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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Home visiting and the biology of toxic stress: Opportunities to address early childhood adversity
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Home visiting and the biology of toxic stress: Opportunities to address early childhood adversity

机译：家访和毒性应激的生物学：解决幼儿逆境的机会

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摘要

Home visiting is an important mechanism for minimizing the lifelong effects of early childhood adversity. To do so, it must be informed by the biology of early brain and child development. Advances in neuroscience, epigenetics, and the physiology of stress are revealing the biological mechanisms underlying well-established associations between early childhood adversity and suboptimal life-course trajectories. Left unchecked, mediators of physiologic stress become toxic, alter both genome and brain, and lead to a vicious cycle of chronic stress. This so-called "toxic stress" results a wide array of behavioral attempts to blunt the stress response, a process known as "behavioral allostasis." Although behaviors like smoking, overeating, promiscuity, and substance abuse decrease stress transiently, over time they become maladaptive and result in the unhealthy lifestyles and noncommunicable diseases that are the leading causes of morbidity and mortality. The biology of toxic stress and the concept of behavioral allostasis shed new light on the developmental origins of lifelong disease and highlight opportunities for early intervention and prevention. Future efforts to minimize the effects of childhood adversity should focus on expanding the capacity of caregivers and communities to promote (1) the safe, stable, and nurturing relationships that buffer toxic stress, and (2) the rudimentary but foundational social-emotional, language, and cognitive skills needed to develop healthy, adaptive coping skills. Building these critical caregiver and community capacities will require a public health approach with unprecedented levels of collaboration and coordination between the healthcare, childcare, early education, early intervention, and home visiting sectors. Pediatrics 2013;132:S65-S73.
机译：家访是一种重要的机制，可以最大程度地减少幼儿期逆境的终身影响。为此，必须从早期大脑和儿童发育的生物学知识中获悉。神经科学，表观遗传学和压力生理学的进步揭示了早年逆境与生命周期轨迹欠佳之间公认的关联背后的生物学机制。任其发展，生理压力的介质将变得有毒，改变基因组和大脑，并导致慢性压力的恶性循环。这种所谓的“毒性应激”导致了各种各样的行为尝试，从而减弱了应激反应，这一过程被称为“行为同化”。尽管吸烟，暴饮暴食，滥交和滥用药物等行为可暂时减轻压力，但随着时间的推移，它们会变得适应不良，并导致不良的生活方式和非传染性疾病，这是发病率和死亡率的主要原因。毒性应激的生物学和行为同构性的概念为终身疾病的发展起源提供了新的思路，并突出了早期干预和预防的机会。未来将儿童逆境的影响降至最低的努力应集中在扩大看护者和社区的能力上，以促进（1）缓解毒性压力的安全，稳定和养育的关系，以及（2）基本但基本的社会情感语言和认知技能，以发展健康的适应性应对技能。建设这些重要的照料者和社区能力将需要一种公共卫生方法，在医疗保健，育儿，早期教育，早期干预和家庭访问部门之间要达到前所未有的协作水平。儿科2013; 132：S65-S73。

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