Posttraumatic Stress Disorder and the Developing Adolescent Brain.
Posttraumatic Stress Disorder and the Developing Adolescent Brain.
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DOI：
10.1016/j.biopsych.2020.06.001
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发表时间：
2021-01-15
影响因子：
10.6
通讯作者：
Herringa RJ
中科院分区：
文献类型：
--
作者：
Cisler JM;Herringa RJ
PTSD in adolescents is common and debilitating. In contrast to adult PTSD, relatively little is known about the neurobiology of adolescent PTSD, nor how current treatments may alter adolescent neurodevelopment to allow recovery from PTSD. Improving our understanding of biological mechanisms of adolescent PTSD, taken in the context of neurodevelopment, is crucial for developing novel and personalized treatment approaches. In this review, we highlight prevailing constructs of PTSD and current findings on these domains in adolescent PTSD. Notably, little data exist in adolescent PTSD for prominent adult PTSD constructs, including threat learning and attentional threat bias. Most work to date has examined general threat processing, emotion regulation, and their neural substrates. These studies suggest that adolescent PTSD, while phenomenologically similar to adult PTSD, shows unique neurodevelopmental substrates which may impair recovery, but could also be targeted in the context of adolescent neuroplasticity to improve outcomes. Both cross-sectional and longitudinal data suggest abnormal frontolimbic development compared to typically developing youth, a pattern which may differ from resilient youth. Whether current treatments such as trauma-focused psychotherapy engage these targets and restore healthy neurodevelopment remains an open question. We end our review by highlighting emerging areas and knowledge gaps that could be addressed to better characterize the biology underlying adolescent PTSD. Emerging studies in computational modeling of decision making, caregiver-related transmission of traumatic stress, and other areas may offer new targets which could harness adolescent neurobehavioral plasticity to improve resilience and recovery for some of our most vulnerable youth.
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