A Social Affective Neuroscience Model of Risk and Resilience in Adolescent Depression: Preliminary Evidence and Application to Sexual and Gender Minority Adolescents.

Depression is a disorder of dysregulated affective and social functioning, with attenuated response to reward, heightened response to threat (perhaps especially social threat), excessive focus on negative aspects of the self, ineffective engagement with other people, and difficulty modulating all of these responses. Known risk factors provide a starting point for a model of developmental pathways to resilience, and we propose that the interplay of social threat experiences and neural social-affective systems is critical to those pathways. We describe a model of risk and resilience, review supporting evidence, and apply the model to sexual and gender minority adolescents, a population with high disparities in depression and unique social risk factors. This approach illustrates the fundamental role of a socially and developmental informed clinical neuroscience model for understanding a population disproportionately affected by risk factors and psychopathology outcomes. We consider it a public health imperative to apply conceptual models to high-need populations to elucidate targets for effective interventions to promote healthy development and enhance resilience.

抑郁症是一种情感和社会功能失调的障碍，对奖励的反应减弱，对威胁（可能尤其是社会威胁）的反应增强，过度关注自身的负面方面，与他人交往无效，且难以调节所有这些反应。已知的风险因素为复原力发展路径模型提供了一个起点，我们提出社会威胁经历和神经社会情感系统的相互作用对这些路径至关重要。我们描述了一个风险与复原力模型，回顾了支持性证据，并将该模型应用于性与性别少数青少年，这是一个在抑郁症方面存在高度差异且具有独特社会风险因素的群体。这种方法阐明了一个具有社会和发展信息的临床神经科学模型在理解一个受风险因素和精神病理学结果不成比例影响的群体方面的根本作用。我们认为将概念模型应用于高需求群体以阐明有效干预的目标，从而促进健康发展并增强复原力，是公共卫生的当务之急。