被虐待者の脳科学研究
小児期のマルトリートメント（不適切な養育）経験は高頻度に精神疾患の発症を招き, 脳の器質的・機能的な変化を伴うことがわかってきた。たとえば, 暴言虐待による聴覚野容積の拡大や両親のDV目撃による視覚野容積の縮小をもたらし, うつ病や PTSD, 認知機能の低下を引き起こす。他の被虐待経験によるヒトの脳に与える影響も明らかになってきた。単独の被虐待経験は一次的に感覚野（視覚野や聴覚野など）の障害を引き起こすが, より多くのタイプの虐待を一度に受けるともっと古い皮質である大脳辺縁系（海馬や扁桃体など）に障害を引き起こす。さらに反応性アタッチメント障害を持つ青少年たちには線条体におけるドパミン機能異...
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| Published in | 児童青年精神医学とその近接領域 Vol. 57; no. 5; pp. 719 - 729 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本児童青年精神医学会
01.11.2016
日本児童青年精神医学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0289-0968 2424-1652 |
| DOI | 10.20615/jscap.57.5_719 |
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| Abstract | 小児期のマルトリートメント（不適切な養育）経験は高頻度に精神疾患の発症を招き, 脳の器質的・機能的な変化を伴うことがわかってきた。たとえば, 暴言虐待による聴覚野容積の拡大や両親のDV目撃による視覚野容積の縮小をもたらし, うつ病や PTSD, 認知機能の低下を引き起こす。他の被虐待経験によるヒトの脳に与える影響も明らかになってきた。単独の被虐待経験は一次的に感覚野（視覚野や聴覚野など）の障害を引き起こすが, より多くのタイプの虐待を一度に受けるともっと古い皮質である大脳辺縁系（海馬や扁桃体など）に障害を引き起こす。さらに反応性アタッチメント障害を持つ青少年たちには線条体におけるドパミン機能異常が明らかになってきた。不適切な養育体験と子どもの依存リスクが脳科学的にも密接に関連している可能性が示唆される。 |
|---|---|
| AbstractList | 小児期のマルトリートメント(不適切な養育)経験は高頻度に精神疾患の発症を招き, 脳の器質的・機能的な変化を伴うことがわかってきた. たとえば, 暴言虐待による聴覚野容積の拡大や両親のDV目撃による視覚野容積の縮小をもたらし, うつ病やPTSD, 認知機能の低下を引き起こす. 他の被虐待経験によるヒトの脳に与える影響も明らかになってきた. 単独の被虐待経験は一次的に感覚野(視覚野や聴覚野など)の障害を引き起こすが, より多くのタイプの虐待を一度に受けるともっと古い皮質である大脳辺縁系(海馬や扁桃体など)に障害を引き起こす. さらに反応性アタッチメント障害を持つ青少年たちには線条体におけるドパミン機能異常が明らかになってきた. 不適切な養育体験と子どもの依存リスクが脳科学的にも密接に関連している可能性が示唆される. 「I. はじめに」児童虐待には, (1)殴る, 蹴るといった「身体的虐待」, (2)性的な接触をしたり, 性行為やポルノ写真・性的な映像にさらす「性的虐待」, (3)不適切な養育環境や食事を与えないなどの「ネグレクト」, (4)暴言による虐待, 子どもの目の前で家族に暴力をふるうなど家庭内暴力(ドメスティックバイオレンス: DV)を目撃させる行為などの「心理的虐待」が含まれる. 小児期のマルトリートメント（不適切な養育）経験は高頻度に精神疾患の発症を招き, 脳の器質的・機能的な変化を伴うことがわかってきた。たとえば, 暴言虐待による聴覚野容積の拡大や両親のDV目撃による視覚野容積の縮小をもたらし, うつ病や PTSD, 認知機能の低下を引き起こす。他の被虐待経験によるヒトの脳に与える影響も明らかになってきた。単独の被虐待経験は一次的に感覚野（視覚野や聴覚野など）の障害を引き起こすが, より多くのタイプの虐待を一度に受けるともっと古い皮質である大脳辺縁系（海馬や扁桃体など）に障害を引き起こす。さらに反応性アタッチメント障害を持つ青少年たちには線条体におけるドパミン機能異常が明らかになってきた。不適切な養育体験と子どもの依存リスクが脳科学的にも密接に関連している可能性が示唆される。 |
| Author | 友田, 明美 |
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| References | Mizuno K, Yoneda T, Komi M et al. (2013): Osmotic release oral system-methylphenidate improves neural activity during low reward processing in children and adolescents with attention-deficit/ hyperactivity disorder. Neuroimage Clin, 2, 366-376. Andersen SL, Tomoda A, Vincow ES et al. (2008): Preliminary evidence for sensitive periods in the effect of childhood sexual abuse on regional brain development. J Neuropsychiatry Clin Neurosci, 20, 292-301. de Lange FP, Koers A, Kalkman JS et al. (2008): Increase in prefrontal cortical volume following cognitive behavioural therapy in patients with chronic fatigue syndrome. Brain, 131 (Pt 8), 2172-2180. van der Kolk BA (2003): The neurobiology of childhood trauma and abuse. Child Adolesc Psychiatr Clin N Am, 12, 293-317. Shimada K, Takiguchi S, Mizushima S et al. (2015): Reduced visual cortex grey matter volume in children and adolescents with reactive attachment disorder. Neuroimage Clin, 9, 13-19. Choi J, Jeong B, Rohan ML et al. (2009): Preliminary evidence for white matter tract abnormalities in young adults exposed to parental verbal abuse. Biol Psychiatry, 65, 227-234. Teicher MH & Samson JA (2013): Childhood maltreatment and psychopathology: A case for ecophenotypic variants as clinically and neurobiologically distinct subtypes. Am J Psychiatry, 170, 1114-1133. 友田明美（2012）：新版いやされない傷—児童虐待と傷ついていく脳—．東京, 診断と治療社 Teicher MH, Tomoda A & Andersen SL (2006b): Neurobiological consequences of early stress and childhood maltreatment: are results from human and animal studies comparable? Ann N Y Acad Sci, 1071, 313-323. Takiguchi S, Fujisawa TX, Mizushima S et al. (2015): Ventral striatum dysfunction in children and adolescents with reactive attachment disorder: Functional MRI study. Br J Psychiatry Open, 1, 121-128. Mizuno K, Takiguchi S, Yamazaki M et al. (2015): Impaired neural reward processing in children and adolescents with reactive attachment disorder: A pilot study. Asian J Psychiatry, 17, 89-93. Choi J, Jeong B, Polcari A et al. (2012): Reduced fractional anisotropy in the visual limbic pathway of young adults witnessing domestic violence in childhood. Neuroimage, 59, 1071-1079. Tomoda A, Polcari A, Anderson et al. (2012): Reduced visual cortex gray matter volume and thickness in young adults who witnessed domestic violence during childhood. PloS One, 7 (12), e52528. Teicher MH, Samson JA, Polcari A et al. (2006a): Sticks, stones, and hurtful words: Relative effects of various forms of childhood maltreatment. Am J Psychiatry, 163, 993-1000. Bowlby J (1988): A secure base: Parent-child attachment and healthy human development. New York, Basic Books. Miyaji N (2014): A new metaphor for speaking of trauma: the toroidal island model. Violence Vict, 29, 137-151. Andersen SL & Teicher MH (2004): Delayed effects of early stress on hippocampal development. Neuropsychopharmacology, 29, 1988-1993. Suzuki H & Tomoda A (2015): Roles of attachment and self-esteem: impact of early life stress on depressive symptoms among Japanese institutionalized children. BMC Psychiatry, 15, 8. Oliver JE (1993): Intergenerational transmission of child abuse: rates, research, and clinical implications. Am J Psychiatry, 150, 1315-1324. Brown DW, Anda RF, Tiemeier H et al. (2009): Adverse childhood experiences and the risk of premature mortality. Am J Pre Med, 37, 389-396. Hubel DH & Wiesel TN (1998): Early exploration of the visual cortex. Neuron, 20, 401-412. Polcari A, Rabi K, Bolger E et al. (2014): Parental verbal affection and verbal aggression in childhood differentially influence psychiatric symptoms and wellbeing in young adulthood. Child Abuse Neglect, 38, 91-102. Tomoda A, Sheu YS, Rabi K et al. (2011): Exposure to parental verbal abuse is associated with increased gray matter volume in superior temporal gyrus. Neuroimage, 54 (Suppl 1), S280-S286. Tomoda A, Suzuki H, Rabi K et al. (2009b): Reduced prefrontal cortical gray matter volume in young adults exposed to harsh corporal punishment. Neuroimage, 47 (Suppl 2), T66-T71. Teicher MH, Anderson CM, Ohashi K et al. (2014): Childhood maltreatment: Altered network centrality of cingulate, precuneus, temporal pole and insula. Biol Psychiatry, 76, 297-305. Teicher MH, Anderson CM & Polcari A (2012): Childhood maltreatment is associated with reduced volume in the hippocampal subfields CA3, dentate gyrus, and subiculum. Proc Natl Acad Sci USA, 109, E563-572. Dube SR, Felitti VJ, Dong M et al. (2003): childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. Pediatrics, 111, 564-572. Post RM, Weiss SR, Smith M et al. (1997): Kindling versus quenching. Implications for the evolution and treatment of posttraumatic stress disorder. Ann N Y Acad Sci, 821, 285-295. 友田明美（2011）：脳の発達．五十嵐隆（編）：発達心理小児科学（Vol.10, pp.31-47）．東京, 文光堂 Tomoda A, Navalta CP, Polcari A et al. (2009a): Childhood sexual abuse is associated with reduced gray matter volume in visual cortex of young women. Biol Psychiatry, 66, 642-648. Wada I & Igarashi A (2014): The social costs of child abuse in Japan. Child Youth Serv Rev, 46, 72-77. |
| References_xml | – reference: Post RM, Weiss SR, Smith M et al. (1997): Kindling versus quenching. Implications for the evolution and treatment of posttraumatic stress disorder. Ann N Y Acad Sci, 821, 285-295. – reference: 友田明美（2011）：脳の発達．五十嵐隆（編）：発達心理小児科学（Vol.10, pp.31-47）．東京, 文光堂． – reference: Andersen SL & Teicher MH (2004): Delayed effects of early stress on hippocampal development. Neuropsychopharmacology, 29, 1988-1993. – reference: Polcari A, Rabi K, Bolger E et al. (2014): Parental verbal affection and verbal aggression in childhood differentially influence psychiatric symptoms and wellbeing in young adulthood. Child Abuse Neglect, 38, 91-102. – reference: Choi J, Jeong B, Polcari A et al. (2012): Reduced fractional anisotropy in the visual limbic pathway of young adults witnessing domestic violence in childhood. Neuroimage, 59, 1071-1079. – reference: Teicher MH, Anderson CM, Ohashi K et al. (2014): Childhood maltreatment: Altered network centrality of cingulate, precuneus, temporal pole and insula. Biol Psychiatry, 76, 297-305. – reference: Andersen SL, Tomoda A, Vincow ES et al. (2008): Preliminary evidence for sensitive periods in the effect of childhood sexual abuse on regional brain development. J Neuropsychiatry Clin Neurosci, 20, 292-301. – reference: Wada I & Igarashi A (2014): The social costs of child abuse in Japan. Child Youth Serv Rev, 46, 72-77. – reference: Tomoda A, Navalta CP, Polcari A et al. (2009a): Childhood sexual abuse is associated with reduced gray matter volume in visual cortex of young women. Biol Psychiatry, 66, 642-648. – reference: Miyaji N (2014): A new metaphor for speaking of trauma: the toroidal island model. Violence Vict, 29, 137-151. – reference: Choi J, Jeong B, Rohan ML et al. (2009): Preliminary evidence for white matter tract abnormalities in young adults exposed to parental verbal abuse. Biol Psychiatry, 65, 227-234. – reference: Tomoda A, Polcari A, Anderson et al. (2012): Reduced visual cortex gray matter volume and thickness in young adults who witnessed domestic violence during childhood. PloS One, 7 (12), e52528. – reference: Teicher MH & Samson JA (2013): Childhood maltreatment and psychopathology: A case for ecophenotypic variants as clinically and neurobiologically distinct subtypes. Am J Psychiatry, 170, 1114-1133. – reference: de Lange FP, Koers A, Kalkman JS et al. (2008): Increase in prefrontal cortical volume following cognitive behavioural therapy in patients with chronic fatigue syndrome. Brain, 131 (Pt 8), 2172-2180. – reference: Brown DW, Anda RF, Tiemeier H et al. (2009): Adverse childhood experiences and the risk of premature mortality. Am J Pre Med, 37, 389-396. – reference: van der Kolk BA (2003): The neurobiology of childhood trauma and abuse. Child Adolesc Psychiatr Clin N Am, 12, 293-317. – reference: Teicher MH, Tomoda A & Andersen SL (2006b): Neurobiological consequences of early stress and childhood maltreatment: are results from human and animal studies comparable? Ann N Y Acad Sci, 1071, 313-323. – reference: Tomoda A, Suzuki H, Rabi K et al. (2009b): Reduced prefrontal cortical gray matter volume in young adults exposed to harsh corporal punishment. Neuroimage, 47 (Suppl 2), T66-T71. – reference: 友田明美（2012）：新版いやされない傷—児童虐待と傷ついていく脳—．東京, 診断と治療社． – reference: Oliver JE (1993): Intergenerational transmission of child abuse: rates, research, and clinical implications. Am J Psychiatry, 150, 1315-1324. – reference: Teicher MH, Anderson CM & Polcari A (2012): Childhood maltreatment is associated with reduced volume in the hippocampal subfields CA3, dentate gyrus, and subiculum. Proc Natl Acad Sci USA, 109, E563-572. – reference: Bowlby J (1988): A secure base: Parent-child attachment and healthy human development. New York, Basic Books. – reference: Shimada K, Takiguchi S, Mizushima S et al. (2015): Reduced visual cortex grey matter volume in children and adolescents with reactive attachment disorder. Neuroimage Clin, 9, 13-19. – reference: Tomoda A, Sheu YS, Rabi K et al. (2011): Exposure to parental verbal abuse is associated with increased gray matter volume in superior temporal gyrus. Neuroimage, 54 (Suppl 1), S280-S286. – reference: Mizuno K, Takiguchi S, Yamazaki M et al. (2015): Impaired neural reward processing in children and adolescents with reactive attachment disorder: A pilot study. Asian J Psychiatry, 17, 89-93. – reference: Takiguchi S, Fujisawa TX, Mizushima S et al. (2015): Ventral striatum dysfunction in children and adolescents with reactive attachment disorder: Functional MRI study. Br J Psychiatry Open, 1, 121-128. – reference: Dube SR, Felitti VJ, Dong M et al. (2003): childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. Pediatrics, 111, 564-572. – reference: Hubel DH & Wiesel TN (1998): Early exploration of the visual cortex. Neuron, 20, 401-412. – reference: Mizuno K, Yoneda T, Komi M et al. (2013): Osmotic release oral system-methylphenidate improves neural activity during low reward processing in children and adolescents with attention-deficit/ hyperactivity disorder. Neuroimage Clin, 2, 366-376. – reference: Suzuki H & Tomoda A (2015): Roles of attachment and self-esteem: impact of early life stress on depressive symptoms among Japanese institutionalized children. BMC Psychiatry, 15, 8. – reference: Teicher MH, Samson JA, Polcari A et al. (2006a): Sticks, stones, and hurtful words: Relative effects of various forms of childhood maltreatment. Am J Psychiatry, 163, 993-1000. |
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| Snippet | 小児期のマルトリートメント（不適切な養育）経験は高頻度に精神疾患の発症を招き, 脳の器質的・機能的な変化を伴うことがわかってきた。たとえば, 暴言虐待による聴覚野容... 小児期のマルトリートメント(不適切な養育)経験は高頻度に精神疾患の発症を招き, 脳の器質的・機能的な変化を伴うことがわかってきた. たとえば, 暴言虐待による聴覚野容... |
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| Title | 被虐待者の脳科学研究 |
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