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1、Lanius/VermettenBookChapter“TheHiddenEpidemic:TheImpactofEarlyLifeTraumaonHealthandDisease”CambridgeUniversityPress,2008Chaptertitle:TheRelationshipofAdverseChildhoodExperiencestoAdultHealth,Well-being,SocialFunction,andHealthcare6-01-2007v1.1VincentJ.Felitti,MD(VJFMDSDCA@msn.com)KaiserPermanen
2、teMedicalCareProgram,SanDiego,CARobertF.Anda,MD,MS(RFA1@cdc.gov)USCentersforDiseaseControlandPrevention,Atlanta,GA17Felitti/AndaACEStudychapterLaniusVermettenbookTheRelationshipofAdverseChildhoodExperiencestoAdultHealth,Well-being,SocialFunction,andHealthcare“Inmybeginningismyend.”T.S.Eliot,Fou
3、rQuartets1Introduction:Medicineincreasinglyrecognizesthatearlylifeevents,includingoften-unrecognizedemotionaltraumas,havebothdramaticandlong-lastingeffectsontheneuralandbiologicalsystemsinvolvedinwell-being,biomedicaldisease,socialfunction,andpsychopathology.Ourcurrentunderstandingisrelativelyn
4、ew,developinginthetwentiethcentury.TheturningpointinmodernunderstandingiscommonlyattributedtothegreatFrenchneurologist,Jean-MartinCharcot,andhisstudiesofhysteriaintheclosingyearsofthenineteenthcentury.Janet,Freud,andBreuersoonweretoexploretheroleofemotionaltraumainhumandevelopment.2Subsequently
5、,psychoanalystsandpoetsprovidedtheearlygeneralinsightsintomanyofthesedevelopmentalphenomena.ThesedescriptionsrepresentedanenormousshiftawayfromBiblicalandRenaissanceviewsthatmentalillnessandbiomedicaldiseaseweregod-given,ortheresultofsatanicpossession,orofmoralfailure.JudithHermanprovidesachron
6、ologyofthesetransformationsinherbook,TraumaandRecovery.3HarryHarlow4providedinhisprimateworkexperimentaldemonstrationoftheneedininfancyformorethanenvironmentalwarmth,physicalsafety,andfoodifafunctionaladultrhesusmonkeyistoemerge.JohnBowlby5describedtheimportanceofthemissingingredientinhisworkon
7、humanattachment.Neurobiologistsarecurrentlydiscoveringanddescribingtheintermediarybiomedicalmechanismsbywhichtheseprocessesmanifestthemselves.Thefocusofthischapterwillbeanexaminationoftherelationsbetweenearlylifetraumasandtheeffec
