Khalid Kiran, Baqir Huma, Stevens Hanna E
Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York.
JAACAP Open. 2024 May 16;3(2):171-191. doi: 10.1016/j.jaacop.2024.05.001. eCollection 2025 Jun.
Children and adolescents are faced with multiple factors that may pose risks for development of psychiatric morbidity. These include both inherited and environmental factors such as a family history of depression or experiencing adversity. However, not all individuals who have such risks develop illness, due to resilience factors that effectively provide protection from risk. The topic of resilience has received much attention in research in recent years. Its importance lies in improving our theoretical understanding of protection from illness and may also pave the way for psychoeducation to families and intervention for youth.
Understanding the neurobiology underlying resilience may reveal brain-based methods to protect mental health. Relevant literature from 2008 to 2023 was searched for neuroimaging studies that demonstrated youth outcomes linked with fewer psychiatric symptoms or better functioning in the face of psychiatric risks.
This narrative review summarizes current evidence pertaining to the neurobiological underpinnings of resilience, including anatomical, functional, and genetic perspectives of the hippocampus, amygdala, prefrontal and cingulate cortices, white matter tracts, and related networks in youth with environmental or inherited psychiatric risks. In addition, a functional and developmental overview of the involved regions is provided for a comprehensive understanding. Avenues for further research are also discussed.
Psychiatric resilience in youth is linked with multiple neurobiological and genetic features. This evidence could be leveraged toward identification and intervention development to protect mental health in the face of risks.
• When constructing clinical case formulations, it is important to include both risk and resilience factors, to reflect parallels in the structure and function of the brain.• In psychoeducation with youth and families, consider inclusion of evidence indicating neurobiological strengths to promote better outcomes.• Functional aspects of the brain, including neurobiology underlying resilience needs to be studied and targeted to develop effective prevention and intervention programs.
儿童和青少年面临多种可能导致精神疾病发病风险的因素。这些因素包括遗传和环境因素，如抑郁症家族史或经历逆境。然而，并非所有有此类风险的个体都会患病，这是因为存在能有效抵御风险的复原力因素。近年来，复原力这一主题在研究中受到了广泛关注。其重要性在于增进我们对预防疾病的理论理解，还可能为面向家庭的心理教育和青少年干预铺平道路。
了解复原力背后的神经生物学机制可能会揭示基于大脑的保护心理健康的方法。检索了2008年至2023年的相关文献，以查找神经影像学研究，这些研究表明青少年在面对精神疾病风险时，其结果与较少的精神症状或更好的功能相关。
本叙述性综述总结了目前有关复原力神经生物学基础的证据，包括在有环境或遗传精神疾病风险的青少年中，海马体、杏仁核、前额叶和扣带回皮质、白质束及相关网络的解剖学、功能和遗传学视角。此外，还提供了所涉区域的功能和发育概述，以助于全面理解。同时也讨论了进一步研究的方向。
青少年的精神复原力与多种神经生物学和遗传特征相关。这一证据可用于识别风险并开发干预措施，以在面对风险时保护心理健康。
• 在构建临床病例时，纳入风险和复原力因素很重要，以反映大脑结构和功能的相似之处。• 在对青少年及其家庭进行心理教育时，考虑纳入表明神经生物学优势的证据，以促进更好的结果。• 需要研究大脑的功能方面，包括复原力背后的神经生物学机制，并以此为目标制定有效的预防和干预计划。
