PBS高端访谈:对遭受毒性压力的儿童重视不足

JUDY WOODRUFF: You have heard them all: Wear your seat belt. Don't smoke. Don't drink and drive. These are all pieces of advice that we're accustomed to hearing. But they have become second nature only because of effective public health campaigns. It takes time and persuasion¹ to change behavior. Tonight, pediatrician Nadine Burke Harris shares her Humble² Opinion on what she sees as a grave threat to many children, one she believes has been misdiagnosed and overlooked.

DR.NADINE BURKE HARRIS, Author, "The Deepest Well": Ten years ago at my pediatric clinic in San Francisco, teachers, social workers and parents were bringing me child after child with concerns of ADHD. As I examined my patients, I noticed that the highest rate of behavioral problems was occurring in the kids whose parents had drug addictions⁴ or mental illness, or those who were subject to violence at home. When I dug into the science, what I found was that, for most of these kids, the problem wasn't run-of-the-mill ADHD. For most of my kids, the real problem is what the American Academy of Pediatrics now recognizes as toxic⁵ stress. Ultimately, it all boils down to our flight-or-fight response, what happens in our bodies when we experience something scary. But when activated⁶ too often, like with repeated abuse or neglect or parental⁷ addiction³, it can change the structure and function of children's developing brains. It can affect their hormones⁸, the immune system, even the way DNA⁹ is read and transcribed¹⁰. And it dramatically increases the risk of both behavioral and health problems in childhood and in adulthood¹¹. Toxic stress affects white kids, black and brown kids, rich, poor, urban, rural. In other words, it can affect anyone, and it can happen anywhere. But, right now, only 4 percent of pediatricians in the U.S. are screening for toxic stress. Most haven't received any training on how to identify kids who are at risk. This has to change. Too many children with behavioral symptoms of toxic stress are being labeled with ADHD and given stimulants¹² without any identification of the root cause. And many kids show no behavioral symptoms at all. Yet they are still more than twice as likely to go on to develop asthma¹³, autoimmune disease, heart disease and cancer. And their life expectancy¹⁴ can be cut short by decades. More than 34 million American children have had at least one adverse¹⁵ childhood experience, like witnessing violence at home or being sexually molested¹⁶. We need every medical professional in this country to be equipped with the right tools for universal screening. When identified early, doctors, educators and caregivers can help reverse the biological effects of childhood trauma¹⁷. Together, we can give every child a shot at a healthy life.

JUDY WOODRUFF: Important advice from Nadine Burke Harris.

茱蒂·伍德瑞夫：所有这些你都听过：系好你的安全带。不要吸烟。严禁酒后驾车。这些都是我们习以为常的忠告。但是，由于公共健康运动奏效，它们已成为了第二天性。改变行为需要时间和说服力。今晚，儿科医生纳丁·伯克·哈里斯与我们分享观点，在她看来，这对许多孩子来说简直是致命威胁，她相信这件事一直以来都为人们误解和忽视。

纳丁·伯克·哈里斯医生，《最深陷阱》作家：十年前我在旧金山开了一家儿科诊所，老师、社会工作者以及父母会带着那些被认为患有多动症的孩子来我这里就诊。当我给病人做检查时，我发现那些父母吸毒或患有精神疾病的儿童，行为问题发生率最高或那些遭受家庭暴力的儿童。当我钻研于此的时候，我发现，对于大多数孩子来说，问题不在于简单的多动症。对我的大多数孩子来说，真正的问题是现在美国儿科学会所认识的“毒性压力”。最终，这一切归结为，当我们的身体遭遇可怕事情时，我们的“战斗还是逃跑”反应。但是，如果刺激频繁发生，像反复施虐、忽视或父母酗酒吸毒，就可能影响儿童脑结构及功能发育。它会影响他们的荷尔蒙、免疫系统，甚至影响到DNA的读取和转录。它极大地增加了儿童在其儿童期及成年期的行为健康问题发生风险。“毒性压力”影响广泛，涉及白人、黑人及棕色人种，富人、穷人、城里人和农村人。换句话说，它可以影响到任何人，它可能发生在任何地方。但目前，在美国，正在筛查毒性压力的儿科医生只有4%。大多数人没有接受过任何关于如何识别风险儿童的培训。这种情况必须得到改变。太多有毒性压力症状的孩子被贴上多动症的标签，他们受到刺激，然而造成此结果的根本原因却从未得到识别。许多孩子根本没有表现出任何行为异常。然而，他们罹患哮喘、自身免疫疾病、心脏病及癌症的可能性仍超过（正常情况的）两倍。他们的寿命可以缩短几十年。 至少有过一次不良童年经历的美国儿童超过3400万名，比如目睹家庭暴力或性骚扰。我们需要这个国家的每一位医疗专业人士，配备合适的工具，对“毒性压力”进行普遍筛查。如果及早发现，医生、教育工作者及护理人员就可以帮助扭转童年创伤所造成的生物结果。共同努力，我们可以给每个孩子一个健康生活的机会。

茱蒂·伍德瑞夫：来自纳丁·伯克·哈里斯的重要建议。

1 persuasion   

n.劝说；说服；持有某种信仰的宗派

参考例句：

• He decided to leave only after much persuasion.经过多方劝说，他才决定离开。
• After a lot of persuasion,she agreed to go.经过多次劝说后，她同意去了。

2 humble   

adj.谦卑的，恭顺的；地位低下的；v.降低，贬低

参考例句：

• In my humble opinion,he will win the election.依我拙见，他将在选举中获胜。
• Defeat and failure make people humble.挫折与失败会使人谦卑。

3 addiction   

n.上瘾入迷，嗜好

参考例句：

• He stole money from his parents to feed his addiction.他从父母那儿偷钱以满足自己的嗜好。
• Areas of drug dealing are hellholes of addiction,poverty and murder.贩卖毒品的地区往往是吸毒上瘾、贫困和发生谋杀的地方。

4 addictions   

瘾( addiction的名词复数 )； 吸毒成瘾； 沉溺； 癖好

参考例句：

• He has removed the stigma of drug addictions. 他已经洗去吸毒的污点了。
• Intelligent people are good at using reason to control excessive addictions. 智慧的人善于用理性来控制过度的嗜欲。

5 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。

6 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。

7 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。

8 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。

9 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。

10 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。

11 adulthood   

n.成年，成人期

参考例句：

• Some infantile actions survive into adulthood.某些婴儿期的行为一直保持到成年期。
• Few people nowadays are able to maintain friendships into adulthood.如今很少有人能将友谊维持到成年。

12 stimulants   

n.兴奋剂( stimulant的名词复数 )；含兴奋剂的饮料；刺激物；激励物

参考例句：

• Coffee and tea are mild stimulants. 咖啡和茶是轻度兴奋剂。
• At lower concentrations they may even be stimulants of cell division. 在浓度较低时，它们甚至能促进细胞分裂。 来自辞典例句

13 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。

14 expectancy   

n.期望，预期，（根据概率统计求得）预期数额

参考例句：

• Japanese people have a very high life expectancy.日本人的平均寿命非常长。
• The atomosphere of tense expectancy sobered everyone.这种期望的紧张气氛使每个人变得严肃起来。

15 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。

16 molested   

v.骚扰( molest的过去式和过去分词 )；干扰；调戏；猥亵

参考例句：

• The bigger children in the neighborhood molested the younger ones. 邻居家的大孩子欺负小孩子。 来自《简明英汉词典》
• He molested children and was sent to jail. 他猥亵儿童，进了监狱。 来自《简明英汉词典》

17 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。