Department of Psychology, University of California, Los Angeles, California.
Department of Psychology, University of California, Los Angeles, California; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California.
Biol Psychiatry. 2021 Jan 15;89(2):184-193. doi: 10.1016/j.biopsych.2020.06.028. Epub 2020 Jul 10.
Adolescence is characterized by significant changes in several domains, including brain structure and function, puberty, and social and environmental factors. Some of these changes serve to increase the likelihood of psychosis onset during this period, while others may buffer this risk. This review characterizes our current knowledge regarding the unique aspects of adolescence that may serve as risk factors for schizophrenia spectrum disorders. In addition, we provide potential future directions for research into adolescent-specific developmental mechanisms that impart vulnerability to psychosis and the possibility of interventions that capitalize on adolescents' unique characteristics. Specifically, we explore the ways in which gray and white matter develop throughout adolescence in typically developing youth as well as in those with psychosis spectrum disorders. We also discuss current views on the function that social support and demands, as well as role expectations, play in risk for psychosis. We further highlight the importance of considering biological factors such as puberty and hormonal changes as areas of unique vulnerability for adolescents. Finally, we discuss cannabis use as a factor that may have a unique impact during adolescent neurodevelopment, and subsequently potentially impact psychosis onset. Throughout, we include discussion of resilience factors that may provide unique opportunities for intervention during this dynamic life stage.
青春期的特点是大脑结构和功能、青春期以及社会和环境因素等多个领域发生重大变化。其中一些变化增加了在此期间出现精神病的可能性,而另一些变化则可能缓冲这种风险。本综述描述了我们目前对青春期可能成为精神分裂症谱系障碍风险因素的独特方面的认识。此外,我们还为研究青少年特有的发育机制提供了潜在的未来方向,这些机制会导致对精神病的易感性,并有可能利用青少年的独特特征进行干预。具体来说,我们探讨了在典型发展的青少年以及患有精神分裂症谱系障碍的青少年中,灰质和白质在整个青春期是如何发育的。我们还讨论了目前关于社会支持和需求以及角色期望在精神病风险中的作用的观点。我们进一步强调了考虑青春期独特脆弱性的生物因素(如青春期和荷尔蒙变化)的重要性。最后,我们讨论了大麻使用作为在青少年神经发育过程中可能具有独特影响的因素,以及随后可能对精神病发作产生影响的因素。在整个讨论中,我们还包括了对可能在这个充满活力的生命阶段提供独特干预机会的恢复力因素的讨论。