美国国家公共电台 NPR Nadine Burke Harris: How Does Trauma Affect A Child's DNA?

 

GUY RAZ, HOST:

So if Moshe Szyf is right, that positive experiences can rewrite DNA¹ and improve health, what about negative experiences? Well, about 10 years ago, a pediatrician named Nadine Burke Harris was asking herself that very same question.

NADINE BURKE HARRIS: In the back of my mind, I always thought, like, I wonder if stress hormones² are affecting the health of my patients. I'm like, I wonder if that's even possible.

RAZ: Back then, Nadine had just finished her medical training at Stanford.

BURKE HARRIS: That's right. I started a clinic, a pediatric clinic, in Bayview-Hunters Point, which is one of San Francisco's most low-income and underserved neighborhoods.

RAZ: And as soon as Nadine opened that clinic, she started to notice something.

BURKE HARRIS: A lot of kids were being referred to me by teachers, by principals, by school counselors⁴ for ADHD. It was a lot. Like, it wasn't (laughter) - it wasn't, like, two or three. It was a lot.

RAZ: And then she noticed another thing that, at first, seemed totally unrelated. One of her patients came in with asthma⁵.

BURKE HARRIS: I asked, what could it be that could be setting off, you know, your daughter's asthma? Could it be, you know, pet dander or could it be pollen⁶? Like, when do you notice that her asthma flares⁷ up? And this mom said to me, you know, doctora, I noticed that her asthma tends to get worse when her dad punches a hole in the wall.

RAZ: And hearing that convinced Nadine to start asking all of her patients about what was happening at home.

BURKE HARRIS: So I had all of these patients who had these symptoms of ADHD, asthma, eczema, you know, skin rashes - right? - but who also had severe histories of adversity, you know, violence in the community, violence at home, parents who are either mentally ill or substance dependent or incarcerated⁸. What I observed, and I started to notice this pattern, was that my patients who had the worst symptoms were also the ones who had the worst histories of adversity.

RAZ: So you start to think that this adversity, this trauma⁹ is potentially affecting their physical health.

BURKE HARRIS: Yes.

RAZ: But this was a hunch¹⁰ at the beginning, right?

BURKE HARRIS: Yes, that's exactly right. Yeah, it's like that voice in the back of your mind saying, ha.

RAZ: So what did you do?

BURKE HARRIS: Well, one day, my colleague Dr. Whitney Clarke walked into my office and he said, have you seen this? And he was holding in his hand a research paper called the Adverse¹¹ Childhood Experiences Study. And it was like I was hit by a bolt of lightning.

RAZ: Yeah.

BURKE HARRIS: Because what it said was childhood adversity in and of itself is a risk factor for major health problems.

RAZ: The study seemed to confirm what Nadine had suspected all along, that adversity could rewire a child's brain and body, Nadine Burke Harris picks up the story from the TED³ stage.

(SOUNDBITE OF TED TALK)

BURKE HARRIS: That day changed my clinical practice and ultimately my career. The Adverse Childhood Experiences Study was done by Dr. Vince Felitti at Kaiser and Dr. Bob Anda at the CDC. And together, they asked 17,500 adults about their history of exposure to what they called adverse childhood experiences or ACEs¹³. Those include physical, emotional or sexual abuse, physical or emotional neglect, parental¹⁴ mental illness, substance dependence¹⁵, incarceration¹⁶, parental separation or divorce or domestic violence. For every yes, you would get a point on your ACE¹² score.

And then what they did was they correlated these ACE scores against health outcomes. What they found was striking. Two things - number one, ACEs are incredibly common. Sixty-seven percent of the population had at least one ACE and 12.6 percent, 1 in 8, had four or more ACEs. The second thing that they found was that there was a dose response relationship between ACEs and health outcomes. The higher your ACE score, the worse your health outcomes.

For a person with an ACE score of four or more, their relative risk of chronic¹⁷ obstructive pulmonary disease was 2.5 times that of someone with an ACE score of zero. For hepatitis, it was also 2.5 times. For depression, it was 4.5 times. For suicidality, it was 12 times. A person with an ACE score of seven or more had triple the lifetime risk of lung cancer. And 3.5 times the risk of ischemic heart disease, the number-one killer¹⁸ in the United States of America. Some people looked at this data and they said, come on, you know, you have a rough childhood, you're more likely to drink and smoke and do all these things that are going to ruin your health.

This isn't science. This is just bad behavior. It turns out this is exactly where the science comes in.

RAZ: In just a moment, Nadine Burke Harris explains how childhood adversity can rewrite a child's DNA. Stay with us. I'm Guy Raz, and you're listening to the TED Radio Hour from NPR.

(SOUNDBITE OF MUSIC)

RAZ: It's the TED Radio Hour from NPR. I'm Guy Raz. And on the show today, Hardwired - ideas about how our biology and our experiences determine who we are. And before the break, Pediatrician Nadine Burke Harris was explaining that childhood adversity is one kind of experience that can result in severe health problems.

(SOUNDBITE OF TED TALK)

BURKE HARRIS: We now understand better than we ever have before how exposure to early adversity affects the developing brains and bodies of children. It affects areas like the nucleus¹⁹ accumbens, the pleasure and reward center of the brain that is implicated²⁰ in substance dependence. It inhibits²¹ the prefrontal cortex, which is necessary for impulse control, an executive function, a critical area for learning. And on MRI scans, we see measurable differences in the amygdala, the brain's fear response center.

So there are real neurologic reasons why folks are exposed to high doses of adversity are more likely to engage in high-risk behavior. And that's important to know. But it turns out that even if you don't engage in any high-risk behavior, you're still more likely to develop heart disease or cancer. The reason for this has to do with the hypothalamic-pituitary-adrenal axis²², the brain's and body's stress response system that governs our fight-or-flight response. How does it work?

Well, imagine you're walking in the forest, and you see a bear. Immediately, your hypothalamus sends a signal to your pituitary, which sends a signal to your adrenal gland²³ that says, release stress hormones adrenaline, cortisol. And so your heart starts to pound. Your pupils dilate²⁴. Your airways²⁵ open up. And you are ready to either fight that bear or run from the bear. And that is wonderful if you're in a forest, and there's a bear. But the problem is what happens when the bear comes home every night. And this system is activated²⁶ over and over and over again.

And it goes from being adaptive or lifesaving to maladaptive or health-damaging. Children are especially sensitive to this repeated stress activation²⁷ because their brains and bodies are just developing. High doses of adversity not only affect brain structure and function. They affect the developing immune system, developing hormonal²⁸ systems and even the way our DNA is read and transcribed²⁹.

RAZ: Wow. So, I mean, that child then exhibits certain behaviors based on that exposure, I guess, right?

BURKE HARRIS: That's exactly right. Probably, I would say behavior is the canary in the coal mine. So some kids demonstrate behavioral symptoms and as adults - more likely to suffer from depression, attempt suicide, have problems in the workplace, become incarcerated. But some kids don't show any behavioral symptoms. Some kids just get sick all the time - rashes or asthma or auto-immune disease - right? - where your immune system attacks your own body, right? And then they're more likely to be sick adults - heart disease and arthritis³⁰ and cancer and strokes and chronic obstructive pulmonary disease and Alzheimer's.

RAZ: I mean, the kids that you have seen, right? - is there any hope? I mean, is it reversible? Is there any way to deal with that?

BURKE HARRIS: Yeah. So the good news is, yes, now that we know that your environment has such a profound effect on your biology. One of the most important things that we can do is early detection.

(SOUNDBITE OF TED TALK)

BURKE HARRIS: So in San Francisco, we created the Center for Youth Wellness to prevent, screen and heal the impacts of ACEs and toxic³¹ stress. We started simply with routine screening of every one of our kids at their regular physical. For our patients who do screen positive, we have a multi-disciplinary treatment team that works to reduce the dose of adversity and treat symptoms using best practices, including home visits, care coordination³², mental health care, nutrition, holistic³³ interventions³⁵ and, yes, medication when necessary. But we also educate parents about the impact of ACEs and toxic stress the same way you would for covering electrical outlets³⁶ or lead poisoning.

RAZ: I mean, this is incredible because what you're saying is with the right intervention³⁴, you can prevent and even sometimes reverse these huge health problems.

BURKE HARRIS: Yeah. And here's what's awesome³⁷ - is that we're seeing that it works. I literally³⁸ last week had a follow-up appointment with a patient who is a young girl who had experienced 7 out of the 10 adverse childhood experiences. And this child had stopped growing. She had a diagnosis³⁹ of failure to thrive. And we implemented⁴⁰ some of the things we know to be best practices. We did an intervention called child-parent psychotherapy. But a big part of it was just educating mom about how the child's exposure to adversity was affecting her health. And I will tell you she's back on the growth curve. This family's doing amazing. We can reverse the effects of stress hormones if we detect it early enough. And those things will change their biology.

RAZ: Nadine Burke Harris is a pediatrician and the founder⁴¹ and CEO of the Center for Youth Wellness in San Francisco. You can see her full talk at ted.com.

1 DNA   

(缩)deoxyribonucleic acid 脱氧核糖核酸

参考例句：

• DNA is stored in the nucleus of a cell.脱氧核糖核酸储存于细胞的细胞核里。
• Gene mutations are alterations in the DNA code.基因突变是指DNA密码的改变。

2 hormones   

n. 荷尔蒙，激素 名词hormone的复数形式

参考例句：

• This hormone interacts closely with other hormones in the body. 这种荷尔蒙与体內其他荷尔蒙紧密地相互作用。
• The adrenals produce a large per cent of a man's sex hormones. 肾上腺分泌人体的大部分性激素。

3 ted   

vt.翻晒，撒，撒开

参考例句：

• The invaders gut ted the village.侵略者把村中财物洗劫一空。
• She often teds the corn when it's sunny.天好的时候她就翻晒玉米。

4 counselors   

n.顾问( counselor的名词复数 )；律师；（使馆等的）参赞；（协助学生解决问题的）指导老师

参考例句：

• Counselors began an inquiry into industrial needs. 顾问们开始调查工业方面的需要。 来自《现代英汉综合大词典》
• We have experienced counselors available day and night. ) 这里有经验的法律顾问全天候值班。） 来自超越目标英语 第4册

5 asthma   

n.气喘病，哮喘病

参考例句：

• I think he's having an asthma attack.我想他现在是哮喘病发作了。
• Its presence in allergic asthma is well known.它在过敏性气喘中的存在是大家很熟悉的。

6 pollen   

n.[植]花粉

参考例句：

• Hummingbirds have discovered that nectar and pollen are very nutritious.蜂鸟发现花蜜和花粉是很有营养的。
• He developed an allergy to pollen.他对花粉过敏。

7 flares   

n.喇叭裤v.（使）闪耀( flare的第三人称单数 )；（使）（船舷）外倾；（使）鼻孔张大；（使）（衣裙、酒杯等）呈喇叭形展开

参考例句：

• The side of a ship flares from the keel to the deck. 船舷从龙骨向甲板外倾。 来自《简明英汉词典》
• He's got a fiery temper and flares up at the slightest provocation. 他是火爆性子，一点就着。 来自《现代汉英综合大词典》

8 incarcerated   

钳闭的

参考例句：

• They were incarcerated for the duration of the war. 战争期间，他们被关在狱中。 来自辞典例句
• I don't want to worry them by being incarcerated. 我不想让他们知道我被拘禁的事情。 来自电影对白

9 trauma   

n.外伤，精神创伤

参考例句：

• Counselling is helping him work through this trauma.心理辅导正帮助他面对痛苦。
• The phobia may have its root in a childhood trauma.恐惧症可能源于童年时期的创伤。

10 hunch   

n.预感，直觉

参考例句：

• I have a hunch that he didn't really want to go.我有这么一种感觉，他并不真正想去。
• I had a hunch that Susan and I would work well together.我有预感和苏珊共事会很融洽。

11 adverse   

adj.不利的；有害的；敌对的，不友好的

参考例句：

• He is adverse to going abroad.他反对出国。
• The improper use of medicine could lead to severe adverse reactions.用药不当会产生严重的不良反应。

12 ace   

n.A牌；发球得分；佼佼者；adj.杰出的

参考例句：

• A good negotiator always has more than one ace in the hole.谈判高手总有数张王牌在手。
• He is an ace mechanic.He can repair any cars.他是一流的机械师,什么车都会修。

13 aces   

abbr.adjustable convertible-rate equity security (units) 可调节的股本证券兑换率；aircraft ejection seat 飞机弹射座椅；automatic control evaluation simulator 自动控制评估模拟器n.擅长…的人( ace的名词复数 )；精于…的人；（ 网球 ）（对手接不到发球的）发球得分；爱司球

参考例句：

• The local representative of ACES will define the local area. ACES的当地代表将划定当地的范围。 来自互联网
• Any medical expenses not covered by ACES insurance are the sole responsibility of the parents. 任何ACES保险未包括的医疗费用一律是父母的责任。 来自互联网

14 parental   

adj.父母的；父的；母的

参考例句：

• He encourages parental involvement in the running of school.他鼓励学生家长参与学校的管理。
• Children always revolt against parental disciplines.孩子们总是反抗父母的管束。

15 dependence   

n.依靠，依赖；信任，信赖；隶属

参考例句：

• Doctors keep trying to break her dependence of the drug.医生们尽力使她戒除毒瘾。
• He was freed from financial dependence on his parents.他在经济上摆脱了对父母的依赖。

16 incarceration   

n.监禁，禁闭；钳闭

参考例句：

• He hadn't changed much in his nearly three years of incarceration. 在将近三年的监狱生活中，他变化不大。 来自辞典例句
• Please, please set it free before it bursts from its long incarceration! 请你，请你将这颗心释放出来吧！否则它会因长期的禁闭而爆裂。 来自辞典例句

17 chronic   

adj.(疾病)长期未愈的，慢性的；极坏的

参考例句：

• Famine differs from chronic malnutrition.饥荒不同于慢性营养不良。
• Chronic poisoning may lead to death from inanition.慢性中毒也可能由虚弱导致死亡。

18 killer   

n.杀人者，杀人犯，杀手，屠杀者

参考例句：

• Heart attacks have become Britain's No.1 killer disease.心脏病已成为英国的头号致命疾病。
• The bulk of the evidence points to him as her killer.大量证据证明是他杀死她的。

19 nucleus   

n.核，核心，原子核

参考例句：

• These young people formed the nucleus of the club.这些年轻人成了俱乐部的核心。
• These councils would form the nucleus of a future regime.这些委员会将成为一个未来政权的核心。

20 implicated   

adj.密切关联的；牵涉其中的

参考例句：

• These groups are very strongly implicated in the violence. 这些组织与这起暴力事件有着极大的关联。 来自《简明英汉词典》
• Having the stolen goods in his possession implicated him in the robbery. 因藏有赃物使他涉有偷盗的嫌疑。 来自《现代汉英综合大词典》

21 inhibits   

阻止，抑制( inhibit的第三人称单数 )； 使拘束，使尴尬

参考例句：

• A small manufacturing sector inhibits growth in the economy. 制造业规模太小有碍经济增长。
• His bad English inhibits him from speaking freely. 他英语学得不好，这使他不能表达自如。

22 axis   

n.轴，轴线，中心线；坐标轴，基准线

参考例句：

• The earth's axis is the line between the North and South Poles.地轴是南北极之间的线。
• The axis of a circle is its diameter.圆的轴线是其直径。

23 gland   

n.腺体，(机)密封压盖，填料盖

参考例句：

• This is a snake's poison gland.这就是蛇的毒腺。
• Her mother has an underactive adrenal gland.她的母亲肾上腺机能不全。

24 dilate   

vt.使膨胀，使扩大

参考例句：

• At night,the pupils dilate to allow in more light.到了晚上，瞳孔就会扩大以接收更多光线。
• Exercise dilates blood vessels on the surface of the brain.运动会使大脑表层的血管扩张。

25 AIRWAYS   

航空公司

参考例句：

• The giant jets that increasingly dominate the world's airways. 越来越称雄于世界航线的巨型喷气机。
• At one point the company bought from Nippon Airways a 727 jet. 有一次公司从日本航空公司买了一架727型喷气机。

26 activated   

adj. 激活的 动词activate的过去式和过去分词

参考例句：

• The canister is filled with activated charcoal.蒸气回收罐中充满了活性炭。

27 activation   

n. 激活，催化作用

参考例句：

• A computer controls the activation of an air bag.电脑控制着气囊的启动。

28 hormonal   

adj.激素的

参考例句：

• Some viral diseases are more severe during pregnancy, probably tecause of hormonal changes. 有些病毒病在妊娠期间比较严重，可能是由于激素变化引起的。
• She underwent surgical intervention and a subsequent short period of hormonal therapy. 他接受外科手术及随后短暂荷尔蒙治疗。

29 transcribed   

（用不同的录音手段）转录( transcribe的过去式和过去分词 )； 改编（乐曲）（以适应他种乐器或声部）； 抄写； 用音标标出（声音）

参考例句：

• He transcribed two paragraphs from the book into his notebook. 他把书中的两段抄在笔记本上。
• Every telephone conversation will be recorded and transcribed. 所有电话交谈都将被录音并作全文转写。

30 arthritis   

n.关节炎

参考例句：

• Rheumatoid arthritis has also been linked with the virus.风湿性关节炎也与这种病毒有关。
• He spent three months in the hospital with acute rheumatic arthritis.他患急性风湿性关节炎，在医院住了三个月。

31 toxic   

adj.有毒的，因中毒引起的

参考例句：

• The factory had accidentally released a quantity of toxic waste into the sea.这家工厂意外泄漏大量有毒废物到海中。
• There is a risk that toxic chemicals might be blasted into the atmosphere.爆炸后有毒化学物质可能会进入大气层。

32 coordination   

n.协调，协作

参考例句：

• Gymnastics is a sport that requires a considerable level of coordination.体操是一项需要高协调性的运动。
• The perfect coordination of the dancers and singers added a rhythmic charm to the performance.舞蹈演员和歌手们配合得很好，使演出更具魅力。

33 holistic   

adj.从整体着眼的，全面的

参考例句：

• There is a fundamental ambiguity in the use of word "whole" in recent holistic literature.在近代的整体主义著作中，“整体”这个词的用法极其含混。
• In so far as historicism is technological,its approach is not piecemeal,but "holistic".仅就历史决定论是一种技术而论，它的方法不是渐进的，而是“整体主义的”。

34 intervention   

n.介入，干涉，干预

参考例句：

• The government's intervention in this dispute will not help.政府对这场争论的干预不会起作用。
• Many people felt he would be hostile to the idea of foreign intervention.许多人觉得他会反对外来干预。

35 interventions   

n.介入，干涉，干预( intervention的名词复数 )

参考例句：

• Economic analysis of government interventions deserves detailed discussion. 政府对经济的干预应该给予充分的论述。 来自辞典例句
• The judge's frequent interventions made a mockery of justice. 法官的屡屡干预是对正义的践踏。 来自互联网

36 outlets   

n.出口( outlet的名词复数 )；经销店；插座；廉价经销店

参考例句：

• The dumping of foreign cotton blocked outlets for locally grown cotton. 外国棉花的倾销阻滞了当地生产的棉花的销路。 来自《简明英汉词典》
• They must find outlets for their products. 他们必须为自己的产品寻找出路。 来自《现代汉英综合大词典》

37 awesome   

adj.令人惊叹的，难得吓人的，很好的

参考例句：

• The church in Ireland has always exercised an awesome power.爱尔兰的教堂一直掌握着令人敬畏的权力。
• That new white convertible is totally awesome.那辆新的白色折篷汽车简直棒极了.

38 literally   

adv.照字面意义，逐字地；确实

参考例句：

• He translated the passage literally.他逐字逐句地翻译这段文字。
• Sometimes she would not sit down till she was literally faint.有时候，她不走到真正要昏厥了，决不肯坐下来。

39 diagnosis   

n.诊断，诊断结果，调查分析，判断

参考例句：

• His symptoms gave no obvious pointer to a possible diagnosis.他的症状无法作出明确的诊断。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做一次彻底的调查分析。

40 implemented   

v.实现( implement的过去式和过去分词 )；执行；贯彻；使生效

参考例句：

• This agreement, if not implemented, is a mere scrap of paper. 这个协定如不执行只不过是一纸空文。 来自《现代汉英综合大词典》
• The economy is in danger of collapse unless far-reaching reforms are implemented. 如果不实施影响深远的改革，经济就面临崩溃的危险。 来自辞典例句

41 Founder   

n.创始者，缔造者

参考例句：

• He was extolled as the founder of their Florentine school.他被称颂为佛罗伦萨画派的鼻祖。
• According to the old tradition,Romulus was the founder of Rome.按照古老的传说，罗穆卢斯是古罗马的建国者。