THE IMPACT OF EARLY ADVERSITY ON TRAJECTORIES OF BRAIN MATURATION AND MENTAL HEALTH IN YOUNG ADOLESCENTS

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WHAT IS THE PROPOSED STUDY ABOUT?Psychiatric disorders, like depression, schizophrenia, bipolar disorder, and anxiety affect millions of people around the world. They disturb thinking, mood, and behaviour, and can interfere with daily life with devastating effects. They usually strike at a young age and it is very important to understand how early in the life of an individual we are still able to intervene and modify the risk of developing these disorders. For example, the risk is higher in those who have experienced trauma and adversity, and in those living in deprived social conditions. However, we do not know if the brain develops differently in those adolescents with adversity, and whether this explains why they are more likely to experience certain types of mental health problems. Furthermore, we do not know whether factors such as growing up in a very supportive family environment, or having higher general intelligence, may protect some adolescents from the effects of early adversity, preventing the brain from developing differently and from experiencing psychiatric symptoms later on. WHAT IS ALREADY KNOWN ABOUT THIS AREA?We know that individuals who have suffered traumatic experiences, and those with mental health problems, show alterations in the structure of the brain. For example, regions involved in memory (frontal lobe, hippocampus) are smaller in volumes. However, we do not know when these alterations start, or whether they stay the same throughout adolescence. Also, we do not know whether they particularly occur in those adolescents that have an activation of the body's response to stress. In fact, the activation of the stress system triggers a response in the "immune system", the system dedicated to fight infections in our body. This is a situation also seen in patients with depression and schizophrenia, whose bodies behave as if they were fighting an infective agent, even though they do not have an ongoing infection. Therefore, it is possible that social adversity and this immune response interact with an underlying vulnerability in the brain, causing the brain to develop differently across adolescence, and making the person more likely to experience certain mental health problems, such as depression or psychosis. Unfortunately, the development of the brain throughout the full adolescence, and its relationship with the environment, and the immune system, in adolescents from the general community has never been studied. This is what we are planning to do in this study.WHAT WILL THE STUDY INVOLVE? We propose to evaluate and follow up 440 school adolescents (age 11-14 years), with and without an experience of adversity, who are already participating in other studies on risk factors for poor mental health. These studies are being conducted in the UK and in six other European countries. We will evaluate these adolescents three times, over a few years. Each time, we will assess brain structure and immune response. We will use an approach called "magnetic resonance", which allows us to look at the brain structure without using radiations, and to look at how brain changes over time. We will measure immune response in a blood sample. This study has the big advantage that more than half of these adolescents have already been evaluated with these measures in the two studies, and we will simply access the existing assessments.HOW WILL THE STUDY HELP PEOPLE WITH MENTAL HEALTH PROBLEMS?We are confident that this study can help us understand what are the times when adolescents are most vulnerable to mental health problems, when interventions (talking therapy or medications) can reduce risk of adverse mental health outcomes.