature. First, it has been suggested that emotion regulation difficulties are part of the complex sequelae of early-onset chronic interpersonal trauma and less common following late-onset or single-event traumas. Second, PTSD in general has been suggested to be related to emotion regulation difficulties. Bringing these two lines of research together, the current study aimed to investigate the role of trauma type and PTSD symptom severity on emotion regulation difficulties in a large sample of trauma survivors (N=616). In line with the hypotheses, PTSD symptom severity was significantly associated with all variables assessing emotion regulation difficulties. In addition, survivors of early-onset chronic interpersonal trauma showed higher scores on these measures than survivors of single-event and/or late-onset traumas. However, when controlling for PTSD symptom severity, the group differences only remained significant for 2 out of 9 variables. The most robust findings were found for the variable "lack of clarity of emotions." Implications for future research, theoretical models of trauma-related disorders, and their treatment will be discussed.

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The role of early life stress as a predictor for alcohol and drug dependence

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Abstract RATIONALE: Genetic and environmental influences on the development of alcohol and drug dependence are equally important. Exposure to early life stress, that is unfortunately common in the general population, has been shown to predict a wide range of psychopathology, including addiction. OBJECTIVE: This review will look at the characteristics of early life stress that may be specific predictors for adolescent and adult alcohol and drug dependence and will focus on studies in humans, non-human primates and rodents. RESULTS: Experiencing maltreatment and cumulative stressful life events prior to puberty and particularly in the first few years of life is associated with early onset of problem drinking in adolescence and alcohol and drug dependence in early adulthood. Early life stress can result in permanent neurohormonal and hypothalamic-pituitary-adrenal axis changes, morphological changes in the brain, and gene expression changes in the mesolimbic dopamine reward pathway, all of which are implicated in the development of addiction. However, a large proportion of children who have experienced even severe early life stress do not develop psychopathology indicating that mediating factors such as gene-environment interactions and family and peer relationships are important for resilience. CONCLUSIONS: There appears to be a direct pathway from chronic stress exposure in pre-pubertal children via adolescent problem drinking to alcohol and drug dependence in early adulthood. However, this route can be moderated by genetic and environmental factors. The role that gene-environment interactions play in the risk-resilience balance is being increasingly recognized.

Etkin A., Büchel C., & Gross J. J . ( 2015).

The neural bases of emotion regulation

Nature Reviews Neuroscience, 16( 11), 693-700.

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Emotions are powerful determinants of behaviour, thought and experience, and they may be regulated in various ways. Neuroimaging studies have implicated several brain regions in emotion regulation, including the ventral anterior cingulate and ventromedial prefrontal cortices, as well as the lateral prefrontal and parietal cortices. Drawing on computational approaches to value-based decision-making and reinforcement learning, we propose a unifying conceptual framework for understanding the neural bases of diverse forms of emotion regulation.

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Resolving emotional conflict: A role for the rostral anterior cingulate cortex in modulating activity in the amygdala

Neuron, 51( 6), 871-882.

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Abstract Effective mental functioning requires that cognition be protected from emotional conflict due to interference by task-irrelevant emotionally salient stimuli. The neural mechanisms by which the brain detects and resolves emotional conflict are still largely unknown, however. Drawing on the classic Stroop conflict task, we developed a protocol that allowed us to dissociate the generation and monitoring of emotional conflict from its resolution. Using functional magnetic resonance imaging (fMRI), we find that activity in the amygdala and dorsomedial and dorsolateral prefrontal cortices reflects the amount of emotional conflict. By contrast, the resolution of emotional conflict is associated with activation of the rostral anterior cingulate cortex. Activation of the rostral cingulate is predicted by the amount of previous-trial conflict-related neural activity and is accompanied by a simultaneous and correlated reduction of amygdalar activity. These data suggest that emotional conflict is resolved through top-down inhibition of amygdalar activity by the rostral cingulate cortex.

Fan F., Su L. Y., Gill M. K., & Birmaher B . ( 2010).

Emotional and behavioral problems of Chinese left-behind children: A preliminary study

Social Psychiatry & Psychiatric Epidemiology, 45( 6), 655-664.

DOI:10.1007/s00127-009-0107-4      URL     PMID:19657573      [本文引用: 1]

Abstract OBJECTIVE: To examine the behavioral and emotional problems and their correlates in left-behindchildren (LBC) in the Hunan Province of China. METHODS: A sample of 1,274 schoolchildren (48.7% girls; 12.4 +/- 2.2 years old) completed the Strength and Difficulties Questionnaire and their current caregivers completed questionnaires about caregiver/bio-parent's demographics and teachers' involvement with the family. RESULTS: There were 629 (49%) children with a history of being left behind, of which 486 were currently cared for by a relative (RLC) and 41 by a non-relative (NRC). As much as 102 had a past history of being left behind, but were currently living with one or more biological parents at the time of the survey (PLB). A total of 645 (51%) children had no history of being left behind and were included as controls. LBC had significantly more psychopathology and less pro-social behaviors than the controls. These differences, with the exception of more hyperactivity and less pro-social behaviors, disappeared after adjusting for age, education and socioeconomic status of the children, parents/caregivers, and the involvement of the teachers. The psychopathology of LBC was significantly inversely correlated with these variables. Long duration and being left behind at a younger age were significantly associated with more psychopathology. Overall, NRC showed more psychopathology, followed by PLB and then RLC. However, with the exception of pro-social behaviors, after adjusting for demographic variables and duration of being left behind, all differences disappeared. CONCLUSIONS: LBC are at risk to develop emotional/behavior problems, particularly if they are left behind early in life, for longer periods, in the care of young caregivers or nonrelatives with poor education and low socioeconomic status, and with less teacher support. Strategies to prevent the development of psychopathology and its amelioration, and governmental policies to decrease the rates of LBC are warranted.

Fareri, D. S., & Tottenham, N. ( 2016).

Effects of early life stress on amygdala and striatal development

Developmental Cognitive Neuroscience, 19, 233-247.

DOI:10.1016/j.dcn.2016.04.005      URL     PMID:27174149      [本文引用: 1]

Abstract Species-expected caregiving early in life is critical for the normative development and regulation of emotional behavior, the ability to effectively evaluate affective stimuli in the environment, and the ability to sustain social relationships. Severe psychosocial stressors early in life (early life stress; ELS) in the form of the absence of species expected caregiving (i.e., caregiver deprivation), can drastically impact one's social and emotional success, leading to the onset of internalizing illness later in life. Development of the amygdala and striatum, two key regions supporting affective valuation and learning, is significantly affected by ELS, and their altered developmental trajectories have important implications for cognitive, behavioral and socioemotional development. However, an understanding of the impact of ELS on the development of functional interactions between these regions and subsequent behavioral effects is lacking. In this review, we highlight the roles of the amygdala and striatum in affective valuation and learning in maturity and across development. We discuss their function separately as well as their interaction. We highlight evidence across species characterizing how ELS induced changes in the development of the amygdala and striatum mediate subsequent behavioral changes associated with internalizing illness, positing a particular import of the effect of ELS on their interaction. Copyright 脗漏 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Fonzo G. A., Ramsawh H. J., Flagan T. M., Simmons A. N., Sullivan S. G., Allard C. B., .. Stein M. B . ( 2016).

Early life stress and the anxious brain: Evidence for a neural mechanism linking childhood emotional maltreatment to anxiety in adulthood

Psychological Medicine, 46( 5), 1037-1054.

DOI:10.1017/S0033291715002603      URL     PMID:26670947      [本文引用: 3]

BACKGROUND: Childhood emotional maltreatment (CEM) increases the likelihood of developing an anxiety disorder in adulthood, but the neural processes underlying conferment of this risk have not been established. Here, we test the potential for neuroimaging the adult brain to inform understanding of the mechanism linking CEM to adult anxiety symptoms. METHOD: One hundred eighty-two adults (148 females, 34 males) with a normal-to-clinical range of anxiety symptoms underwent structural and functional magnetic resonance imaging while completing an emotion-processing paradigm with facial expressions of fear, anger, and happiness. Participants completed self-report measures of CEM and current anxiety symptoms. Voxelwise mediation analyses on gray-matter volumes and activation to each emotion condition were used to identify candidate brain mechanisms relating CEM to anxiety in adulthood. RESULTS: During processing of fear and anger faces, greater amygdala and less right dorsolateral prefrontal (dlPFC) activation partially mediated the positive relationship between CEM and anxiety symptoms. Greater right posterior insula activation to fear also partially mediated this relationship, as did greater ventral anterior cingulate (ACC) and less dorsal ACC activation to anger. Responses to happy faces in these regions did not mediate the CEM-anxiety relationship. Smaller right dlPFC gray-matter volumes also partially mediated the CEM-anxiety relationship. CONCLUSIONS: Activation patterns of the adult brain demonstrate the potential to inform mechanistic accounts of the CEM conferment of anxiety symptoms. RESULTS support the hypothesis that exaggerated limbic activation to negative valence facial emotions links CEM to anxiety symptoms, which may be consequent to a breakdown of cortical regulatory processes.

Frank D. W., Dewitt M., Hudgens-Haney M., Schaeffer D. J., Ball B. H., Schwarz N. F., .. Sabatinelli D . ( 2014).

Emotion regulation: Quantitative meta-analysis of functional activation and deactivation

Neuroscience and Biobehavioral Reviews, 45, 202-211.

DOI:10.1016/j.neubiorev.2014.06.010      URL     PMID:24984244      [本文引用: 1]

Abstract Emotion regulation is hypothesized to be a multifaceted process by which individuals willfully modulate the intensity and direction of emotional response via prefrontally mediated inhibition of subcortical response-related regions of the brain. Here we employ activation likelihood estimation (ALE) meta-analysis of functional magnetic resonance imaging studies to (1) reveal a consistent network of structures active during emotion regulation, (2) identify the target regions inactivated by the willful regulation process, and (3) investigate the consistency of activated structures associated with downregulation and upregulation. Results reveal signal change in bilateral amygdala/parahippocampal gyrus that decreased in downregulated states and increased in upregulated states, while cortical regions including superior frontal gyrus, cingulate, and premotor areas exhibited enhanced activity across all regulation conditions. These results provide consistent evidence for the role of amygdala activity in experienced emotional intensity, where intentional dampening and exaggeration are clearly expressed. However, the execution of emotional upregulation and downregulation may involve distinct subsets of frontocortical structures. Copyright 2014 Elsevier Ltd. All rights reserved.

Goldin P. R., McRae K., Ramel W., & Gross J. J . ( 2008).

The neural bases of emotion regulation: Reappraisal and suppression of negative emotion

Biological Psychiatry, 63( 6), 577-586.

DOI:10.1016/j.biopsych.2007.05.031      URL     [本文引用: 2]

Gratz K. L., Bornovalova M. A., Delany-Brumsey A., Nick B., & Lejuez C. W . ( 2007).

A laboratory-based study of the relationship between childhood abuse and experiential avoidance among inner-city substance users: The role of emotional nonacceptance

Behavior Therapy, 38( 3), 256-268.

DOI:10.1016/j.beth.2006.08.006      URL     PMID:17697851      [本文引用: 1]

Despite the theorized centrality of experiential avoidance in abuse-related psychopathology, empirical examinations of the relationship between childhood abuse and experiential avoidance remain limited. The present study adds to the extant literature on this relationship, providing a laboratory-based investigation of the relationships between childhood sexual, physical, and emotional abuse, experiential avoidance (indexed as unwillingness to persist on 2 psychologically distressing laboratory tasks), and self-reported emotional nonacceptance among a sample of 76 inner-city treatment-seeking substance users. As hypothesized, results provide evidence for heightened experiential avoidance and emotional nonacceptance among individuals with moderate-severe sexual, physical, and emotional abuse (compared to individuals reporting none-low abuse). However, although emotional nonacceptance was associated with increased risk for experiential avoidance, it mediated the relationship between childhood abuse and experiential avoidance only for emotional abuse. As such, results suggest that one mechanism through which emotional abuse in particular leads to experiential avoidance is emotional nonacceptance. Findings suggest the utility of interventions aimed at decreasing experiential avoidance and promoting emotional acceptance among abused individuals.

Gratz, K. L., & Roemer, L . ( 2004).

Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale

Journal of Psychopathology & Behavioral Assessment, 26( 1), 41-54.

DOI:10.1007/s10862-008-9102-4      URL     [本文引用: 1]

Given recent attention to emotion regulation as a potentially unifying function of diverse symptom presentations, there is a need for comprehensive measures that adequately assess difficulties in emotion regulation among adults. This paper (a) proposes an integrative conceptualization of emotion regulation as involving not just the modulation of emotional arousal, but also the awareness, understanding, and acceptance of emotions, and the ability to act in desired ways regardless of emotional state; and (b) begins to explore the factor structure and psychometric properties of a new measure, the Difficulties in Emotion Regulation Scale (DERS). Two samples of undergraduate students completed questionnaire packets. Preliminary findings suggest that the DERS has high internal consistency, good test09“retest reliability, and adequate construct and predictive validity.

Gross, J. J . ( 1998).

Antecedent- and response-focused emotion regulation: Divergent consequences for experience, expression, and physiology

Journal of Personality & Social Psychology, 74( 1), 224-237.

DOI:10.1037//0022-3514.74.1.224      URL     PMID:9457784      [本文引用: 1]

Using a process model of emotion, a distinction between antecedent-focused and response-focused emotion regulation is proposed. To test this distinction, 120 participants were shown a disgusting film while their experiential, behavioral, and physiological responses were recorded. Participants were told to either (a) think about the film in such a way that they would feel nothing (reappraisal, a form of antecedent-focused emotion regulation), (b) behave in such a way that someone watching them would not know they were feeling anything (suppression, a form of response-focused emotion regulation), or (c) watch the film (a control condition). Compared with the control condition, both reappraisal and suppression were effective in reducing emotion-expressive behavior. However, reappraisal decreased disgust experience, whereas suppression increased sympathetic activation. These results suggest that these 2 emotion regulatory processes may have different adaptive consequences.

Gyurak A., Gross J. J., & Etkin A . ( 2011).

Explicit and implicit emotion regulation: A dual-process framework

Cognition and Emotion, 25( 3), 400-412.

DOI:10.1080/02699931.2010.544160      URL     PMID:21432682      [本文引用: 1]

It is widely acknowledged that emotions can be regulated in an astonishing variety of ways. Most research to date has focused on explicit (effortful) forms of emotion regulation. However, there is growing research interest in implicit (automatic) forms of emotion regulation. To organise emerging findings, we present a dual-process framework that integrates explicit and implicit forms of emotion regulation, and argue that both forms of regulation are necessary for well-being. In the first section of this review, we provide a broad overview of the construct of emotion regulation, with an emphasis on explicit and implicit processes. In the second section, we focus on explicit emotion regulation, considering both neural mechanisms that are associated with these processes and their experiential and physiological consequences. In the third section, we turn to several forms of implicit emotion regulation, and integrate the burgeoning literature in this area. We conclude by outlining open questions and areas for future research.

Haller J., Harold G., Sandi C., & Neumann I. D . ( 2014).

Effects of adverse early-life events on aggression and anti-social behaviours in animals and humans

Journal of Neuroendocrinology, 26( 10), 724-738.

DOI:10.1111/jne.12182      URL     PMID:25059307      [本文引用: 1]

We review the impact of early adversities on the development of violence and antisocial behaviour in humans, and present three aetiological animal models of escalated rodent aggression, each disentangling the consequences of one particular adverse early-life factor. A review of the human data, as well as those obtained with the animal models of repeated maternal separation, post-weaning social isolation and peripubertal stress, clearly shows that adverse developmental conditions strongly affect aggressive behaviour displayed in adulthood, the emotional responses to social challenges and the neuronal mechanisms activated by conflict. Although similarities between models are evident, important differences were also noted, demonstrating that the behavioural, emotional and neuronal consequences of early adversities are to a large extent dependent on aetiological factors. These findings support recent theories on human aggression, which suggest that particular developmental trajectories lead to specific forms of aggressive behaviour and brain dysfunctions. However, dissecting the roles of particular aetiological factors in humans is difficult because these occur in various combinations; in addition, the neuroscientific tools employed in humans still lack the depth of analysis of those used in animal research. We suggest that the analytical approach of the rodent models presented here may be successfully used to complement human findings and to develop integrative models of the complex relationship between early adversity, brain development and aggressive behaviour.

Hanson J. L., Chung M. K., Avants B. B., Shirtcliff E. A., Gee J. C., Davidson R. J., & Pollak S. D . ( 2010).

Early stress is associated with alterations in the orbitofrontal cortex: A tensor-based morphometry investigation of brain structure and behavioral risk

Journal of Neuroscience, 30( 22), 7466-7472.

DOI:10.1523/JNEUROSCI.0859-10.2010      URL     PMID:20519521      [本文引用: 1]

Individuals who experience early adversity, such as child maltreatment, are at heightened risk for a broad array of social and health difficulties. However, little is known about how this behavioral risk is instantiated in the brain. Here we examine a neurobiological contribution to individual differences in human behavior using methodology appropriate for use with pediatric populations paired with an in-depth measure of social behavior. We show that alterations in the orbitofrontal cortex among individuals who experienced physical abuse are related to social difficulties. These data suggest a biological mechanism linking early social learning to later behavioral outcomes.

Hanson J. L., Nacewicz B. M., Sutterer M. J., Cayo A. A., Schaefer S. M., Rudolph K. D., .. Davidson R. J . ( 2015).

Behavioral problems after early life stress: Contributions of the hippocampus and amygdala

Biological Psychiatry, 77( 4), 314-323.

DOI:10.1016/j.biopsych.2014.04.020      URL     PMID:4241384      [本文引用: 1]

Early life stress (ELS) can compromise development, with higher amounts of adversity linked to behavioral problems. To understand this linkage, a growing body of research has examined two brain regions involved with socioemotional functioning mygdala and hippocampus. Yet empirical studies have reported increases, decreases, and no differences within human and nonhuman animal samples exposed to different forms of ELS. This divergence in findings may stem from methodological factors, nonlinear effects of ELS, or both. We completed rigorous hand-tracing of the amygdala and hippocampus in three samples of children who experienced different forms of ELS (i.e., physical abuse, early neglect, or low socioeconomic status). Interviews were also conducted with children and their parents or guardians to collect data about cumulative life stress. The same data were also collected in a fourth sample of comparison children who had not experienced any of these forms of ELS. Smaller amygdala volumes were found for children exposed to these different forms of ELS. Smaller hippocampal volumes were also noted for children who were physically abused or from low socioeconomic status households. Smaller amygdala and hippocampal volumes were also associated with greater cumulative stress exposure and behavioral problems. Hippocampal volumes partially mediated the relationship between ELS and greater behavioral problems. This study suggests ELS may shape the development of brain areas involved with emotion processing and regulation in similar ways. Differences in the amygdala and hippocampus may be a shared diathesis for later negative outcomes related to ELS.

Hariri A. R., Mattay V. S., Tessitore A., Kolachana B., Fera F., Goldman D., … Weinberger D. R . ( 2002).

Serotonin transporter genetic variation and the response of the human amygdala

Science, 297( 5580), 400-403.

DOI:10.1126/science.1071829      URL     PMID:12130784      [本文引用: 1]

A functional polymorphism in the promoter region of the human serotonin transporter gene (SLC6A4) has been associated with several dimensions of neuroticism and psychopathology, especially anxiety traits, but the predictive value of this genotype against these complex behaviors has been inconsistent. Serotonin [5- hydroxytryptamine, (5-HT)] function influences normal fear as well as pathological anxiety, behaviors critically dependent on the amygdala in animal models and in clinical studies. We now report that individuals with one or two copies of the short allele of the serotonin transporter (5-HTT) promoter polymorphism, which has been associated with reduced 5-HTT expression and function and increased fear and anxiety-related behaviors, exhibit greater amygdala neuronal activity, as assessed by BOLD functional magnetic resonance imaging, in response to fearful stimuli compared with individuals homozygous for the long allele. These results demonstrate genetically driven variation in the response of brain regions underlying human emotional behavior and suggest that differential excitability of the amygdala to emotional stimuli may contribute to the increased fear and anxiety typically associated with the short SLC6A4 allele.

Hart, H., & Rubia, K . ( 2012).

Neuroimaging of child abuse: A critical review

Frontiers in Human Neuroscience, 6, 52.

DOI:10.3389/fnhum.2012.00052      URL     PMID:3307045      [本文引用: 2]

Childhood maltreatment is a severe stressor that can lead to the development of behaviour problems and affect brain structure and function. This review summarizes the current evidence for the effects of early childhood maltreatment on behavior, cognition and the brain in adults and children. Neuropsychological studies suggest an association between child abuse and deficits in IQ, memory, executive function and emotion discrimination. Structural neuroimaging studies provide evidence for deficits in brain volume, grey and white matter of several regions, most prominently the dorsolateral and ventromedial prefrontal cortex but also hippocampus, amygdala, and corpus callosum. Diffusion tensor imaging studies show evidence for deficits in structural interregional connectivity between these areas, suggesting neural network abnormalities. Functional imaging studies support this evidence by reporting atypical activation in the same brain regions during executive function and emotion processing. There are, however, several limitations of the abuse research literature which are discussed, most prominently the lack of control for co-morbid psychiatric disorders, which make it difficult to disentangle which of the above effects are due to maltreatment, the associated psychiatric conditions or a combination or interaction between both. Overall, the better controlled studies that show a direct correlation between childhood abuse and brain measures suggest that the most prominent deficits associated with early childhood abuse are in the function and structure of lateral and ventromedial fronto-limbic brain areas and networks that mediate behavioural and affect control. Future, large scale multimodal neuroimaging studies in medication-na茂ve subjects, however, are needed that control for psychiatric co-morbidities in order to elucidate the structural and functional brain sequelae that are associated with early environmental adversity, independently of secondary co-morbid conditions.

Heim, C., & Binder, E. B . ( 2012).

Current research trends in early life stress and depression: Review of human studies on sensitive periods, gene-environment interactions, and epigenetics

Experimental Neurology, 233( 1), 102-111.

DOI:10.1016/j.expneurol.2011.10.032      URL     PMID:22101006      [本文引用: 1]

Early life stress, such as childhood abuse, neglect and loss, is a well established major risk factor for developing depressive disorders later in life. We here summarize and discuss current developments in human research regarding the link between early life stress and depression. Specifically, we review the evidence for the existence of sensitive periods for the adverse effects of early life stress in humans. We further review the current state of knowledge regarding gene×environment (G×E) interactions in the effects of early life stress. While multiple genes operate in multiple environments to induce risk for depression after early life stress, these same genes also seem to enhance the beneficial effects of a positive early environment. Also, we discuss the epigenetic mechanisms that might underlie these G×E interactions. Finally, we discuss the potential importance of identifying sensitive time periods of opportunity, as well as G×E interactions and epigenetic mechanisms, for early interventions that might prevent or reverse the detrimental outcomes of early life stress and its transmission across generations.

Heim, C., & Nemeroff, C. B . ( 2001).

The role of childhood trauma in the neurobiology of mood and anxiety disorders: Preclinical and clinical studies

Biological Psychiatry, 49( 12), 1023-1039.

DOI:10.1016/S0006-3223(01)01157-X      URL     PMID:11430844      [本文引用: 1]

Epidemiologic studies indicate that children exposed to early adverse experiences are at increased risk for the development of depression, anxiety disorders, or both. Persistent sensitization of central nervous system (CNS) circuits as a consequence of early life stress, which are integrally involved in the regulation of stress and emotion, may represent the underlying biological substrate of an increased vulnerability to subsequent stress as well as to the development of depression and anxiety. A number of preclinical studies suggest that early life stress induces long-lived hyper(re)activity of corticotropin-releasing factor (CRF) systems as well as alterations in other neurotransmitter systems, resulting in increased stress responsiveness. Many of the findings from these preclinical studies are comparable to findings in adult patients with mood and anxiety disorders. Emerging evidence from clinical studies suggests that exposure to early life stress is associated with neurobiological changes in children and adults, which may underlie the increased risk of psychopathology. Current research is focused on strategies to prevent or reverse the detrimental effects of early life stress on the CNS. The identification of the neurobiological substrates of early adverse experience is of paramount importance for the development of novel treatments for children, adolescents, and adults.

Heinz A., Braus D. F., Smolka M. N., Wrase J., Puls I., Hermann D., .. Büchel C . ( 2005).

Amygdala-prefrontal coupling depends on a genetic variation of the serotonin transporter

Nature Neuroscience, 8( 1), 20-21.

DOI:10.1038/nn1366      URL     PMID:15592465      [本文引用: 1]

Abstract Major depression is conditionally linked to a polymorphism of the human serotonin transporter gene (SLC6A4). During the presentation of aversive, but not pleasant, pictures, healthy carriers of the SLC6A4 short (s) allele showed stronger activation of the amygdala on functional magnetic resonance imaging. s carriers also showed greater coupling between the amygdala and the ventromedial prefrontal cortex, which may contribute to the abnormally high activity in the amygdala and medial prefrontal cortex seen in major depression.

Hermann A., Küpper Y., Schmitz A., Walter B., Vaitl D., Hennig J., .. Tabbert K . ( 2012).

Functional gene polymorphisms in the serotonin system and traumatic life events modulate the neural basis of fear acquisition and extinction

PLoS One, 7( 9), e44352.

DOI:10.1371/journal.pone.0044352      URL     PMID:22957066      [本文引用: 2]

Fear acquisition and extinction are crucial mechanisms in the etiology and maintenance of anxiety disorders. Moreover, they might play a pivotal role in conveying the influence of genetic and environmental factors on the development of a (more or less) stronger proneness for, or resilience against psychopathology. There are only few insights in the neurobiology of genetically and environmentally based individual differences in fear learning and extinction. In this functional magnetic resonance imaging study, 74 healthy subjects were investigated. These were invited according to 5-HTTLPR/rs25531 (S+ vs. LALA; triallelic classification) and TPH2 (G(-703)T) (T+ vs. T-) genotype. The aim was to investigate the influence of genetic factors and traumatic life events on skin conductance responses (SCRs) and neural responses (amygdala, insula, dorsal anterior cingulate cortex (dACC) and ventromedial prefrontal cortex (vmPFC)) during acquisition and extinction learning in a differential fear conditioning paradigm. Fear acquisition was characterized by stronger late conditioned and unconditioned responses in the right insula in 5-HTTLPR S-allele carriers. During extinction traumatic life events were associated with reduced amygdala activation in S-allele carriers vs. non-carriers. Beyond that, T-allele carriers of the TPH2 (G(-703)T) polymorphism with a higher number of traumatic life events showed enhanced responsiveness in the amygdala during acquisition and in the vmPFC during extinction learning compared with non-carriers. Finally, a combined effect of the two polymorphisms with higher responses in S- and T-allele carriers was found in the dACC during extinction. The results indicate an increased expression of conditioned, but also unconditioned fear responses in the insula in 5-HTTLPR S-allele carriers. A combined effect of the two polymorphisms on dACC activation during extinction might be associated with prolonged fear expression. Gene-by-environment interactions in amygdala and vmPFC activation may reflect a neural endophenotype translating genetic and adverse environmental influences into vulnerability for or resilience against developing affective psychopathology.

Hodel A. S., Hunt R. H., Cowell R. A., van Den Heuvel, S. E., Gunnar M. R., & Thomas K. M . ( 2015).

Duration of early adversity and structural brain development in post- institutionalized adolescents

NeuroImage, 105, 112-119.

DOI:10.1016/j.neuroimage.2014.10.020      URL     PMID:4262668      [本文引用: 1]

61We examined brain structure in 110 adolescents adopted from orphanages as children.61Prefrontal cortex volume was reduced in internationally adopted adolescents.61Hippocampal volume was sensitive to the duration of early life adversity.61There was no effect of early life adversity on amygdala volume at adolescence.61Neurodevelopmental correlates of early life adversity persist at adolescence.

Hopfinger L., Berking M., Bockting C. L. H., & Ebert D. D . ( 2016).

Emotion regulation mediates the effect of childhood trauma on depression

Journal of Affective Disorders, 198, 189-197.

DOI:10.1016/j.jad.2016.03.050      URL     PMID:27018937      [本文引用: 1]

61Emotion regulation mediated the relationship between childhood trauma and depression.61This finding held true for depression severity and depression lifetime persistency.61Specific emotion regulation skills were mediators for the outcome depression severity.61Willingness to confront was mediator for depression severity and lifetime persistency.

Javanbakht A., King A. P., Evans G. W., Swain J. E., Angstadt M., Phan K. L., & Liberzon I . ( 2015).

Childhood poverty predicts adult amygdala and frontal activity and connectivity in response to emotional faces

Frontiers in Behavioral Neuroscience, 9, 154.

DOI:10.3389/fnbeh.2015.00154      URL     PMID:26124712      [本文引用: 1]

Abstract Childhood poverty negatively impacts physical and mental health in adulthood. Altered brain development in response to social and environmental factors associated with poverty likely contributes to this effect, engendering maladaptive patterns of social attribution and/or elevated physiological stress. In this fMRI study, we examined the association between childhood poverty and neural processing of social signals (i.e., emotional faces) in adulthood. Fifty-two subjects from a longitudinal prospective study recruited as children, participated in a brain imaging study at 23-25 ears of age using the Emotional Faces Assessment Task. Childhood poverty, independent of concurrent adult income, was associated with higher amygdala and medial prefrontal cortical (mPFC) responses to threat vs. happy faces. Also, childhood poverty was associated with decreased functional connectivity between left amygdala and mPFC. This study is unique, because it prospectively links childhood poverty to emotional processing during adulthood, suggesting a candidate neural mechanism for negative social-emotional bias. Adults who grew up poor appear to be more sensitive to social threat cues and less sensitive to positive social cues.

Karg K., Burmeister M., Shedden K., & Sen S . ( 2011).

The serotonin transporter promoter variant (5-HTTLPR), stress, and depression meta-analysis revisited: Evidence of genetic moderation

Archives of General Psychiatry, 68( 5), 444-454.

DOI:10.1001/archgenpsychiatry.2010.189      URL     [本文引用: 1]

Kendler K. S., Kuhn J. W., Vittum J., Prescott C. A., & Riley B . ( 2005).

The interaction of stressful life events and a serotonin transporter polymorphism in the prediction of episodes of major depression: A replication

Archives of General Psychiatry, 62( 5), 529-535.

DOI:10.1001/archpsyc.62.5.529      URL     [本文引用: 1]

People with the SS variant of the human serotonin transporter gene are more susceptible to episodes of major depression when faced with mildly threatening life events than people with the SL or LL variants. Methods for identifying and treating such patients are provided.

Kim P., Evans G. W., Angstadt M., Ho S. S., Sripada C. S., Swain J. E., .. Phan K. L . ( 2013).

Effects of childhood poverty and chronic stress on emotion regulatory brain function in adulthood

Proceedings of the National Academy of Sciences of the United States of America, 110( 46), 18442-18447.

DOI:10.1073/pnas.1308240110      URL     PMID:24145409      [本文引用: 2]

Abstract Childhood poverty has pervasive negative physical and psychological health sequelae in adulthood. Exposure to chronic stressors may be one underlying mechanism for childhood poverty-health relations by influencing emotion regulatory systems. Animal work and human cross-sectional studies both suggest that chronic stressor exposure is associated with amygdala and prefrontal cortex regions important for emotion regulation. In this longitudinal functional magnetic resonance imaging study of 49 participants, we examined associations between childhood poverty at age 9 and adult neural circuitry activation during emotion regulation at age 24. To test developmental timing, concurrent, adult income was included as a covariate. Adults with lower family income at age 9 exhibited reduced ventrolateral and dorsolateral prefrontal cortex activity and failure to suppress amygdala activation during effortful regulation of negative emotion at age 24. In contrast to childhood income, concurrent adult income was not associated with neural activity during emotion regulation. Furthermore, chronic stressor exposure across childhood (at age 9, 13, and 17) mediated the relations between family income at age 9 and ventrolateral and dorsolateral prefrontal cortex activity at age 24. The findings demonstrate the significance of childhood chronic stress exposures in predicting neural outcomes during emotion regulation in adults who grew up in poverty.

Kohn N., Eickhoff S. B., Scheller M., Laird A. R., Fox P. T., & Habel U . ( 2014).

Neural network of cognitive emotion regulation—an ALE meta-analysis and MACM analysis

NeuroImage, 87, 345-355.

DOI:10.1016/j.neuroimage.2015.03.003      URL     PMID:4801480      [本文引用: 1]

Cognitive regulation of emotions is a fundamental prerequisite for intact social functioning which impacts on both well being and psychopathology. The neural underpinnings of this process have been studied intensively in recent years, without, however, a general consensus. We here quantitatively summarize the published literature on cognitive emotion regulation using activation likelihood estimation in fMRI and PET (23 studies/479 subjects). In addition, we assessed the particular functional contribution of identified regions and their interactions using quantitative functional inference and meta-analytic connectivity modeling, respectively. In doing so, we developed a model for the core brain network involved in emotion regulation of emotional reactivity. According to this, the superior temporal gyrus, angular gyrus and (pre) supplementary motor area should be involved in execution of regulation initiated by frontal areas. The dorsolateral prefrontal cortex may be related to regulation of cognitive processes such as attention, while the ventrolateral prefrontal cortex may not necessarily reflect the regulatory process per se, but signals salience and therefore the need to regulate. We also identified a cluster in the anterior middle cingulate cortex as a region, which is anatomically and functionally in an ideal position to influence behavior and subcortical structures related to affect generation. Hence this area may play a central, integrative role in emotion regulation. By focusing on regions commonly active across multiple studies, this proposed model should provide important a priori information for the assessment of dysregulated emotion regulation in psychiatric disorders.

Krause E. D., Mendelson T., & Lynch T. R . ( 2003).

Childhood emotional invalidation and adult psychological distress: The mediating role of emotional inhibition

Child Abuse & Neglect, 27( 2), 199-213.

DOI:10.1016/S0145-2134(02)00536-7      URL     PMID:12615094      [本文引用: 2]

To evaluate a model in which chronic emotional inhibition mediates the relationship between a history of childhood emotional invalidation or abuse and adult psychological distress.One hundred and twenty-seven participants completed a series of self-report questionnaires, and a subset of this group (n=88) completed an additional measure of current avoidant coping in response to a laboratory stressor. Structural equation modeling was used to evaluate and compare a full and partial mediational model.Findings strongly supported a model in which a history of childhood emotional invalidation (i.e., psychological abuse and parental punishment, minimization, and distress in response to negative emotion) was associated with chronic emotional inhibition in adulthood (i.e., ambivalence over emotional expression, thought suppression, and avoidant stress responses). In turn, emotional inhibition significantly predicted psychological distress, including depression and anxiety symptoms.This study found support for a model in which the relation between recollected negative emotion socialization in childhood and adult psychological distress was fully mediated by a style of inhibiting emotional experience and expression. Although it is likely that childhood emotional inhibition is functional (e.g., reduces parental distress and rejection), results suggest that chronic emotional inhibition may have long-term negative consequences for the inhibitor.

Krugers, H. J., & Joëls M . ( 2014).

Long-lasting consequences of early life stress on brain structure, emotion and cognition

In C., Pariante & M. Lapiz-Bluhm (Eds.), Behavioral neurobiology of stress-related disorders( pp. 81-92). Berlin, Heidelberg: Springer.

DOI:10.1007/7854_2014_289      URL     [本文引用: 1]

During the perinatal period, the brain undergoes substantial structural changes, synaptic rearrangements, and development of neuronal circuits which ultimately determine brain function and behavior. Environmental factors—such as exposure to adverse experiences—have major impact on brain function and structure during this sensitive period. These alterations can be long-lasting, and have been implicated in psychopathology such as cognitive decline and emotional dysfunction. Here we briefly review how early postnatal adversity determines structure and function of the hippocampus, amygdala, and prefrontal cortex (PFC) areas, which are crucial for proper cognitive and emotional function.

Lake S., Wood E., Dong H. R., Dobrer S., Montaner J., & Kerr T . ( 2015).

The impact of childhood emotional abuse on violence among people who inject drugs

Drug and Alcohol Review, 34( 1), 4-9.

DOI:10.1111/dar.12133      URL     PMID:24635836      [本文引用: 2]

Abstract Top of page Abstract Introduction Methods Results Discussion Acknowledgements References Introduction and Aims Childhood emotional abuse is a known risk factor for various poor social and health outcomes. While people who inject drugs (IDU) report high levels of violence, in addition to high rates of childhood maltreatment, the relationship between childhood emotional abuse and later life violence within this population has not been examined. Design and Methods Cross-sectional data were derived from an open prospective cohort of IDU in Vancouver, Canada. Childhood emotional abuse was measured using the Childhood Trauma Questionnaire. We used multivariate logistic regression to examine potential associations between childhood emotional abuse and being a recent victim or perpetrator of violence. Results Between December 2005 and May 2013, 1437 IDU were eligible for inclusion in this analysis, including 465 (32.4%) women. In total, 689 (48.0%) reported moderate to severe history of childhood emotional abuse, whereas 333 (23.2%) reported being a recent victim of violence and 173 (12.0%) reported being a recent perpetrator of violence. In multivariate analysis, being a victim of violence (adjusted odds ratio65 = 651.49, 95% confidence interval 1.15–1.94) and being a perpetrator of violence (adjusted odds ratio65 = 651.58, 95% confidence interval 1.12–2.24) remained independently associated with childhood emotional abuse. Discussion and Conclusions We found high rates of childhood emotional abuse and subsequent adult violence among this sample of IDU. Emotional abuse was associated with both victimisation and perpetration of violence. These findings highlight the need for policies and programmes that address both child abuse and historical emotional abuse among adult IDU. [Lake S, Wood E, Dong H, Dobrer S, Montaner J, Kerr T. The impact of childhood emotional abuse on violence among people who inject drugs. Drug Alcohol Rev 2015;34:4–9]

Lee, V., & Hoaken, P. N. S . ( 2007).

Cognition, emotion, and neurobiological development: Mediating the relation between maltreatment and aggression

Child Maltreatment, 12( 3), 281-298.

DOI:10.1177/1077559507303778      URL     PMID:17631627      [本文引用: 1]

Child maltreatment has been consistently linked to aggression, yet there have been few attempts to conceptualize precisely how maltreatment influences the development of aggression. This review proposes that biases in cognitive, emotional, and neurobiological development mediate the relation between childhood maltreatment and the development of aggression. In addition, it is posited that physical abuse and neglect may have differential effects on development: Physical abuse may result in hypervigilance to threat and a hostile attributional bias, whereas neglect may result in difficulties with emotion regulation because of a lack of emotional interactions. These processes may be "hardwired" into neural networks via the overactivation of certain brain regions and dysfunctional cognitive processes. The theoretical and necessarily speculative nature of this article is intended to stimulate hypotheses for future research. Only when the adverse effects of maltreatment on brain and cognitive development are understood can scholars hope to develop more effective interventions to alter the developmental pathway to aggression.

Lovallo, W. R . ( 2013).

Early life adversity reduces stress reactivity and enhances impulsive behavior: Implications for health behaviors

International Journal of Psychophysiology, 90( 1), 8-16.

DOI:10.1016/j.ijpsycho.2012.10.006      URL     [本文引用: 1]

Lupien S. J., McEwen B. S., Gunnar M. R., & Heim C . ( 2009).

Effects of stress throughout the lifespan on the brain, behaviour and cognition

Nature Reviews Neuroscience, 10( 6), 434-445.

DOI:10.1038/nrn2639      URL     PMID:19401723      [本文引用: 1]

Nat Rev Neurosci. 2009 Jun;10(6):434-45. doi: 10.1038/nrn2639. Epub 2009 Apr 29. Review

Macinnes M., Macpherson G., Austin J., & Schwannauer M . ( 2016).

Examining the effect of childhood trauma on psychological distress, risk of violence and engagement, in forensic mental health

Psychiatry Research, 246, 314-320.

DOI:10.1016/j.psychres.2016.09.054      URL     PMID:27744234      [本文引用: 1]

Previous research has found an association between childhood trauma and insecure attachment and psychological distress, risk of violence and engagement in therapy. The aim of this study was to investigate the relationships between these factors in a forensic population. Sixty-four participants from three secure psychiatric hospitals completed the Childhood Trauma Questionnaire (CTQ), the Relationship Scales Questionnaire (RSQ) and the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM). Overall scores from participants’ Historical Clinical Risk Management Violence Risk Assessment Scheme, (HCR-20) were calculated. Staff evaluated participants’ engagement in therapy via completion of the Service Engagement Scale (SES). This retrospective study found childhood trauma and insecure attachment significantly predicted psychological distress and risk of violence. No associations with engagement were found, but methodological reasons for this outcome were acknowledged. The importance of routinely assessing for a history of childhood trauma and insecure attachment was highlighted.

Malter Cohen M., Jing D. Q., Yang R. R., Tottenham N., Lee F. S., & Casey B. J . ( 2013).

Early-life stress has persistent effects on amygdala function and development in mice and humans

Proceedings of the National Academy of Sciences of the United States of America, 110( 45), 18274-18278.

DOI:10.1073/pnas.1310163110      URL     PMID:24145410      [本文引用: 2]

Relatively little is known about neurobiological changes attributable to early-life stressors (e. g., orphanage rearing), even though they have been associated with a heightened risk for later psychopathology. Human neuroimaging and animal studies provide complementary insights into the neural basis of problem behaviors following stress, but too often are limited by dissimilar experimental designs. The current mouse study manipulates the type and timing of a stressor to parallel the early-life stress experience of orphanage rearing, controlling for genetic and environmental confounds inherent in human studies. The results provide evidence of both early and persistent alterations in amygdala circuitry and function following early-life stress. These effects are not reversed when the stressor is removed nor diminished with the development of prefrontal regulation regions. These neural and behavioral findings are similar to our human findings in children adopted from orphanages abroad in that even following removal from the orphanage, the ability to suppress attention toward potentially threatening information in favor of goal-directed behavior was diminished relative to never-institutionalized children. Together, these findings highlight how early-life stress can lead to altered brain circuitry and emotion dysregulation that may increase the risk for psychopathology.

Manly J. T., Kim J. E., Rogosch F. A., & Cicchetti D . ( 2001).

Dimensions of child maltreatment and children's adjustment: Contributions of developmental timing and subtype

Development and Psychopathology, 13( 4), 759-782.

URL     PMID:11771907      [本文引用: 1]

Abstract This investigation examined the dimensions of developmental timing, subtype, and severity of maltreatment and their relations with child adaptation. The 814 children who participated in a summer day camp, 492 of whom were maltreated and 322 of whom were nonmaltreated comparison children, were assessed by camp counselors on their internalizing and externalizing symptomatology, aggressive, withdrawn, and cooperative behavior, and on personality dimensions of ego resiliency and ego control, and were rated by peers on disruptive, aggressive, and cooperative behavior. The severity within each subtype of maltreatment and the developmental period in which each subtype occurred were examined through hierarchical regression analyses. Additionally, children with similar timing or subtype patterns were grouped to explore diversity in outcomes. Results highlighted the role of severity of emotional maltreatment in the infancy-toddlerhood period and physical abuse during the preschool period in predicting externalizing behavior and aggression. Severity of physical neglect, particularly when it occurred during the preschool period, was associated with internalizing symptomatology and withdrawn behavior. Additionally, maltreatment during the school-age period contributed significant variance after earlier maltreatment was controlled. Chronic maltreatment, especially with onset during infancy-toddlerhood or preschool periods, was linked with more maladaptive outcomes. The implications of measuring multiple dimensions for improving research in child maltreatment are discussed.

Marusak H. A., Martin K. R., Etkin A., & Thomason M. E . ( 2015).

Childhood trauma exposure disrupts the automatic regulation of emotional processing

Neuropsychopharmacology, 40( 5), 1250-1258.

DOI:10.1038/npp.2014.311      URL     PMID:25413183      [本文引用: 3]

Neuropsychopharmacology, the official publication of the American College of Neuropsychopharmacology, publishing the highest quality original research and advancing our understanding of the brain and behavior.

Miller G. E., Chen E., & Parker K. J . ( 2011).

Psychological stress in childhood and susceptibility to the chronic diseases of aging: Moving towards a model of behavioral and biological mechanisms

Psychological Bulletin, 137( 6), 959-997.

DOI:10.1037/a0024768      URL     PMID:21787044      [本文引用: 1]

The railroad book of England: historical, topographical, and picturesque : descriptive of the cities, towns, country seats and other subjects of local interest by Edward Churton E. Churton, [1851]

O’Mahen H. A., Karl A., Moberly N., & Fedock G . ( 2015).

The association between childhood maltreatment and emotion regulation: Two different mechanisms contributing to depression?

Journal of Affective Disorders, 174, 287-295.

DOI:10.1016/j.jad.2014.11.028      URL     PMID:25528000      [本文引用: 2]

In a clinical, community-based sample different types of childhood maltreatment are related to unique emotion regulation strategies. Implications for understanding the developmental antecedents of emotion regulation and depression are discussed.

Ochsner K. N., Bunge S. A., Gross J. J., & Gabrieli, J. D. E . ( 2002).

Rethinking feelings: An fMRI study of the cognitive regulation of emotion

Journal of Cognitive Neuroscience, 14( 8), 1215-1229.

DOI:10.1162/089892902760807212      URL     [本文引用: 2]

Ochsner K. N., Silvers J. A., & Buhle J. T . ( 2012).

Functional imaging studies of emotion regulation: A synthetic review and evolving model of the cognitive control of emotion

Annals of the New York Academy of Sciences, 1251, E1-E24.

DOI:10.1111/j.1749-6632.2012.06751.x      URL     PMID:4133790      [本文引用: 3]

Abstract This paper reviews and synthesizes functional imaging research that over the past decade has begun to offer new insights into the brain mechanisms underlying emotion regulation. Toward that end, the first section of the paper outlines a model of the processes and neural systems involved in emotion generation and regulation. The second section surveys recent research supporting and elaborating the model, focusing primarily on studies of the most commonly investigated strategy, which is known as reappraisal. At its core, the model specifies how prefrontal and cingulate control systems modulate activity in perceptual, semantic, and affect systems as a function of one's regulatory goals, tactics, and the nature of the stimuli and emotions being regulated. This section also shows how the model can be generalized to understand the brain mechanisms underlying other emotion regulation strategies as well as a range of other allied phenomena. The third and last section considers directions for future research, including how basic models of emotion regulation can be translated to understand changes in emotion across the life span and in clinical disorders. 2012 New York Academy of Sciences.

Parihar V. K., Hattiangady B., Kuruba R., Shuai B., & Shetty A. K . ( 2011).

Predictable chronic mild stress improves mood, hippocampal neurogenesis and memory

Molecular Psychiatry, 16( 2), 171-183.

DOI:10.1038/mp.2009.130      URL     [本文引用: 1]

Parker, K. J., & Maestripieri, D . ( 2011).

Identifying key features of early stressful experiences that produce stress vulnerability and resilience in primates

Neuroscience & Biobehavioral Reviews, 35( 7), 1466-1483.

DOI:10.1016/j.neubiorev.2010.09.003      URL     PMID:3023826      [本文引用: 2]

This article examines the complex role of early stressful experiences in producing both vulnerability and resilience to later stress-related psychopathology in a variety of primate models of human development. Two types of models are reviewed: Parental Separation Models (e.g., isolate-rearing, peer-rearing, parental separations, and stress inoculation) and Maternal Behavior Models (e.g., foraging demands, variation in maternal style, and maternal abuse). Based on empirical evidence, it is argued that early life stress exposure does not increase adult vulnerability to stress-related psychopathology as a linear function, as is generally believed, but instead reflects a quadratic function. Features of early stress exposure including the type, duration, frequency, ecological validity, sensory modality, and developmental timing, within and between species, are identified to better understand how early stressful experiences alter neurobiological systems to produce such diverse developmental outcomes. This article concludes by identifying gaps in our current knowledge, providing directions for future research, and discussing the translational implications of these primate models for human development and psychopathology.

Pechtel, P., & Pizzagalli, D. A . ( 2011).

Effects of early life stress on cognitive and affective function: An integrated review of human literature

Psychopharmacology, 214( 1), 55-70.

DOI:10.1007/s00213-010-2009-2      URL     [本文引用: 2]

Philip N. S., Sweet L. H., Tyrka A. R., Price L. H., Bloom R. F., & Carpenter L. L . ( 2013).

Decreased default network connectivity is associated with early life stress in medication-free healthy adults

European Neuropsychopharmacology, 23( 1), 24-32.

DOI:10.1016/j.euroneuro.2012.10.008      URL     PMID:23141153      [本文引用: 1]

Early life stress (ELS) is a significant risk factor for psychopathology, although there are few functional imaging studies investigating its effects. Previous literature suggests that ELS is associated with changes in structure and function in the medial prefrontal cortex (MPFC), which forms the main anterior node of the default network (DN). This study investigated the impact of ELS history on resting state DN connectivity, using seed-based correlation analyses (SCA) involving the posterior cingulate cortex (PCC). Data were analyzed from 22 adult subjects without psychiatric or medical illness (13 with and 9 without ELS); none were taking psychotropic medication. Relative to controls, the ELS group had significant decreases in DN connectivity, observed between the PCC seed and the MPFC and inferior temporal cortex. Further analyses revealed a trend-level increase in connectivity between the amygdala and MPFC associated with ELS history. In conclusion, this study found that subjects with ELS, in the absence of psychiatric illness and medication exposure, demonstrated decreased DN connectivity, and trend-level increases in connectivity between the amygdala and MPFC. These findings suggest that altered resting state connectivity is a correlate of stress exposure, rather than a product of medication or psychiatric morbidity. Published by Elsevier B.V.

Pollak, S. D . ( 2008).

Mechanisms linking early experience and the emergence of emotions: Illustrations from the study of maltreated children

Current Directions in Psychological Science, 17( 6), 370-375.

DOI:10.1111/j.1467-8721.2008.00608.x      URL     [本文引用: 1]

Pollak, S. D., & Tolley-Schell, S. A . ( 2003).

Selective attention to facial emotion in physically abused children

Journal of Abnormal Psychology, 112( 3), 323-338.

DOI:10.1037/0021-843X.112.3.323      URL     PMID:12943012      [本文引用: 1]

Abstract The ability to allocate attention to emotional cues in the environment is an important feature of adaptive self-regulation. Existing data suggest that physically abused children overattend to angry expressions, but the attentional mechanisms underlying such behavior are unknown. The authors tested 8-11-year-old physically abused children to determine whether they displayed specific information-processing problems in a selective attention paradigm using emotional faces as cues. Physically abused children demonstrated delayed disengagement when angry faces served as invalid cues. Abused children also demonstrated increased attentional benefits on valid angry trials. Results are discussed in terms of the influence of early adverse experience on children's selective attention to threat-related signals as a mechanism in the development of psychopathology.

Powers A., Etkin A., Gyurak A., Bradley B., & Jovanovic T . ( 2015).

Associations between childhood abuse, posttraumatic stress disorder, and implicit emotion regulation deficits: Evidence from a low-income, inner-city population

Psychiatry, 78( 3), 251-264.

DOI:10.1080/00332747.2015.1069656      URL     PMID:26391833      [本文引用: 2]

Objective: Childhood abuse is associated with a wide range of negative outcomes, including increased risk for development of emotion dysregulation and psychopathology, such as posttraumatic stress disorder (PTSD). The goal of the present study was to examine associations between child abuse, PTSD symptoms, and performance on an emotional conflict regulation task that assesses implicit emotion regulation abilities.Method: The sample consisted of 67 (94% African American) females recruited from a public, urban hospital. Childhood abuse was measured using the Childhood Trauma Questionnaire, and PTSD was measured using the modified PTSD Symptom Scale. Task accuracy and implicit emotion regulation were measured through an emotional conflict regulation behavioral task.Results: A multivariate analysis of covariance showed that exposure to moderate to severe childhood abuse was significantly related to worse emotional conflict regulation scores independent of current PTSD symptoms, depressive symptoms, and adult trauma exposure, suggesting a deficit in implicit emotion regulation. We also found an interaction between PTSD symptoms and abuse exposure in predicting accuracy on the behavioral task; high levels of PTSD symptoms were associated with poorer task accuracy among individuals who reported moderate to severe exposure to childhood abuse. However, no relationship between implicit emotion regulation abilities and overall PTSD symptom severity was found.Conclusions: This study provides preliminary evidence of an implicit emotion regulation deficit for individuals exposed to significant childhood abuse and further supports the growing evidence that addressing various aspects of emotion dysregulation, such as awareness of emotions and strategies to manage strong emotions, in the context of treatment would be valuable.

Provencal, N., & Binder, E. B . ( 2015).

The effects of early life stress on the epigenome: From the womb to adulthood and even before

Experimental Neurology, 268, 10-20.

DOI:10.1016/j.expneurol.2014.09.001      URL     PMID:25218020      [本文引用: 1]

Abstract Exposure to early life stress (ELS), such as childhood abuse and neglect is a well established major risk factor for developing psychiatric and behavioral disorders later in life. Both prenatal and postnatal stressors have been shown to have a long-lasting impact on adult pathological states where the type and timing of the stressor are important factors to consider. There is a growing body of evidence suggesting that epigenetic mechanisms play a major role in the biological embedding of ELS. A number of studies now indicate that the epigenome is responsive to external environmental exposures, including the social environment, both during intra-uterine development and after birth. In this review, we summarize the evidence of long-lasting effects of ELS on mental health and behavior and highlight common and distinct epigenetic effects of stress exposure at different stages during development. These stages include postnatal stress, prenatal stress, i.e. in utero and stress occurring pre-conception, i.e. effects of stress exposure transmitted to the next generation. We also delineate the evidence for the possible molecular mechanisms involved in epigenetic programming by ELS and how these maybe distinct, according to the timing of the stress exposure. Copyright 2014 Elsevier Inc. All rights reserved.

Roberton T., Daffern M., & Bucks R. S . ( 2012).

Emotion regulation and aggression

Aggression and Violent Behavior, 17( 1), 72-82.

DOI:10.1016/j.avb.2011.09.006      URL     [本文引用: 1]

Rocha T. B. M., Hutz M. H., Salatino-Oliveira A., Genro J. P., Polanczyk G. V., Sato J. R., .. Kieling C . ( 2015).

Gene-environment interaction in youth depression: Replication of the 5-HTTLPR moderation in a diverse setting

American Journal of Psychiatry, 172( 10), 978-985.

DOI:10.1176/appi.ajp.2015.14070896      URL     PMID:26315979      [本文引用: 1]

Replication of scientific findings is a major challenge in biomedical research. In psychiatry, the identification of measured gene-environment interactions (G E) has promoted a heated debate over the past decade, with controversial results about its influence on disorders such as major depression. The authors sought to replicate a 2003 study on G E in youth depression in a large birth cohort from a diverse setting.Using data from the 1993 Pelotas Birth Cohort Study, and adopting a design as similar as possible to that of the original study, the authors tested whether the relationship between childhood maltreatment and a subsequent depressive episode diagnosis was moderated by 5-HTTLPR genotype. Of 5,249 individuals assessed at birth and followed up to age 18, data on the evaluation for depressive episodes in early adulthood, on childhood maltreatment, and on genotype were available for 3,558 participants, of whom 2,392 remained after conservative screening for previous depressive symptoms. Associations were investigated with logistic regression analyses and controlling for potential confounders.The results replicated important findings of the original study, this time in a sample of young adults from a middle-income country: there was a differential dose-response relationship between childhood maltreatment and major depression according to 5-HTTLPR genotype.After following a research strategy as comparable as possible to that of the original study, the results corroborated the existence of a measured G E, now in a large sample from a different sociocultural context. These findings provide further evidence that a genetic variant in the 5-HTTLPR moderates the link between childhood maltreatment and youth depression.

Rosenthal M. Z., Rasmussen Hall M. L., Palm K. M., Batten S. V., & Follette V. M . ( 2005).

Chronic avoidance helps explain the relationship between severity of childhood sexual abuse and psychological distress in adulthood

Journal of Child Sexual Abuse, 14( 4), 25-41.

DOI:10.1300/J070v14n04_02      URL     PMID:16354647      [本文引用: 1]

Recent studies have found that chronic avoidance of unpleasant internal experiences (e.g., thoughts, emotions, memories) is a maladaptive means of affect regulation often adopted by women with a history of sexual victimization in childhood. The primary aim of this study was to replicate and extend previous findings suggesting that higher levels of experiential avoidance may account for the relationship between childhood sexual abuse (CSA) and psychological distress in adulthood. It was hypothesized that, in a sample of undergraduate females (n = 151), the relationship between severity of CSA (e.g., frequency, nature of victimization) and trauma-related psychological distress would be mediated by avoidance. Results supported this hypothesis. Findings are consistent with previous studies, and further suggest that the general tendency to avoid or escape from unpleasant internal experiences may be a specific factor that exacerbates psychological distress among women with a history of sexual victimization in childhood.

Schilling E. A., Aseltine R. H., Jr., & Gore S . ( 2007).

Adverse childhood experiences and mental health in young adults: A longitudinal survey

BMC Public Health, 7, 30.

DOI:10.1186/1471-2458-7-30      URL     PMID:17343754      [本文引用: 1]

Abstract BACKGROUND: Adverse childhood experiences (ACEs) have been consistently linked to psychiatric difficulties in children and adults. However, the long-term effects of ACEs on mental health during the early adult years have been understudied. In addition, many studies are methodologically limited by use of non-representative samples, and few studies have investigated gender and racial differences. The current study relates self-reported lifetime exposure to a range of ACEs in a community sample of high school seniors to three mental health outcomes-depressive symptoms, drug abuse, and antisocial behavior-two years later during the transition to adulthood. METHODS: The study has a two-wave, prospective design. A systematic probability sample of high school seniors (N = 1093) was taken from communities of diverse socioeconomic status. They were interviewed in person in 1998 and over the telephone two years later. Gender and racial differences in ACE prevalence were tested with chi-square tests. Each mental health outcome was regressed on one ACE, controlling for gender, race/ethnicity, and SES to obtain partially standardized regression coefficients. RESULTS: Most ACEs were strongly associated with all three outcomes. The cumulative effect of ACEs was significant and of similar magnitude for all three outcomes. Except for sex abuse/assault, significant gender differences in the effects of single ACEs on depression and drug use were not observed. However, boys who experienced ACEs were more likely to engage in antisocial behavior early in young adulthood than girls who experienced similar ACEs. Where racial/ethnic differences existed, the adverse mental health impact of ACEs on Whites was consistently greater than on Blacks and Hispanics. CONCLUSION: Our sample of young adults from urban, socio-economically disadvantaged communities reported high rates of adverse childhood experiences. The public health impact of childhood adversity is evident in the very strong association between childhood adversity and depressive symptoms, antisocial behavior, and drug use during the early transition to adulthood. These findings, coupled with evidence that the impact of major childhood adversities persists well into adulthood, indicate the critical need for prevention and intervention strategies targeting early adverse experiences and their mental health consequences.

Schweizer S., Walsh N. D., Stretton J., Dunn V. J., Goodyer I. M., & Dalgleish T . ( 2016).

Enhanced emotion regulation capacity and its neural substrates in those exposed to moderate childhood adversity

Social Cognitive & Affective Neuroscience, 11( 2), 272-281.

DOI:10.1093/scan/nsv109      URL     PMID:4733337      [本文引用: 2]

Individuals exposed to childhood adversities (CA) present with emotion regulation (ER) difficulties in later life, which have been identified as risk and maintenance factors for psychopathologies. However, it is unclear if CA negatively impacts on ER capacityper seor whether observed regulation difficulties are a function of the challenging circumstances in which ER is being deployed. In this longitudinal study, we aimed to clarify this association by investigating the behavioral and neural effects of exposure to commonmoderateCA (mCA) on a laboratory measure of ER capacity in late adolescence/young adulthood. Our population-derived samples of adolescents/young adults (N= 53) were administered a film-based ER-task during functional magnetic resonance imaging that allowed evaluation of ER across mCA-exposure. mCA-exposure was associated withenhancedER capacity over both positive and negative affect. At the neural level, the better ER of negative material in those exposed to mCA was associated with reduced recruitment of ER-related brain regions, including the prefrontal cortex and temporal gyrus. In addition mCA-exposure was associated with a greater down-regulation of the amygdala during ER of negative material. The implications of these findings for our understanding of the effects of mCA on the emergence of resilience in adolescence are discussed.

Shields, A., & Cicchetti, D . ( 1998).

Reactive aggression among maltreated children: The contributions of attention and emotion dysregulation

Journal of Clinical Child Psychology, 27( 4), 381-395.

DOI:10.1207/s15374424jccp2704_2      URL     [本文引用: 1]

Shields, A., & Cicchetti, D . ( 2001).

Parental maltreatment and emotion dysregulation as risk factors for bullying and victimization in middle childhood

Journal of Clinical Child & Adolescent Psychology, 30( 3), 349-363.

DOI:10.1207/S15374424JCCP3003_7      URL     PMID:11501252      [本文引用: 1]

Abstract Examined whether children who were maltreated by caregivers were more likely to bully others and to be at risk for victimization by peers. An additional focus was to investigate emotion's role in bullying and victimization among children at risk. Participants were 169 maltreated and 98 nonmaltreated boys and girls attending a summer day camp for inner-city children. As predicted, maltreated children were more likely than nonmaltreated children to bully other children. Bullying was especially prevalent among abused children who experienced maltreating acts of commission (physical or sexual abuse). Maltreatment also placed children at risk for victimization by peers. Gender did not moderate these findings, in that maltreated boys and girls appeared to be at similar risk for bullying and victimization. As expected, both bullies and victims evidenced problems with emotion regulation. Furthermore, logistic regression analyses suggested that emotion dysregulation made a unique contribution toward differentiating bullies and victims from children who did not evidence bully-victim problems. In addition, maltreatment's effects on children's risk for bullying and victimization were mediated by emotion dysregulation.

Shonkoff J. P., Garner A. S., Siegel B. S., Dobbins M. I., Earls M. F., Garner A. S., .. Wood D. L . ( 2012).

The lifelong effects of early childhood adversity and toxic stress

Pediatrics, 129( 1), e232-e246

DOI:10.1542/peds.2011-2663      URL     PMID:24717746      [本文引用: 4]

Abstract A rapidly expanding body of research indicates that early social environments characterized by adversity, subordination and stress, along with individual differences in susceptibility to such environments, create risks for lifelong chronic diseases, including declines in oral health. Emerging findings suggest that gene-environment interplay, resulting in epigenetically regulated differences in gene expression, underlie many such declines in health. The origins of these processes in early life reveal how many of the chronic morbidities of adulthood should be viewed as developmental disorders, with etiologic roots in childhood.

Silvers J., Buhle J. T., & Ochsner, K. N .( 2013).

The neuroscience of emotion regulation: Basic mechanisms and their role in development, aging, and psychopathology

In K N Ochsner & S Kosslyn (Eds), The Oxford Handbook of cognitive neuroscience. Oxford: Oxford University Press.

URL     [本文引用: 2]

Publication » The neuroscience of emotion regulation: Basic mechanisms and their role in development, aging and psychopathology.

Taylor S. E., Lehman B. J., Kiefe C. I., & Seeman T. E . ( 2006).

Relationship of early life stress and psychological functioning to adult C-reactive protein in the coronary artery risk development in young adults study

Biological Psychiatry, 60( 8), 819-824.

DOI:10.1016/j.biopsych.2006.03.016      URL     PMID:16712805      [本文引用: 1]

Low childhood SES and a harsh early family environment appear to be related to elevated C-reactive protein in adulthood through pathways involving psychosocial dysfunction and high body mass index.

Teicher M. H., Samson J. A., Anderson C. M., & Ohashi K . ( 2016).

The effects of childhood maltreatment on brain structure, function and connectivity

Nature Reviews Neuroscience, 17( 10), 652-666.

DOI:10.1038/nrn.2016.111      URL     PMID:27640984      [本文引用: 1]

Maltreatment-related childhood adversity is the leading preventable risk factor for mental illness and substance abuse. Although the association between maltreatment and psychopathology is compelling, there is a pressing need to understand how maltreatment increases the risk of psychiatric disorders. Emerging evidence suggests that maltreatment alters trajectories of brain development to affect sensory systems, network architecture and circuits involved in threat detection, emotional regulation and reward anticipation. This Review explores whether these alterations reflect toxic effects of early-life stress or potentially adaptive modifications, the relationship between psychopathology and brain changes, and the distinction between resilience, susceptibility and compensation.

Tottenham N., Hare T. A., Quinn B. T., McCarry T. W., Nurse M., Gilhooly T., .. Casey B. J . ( 2010).

Prolonged institutional rearing is associated with atypically large amygdala volume and difficulties in emotion regulation

Developmental Science, 13( 1), 46-61.

DOI:10.1111/j.1467-7687.2009.00852.x      URL     PMID:2817950      [本文引用: 3]

Abstract Top of page Abstract Introduction Method Results Discussion Acknowledgements References Supporting Information Early adversity, for example poor caregiving, can have profound effects on emotional development. Orphanage rearing, even in the best circumstances, lies outside of the bounds of a species-typical caregiving environment. The long-term effects of this early adversity on the neurobiological development associated with socio-emotional behaviors are not well understood. Seventy-eight children, who include those who have experienced orphanage care and a comparison group, were assessed. Magnetic resonance imaging (MRI) was used to measure volumes of whole brain and limbic structures (e.g. amygdala, hippocampus). Emotion regulation was assessed with an emotional go-nogo paradigm, and anxiety and internalizing behaviors were assessed using the Screen for Child Anxiety Related Emotional Disorders, the Child Behavior Checklist, and a structured clinical interview. Late adoption was associated with larger corrected amygdala volumes, poorer emotion regulation, and increased anxiety. Although more than 50% of the children who experienced orphanage rearing met criteria for a psychiatric disorder, with a third having an anxiety disorder, the group differences observed in amygdala volume were not driven by the presence of an anxiety disorder. The findings are consistent with previous reports describing negative effects of prolonged orphanage care on emotional behavior and with animal models that show long-term changes in the amygdala and emotional behavior following early postnatal stress. These changes in limbic circuitry may underlie residual emotional and social problems experienced by children who have been internationally adopted.

Troy A. S., & Mauss, I. B .( 2011).

Resilience in the face of stress: Emotion regulation as a protective factor

In Resilience and mental health: Challenges across the lifespan (pp 30-44) Cambridge: Cambridge University Press.

DOI:10.1017/CBO9780511994791.004      URL     [本文引用: 1]

Abstract Everyone experiences stress at one time or another from major events such as the death of a loved one, to more minor stressors such as financial difficulties. Not surprisingly, exposure to stress is generally associated with a wide range of negative outcomes, including decreased well-being, increased incidence of disease, post-traumatic stress disorder, generalized anxiety disorder, and major depressive disorder (Dohrenwend & Dohrenwend, 1974; Kendler et al., 1999; Monat et al., 2007). However, not all individuals who are exposed to even high levels of stress develop such negative outcomes. In fact, recent evidence suggests that a considerable number of individuals exhibit resilience, which is commonly defined as maintained or improved mental health in the face of stress, after short disruptions (if any) to normal functioning (Freitas & Downey, 1998; Rutter, 1999; Luthar et al., 2000; Bonanno, 2005). Note that this definition, which we adapt here, conceptualizes resilience as a potential outcome after exposure to stress rather than a psychological trait that leads to positive outcomes (c.f. Norris et al., 2008). It, therefore, appears that, in the face of comparable stressors, some individuals exhibit significantly impaired functioning while others show impressive resilience. Understanding the factors that govern the great individual variance in outcomes after stress is important for understanding mental health and for developing interventions and prevention programs that foster resilience. What factors, then, might predict resilience? One key to this question might lie in the fact that stressful events are inherently highly emotional (Sarason et al., 1978; Lazarus, 1999). For this reason, people ability to regulate emotions may be a critically important factor in determining resilience (Figure 2.1). The present chapter will review relevant literatures and suggest that there is indeed evidence to support this thesis. More specifically, we will propose that a specific type of emotion regulation, cognitive emotion regulation, holds particular promise for contributing to resilience.

van Harmelen A.-L., van Tol M.-J., Dalgleish T., van der Wee, N. J. A., Veltman D. J., Aleman A., .. Elzinga B. M . ( 2014).

Hypoactive medial prefrontal cortex functioning in adults reporting childhood emotional maltreatment

Social Cognitive and Affective Neuroscience, 9( 12), 2026-2033.

DOI:10.1093/scan/nsu008      URL     PMID:4249477      [本文引用: 2]

Childhood emotional maltreatment (CEM) has adverse effects on medial prefrontal cortex (mPFC) morphology, a structure that is crucial for cognitive functioning and (emotional) memory and which modulates the limbic system. In addition, CEM has been linked to amygdala hyperactivity during emotional face processing. However, no study has yet investigated the functional neural correlates of neutral and emotional memory in adults reporting CEM. Using functional magnetic resonance imaging, we investigated CEM-related differential activations in mPFC during the encoding and recognition of positive, negative and neutral words. The sample (N = 194) consisted of patients with depression and/or anxiety disorders and healthy controls (HC) reporting CEM (n = 96) and patients and HC reporting no abuse (n = 98). We found a consistent pattern of mPFC hypoactivation during encoding and recognition of positive, negative and neutral words in individuals reporting CEM. These results were not explained by psychopathology or severity of depression or anxiety symptoms, or by gender, level of neuroticism, parental psychopathology, negative life events, antidepressant use or decreased mPFC volume in the CEM group. These findings indicate mPFC hypoactivity in individuals reporting CEM during emotional and neutral memory encoding and recognition. Our findings suggest that CEM may increase individuals' risk to the development of psychopathology on differential levels of processing in the brain; blunted mPFC activation during higher order processing and enhanced amygdala activation during automatic/lower order emotion processing. These findings are vital in understanding the long-term consequences of CEM.

van Harmelen A. L., van Tol M. J., Demenescu L. R., van der Wee, N. J. A., Veltman D. J., Aleman A., .. Elzinga B. M . ( 2013).

Enhanced amygdala reactivity to emotional faces in adults reporting childhood emotional maltreatment

Social Cognitive & Affective Neuroscience, 8( 4), 362-369.

DOI:10.1093/scan/nss007      URL     PMID:3624946      [本文引用: 2]

In the context of chronic childhood emotional maltreatment (CEM; emotional abuse and/or neglect), adequately responding to facial expressions is an important skill. Over time, however, this adaptive response may lead to a persistent vigilance for emotional facial expressions. The amygdala and the medial prefrontal cortex (mPFC) are key regions in face processing. However, the neurobiological correlates of face processing in adults reporting CEM are yet unknown. We examined amydala and mPFC reactivity to emotional faces (Angry, Fearful, Sad, Happy, Neutral) vs scrambled faces in healthy controls and unmedicated patients with depression and/or anxiety disorders reporting CEM before the age of 16 years (n = 60), and controls and patients who report no childhood abuse (n = 75). We found that CEM was associated with enhanced bilateral amygdala reactivity to emotional faces in general, and independent of psychiatric status. Furthermore, we found no support for differential mPFC functioning, suggesting that amygdala hyper-responsivity to emotional facial perception in adults reporting CEM may be independent from top-down influences of the mPFC. These findings may be key in understanding the increased emotional sensitivity and interpersonal difficulties, that have been reported in individuals with a history of CEM.

van Harmelen A.-L., van Tol M.-J., van der Wee, N. J. A., Veltman D. J., Aleman A., Spinhoven P., .. Elzinga B. M . ( 2010).

Reduced medial prefrontal cortex volume in adults reporting childhood emotional maltreatment

Biological Psychiatry, 68( 9), 832-838.

DOI:10.1016/j.biopsych.2010.06.011      URL     PMID:20692648      [本文引用: 1]

Abstract BACKGROUND: Childhood emotional maltreatment (CEM) has been associated with a profound and enduring negative impact on behavioral and emotional functioning. Animal models have shown that adverse rearing conditions, such as maternal separation, can induce a cascade of long-term structural alterations in the brain, particularly in the hippocampus, amygdala, and prefrontal cortex. However, in humans, the neurobiological correlates of CEM are unknown. METHODS: Using high-resolution T1-weighted 3T magnetic resonance imaging, anatomical scans and a whole-brain optimized voxel-based morphometry approach, we examined whether healthy control subjects and unmedicated patients with depression and/or anxiety disorders reporting CEM before age 16 (n = 84; age: mean = 38.7) displayed structural brain changes compared with control subjects and patients who reported no childhood abuse (n = 97; age: mean = 36.6). RESULTS: We found that self-reported CEM is associated with a significant reduction in predominantly left dorsal medial prefrontal cortex volume, even in the absence of physical or sexual abuse during childhood. In addition, reduced medial prefrontal cortex in individuals reporting CEM is present in males and females, independent of concomitant psychopathology. CONCLUSIONS: In this study, we show that CEM is associated with profound reductions of medial prefrontal cortex volume, suggesting that sustained inhibition of growth or structural damage can occur after exposure to CEM. Given the important role of the medial prefrontal cortex in the regulation of emotional behavior, our finding might provide an important link in understanding the increased emotional sensitivity in individuals reporting CEM. Copyright 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Veenema A. H., Blume A., Niederle D., Buwalda B., & Neumann I. D . ( 2006).

Effects of early life stress on adult male aggression and hypothalamic vasopressin and serotonin

European Journal of Neuroscience, 24( 6), 1711-1720.

DOI:10.1111/j.1460-9568.2006.05045.x      URL     PMID:17004935      [本文引用: 1]

Abstract Early life stress in humans enhances the risk for psychopathologies, including excessive aggression and violence. In rodents, maternal separation is a potent early life stressor inducing long-lasting changes in emotional and neuroendocrine responsiveness to stress, associated with depression- and anxiety-like symptoms. However, effects of maternal separation on adult male aggression and underlying neurobiological mechanisms remain unknown. Therefore, we investigated the effects of maternal separation on adult intermale aggression in Wistar rats and on hypothalamic arginine vasopressin (AVP) mRNA expression, and AVP and serotonin (5-HT) immunoreactivity, as both AVP and 5-HT have been implicated in stress-coping and aggression. We showed that maternal separation induced depression-like behaviour (increased immobility) and higher adrenocorticotropin hormone responses to an acute stressor (forced swimming). Intermale aggression (lateral threat, offensive upright and keep down) was significantly higher in maternally separated rats compared with control rats. AVP mRNA expression and AVP immunoreactivity were higher in the hypothalamic paraventricular and supraoptic nuclei upon resident-intruder test exposure, whereas 5-HT immunoreactivity was decreased in the anterior hypothalamus of maternally separated rats. Moreover, 5-HT immunoreactivity in the anterior hypothalamus and supraoptic nucleus correlated negatively with aggression. These findings show that exposure to early life stress increases adult male aggression in an animal model of maternal separation. Furthermore, the maternal separation-induced changes in hypothalamic AVP and 5-HT systems may underlie these behavioural alterations.

Widom, C. S . ( 1989).

The cycle of violence

Science, 244( 4901), 160-166.

DOI:10.1126/science.2704995      URL     [本文引用: 1]

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