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Social Determinants of Health, the developing brain, and risk and resilience for psychopathology
Rachel E Lean1, Anna Constantino-Pettit2, Lisa S Gorham2
1Department of Psychiatry (Child and Adolescent), Washington University School of Medicine, St. Louis, MO, USA. rachel.lean@wustl.edu.
Abstract:
Social Determinants of Health (SDoH) are defined as the non-biological individual and structural factors that shape the socio-environmental conditions of everyday life. SDoH are major drivers of risk for psychiatric disorders across development. However, what remains less clear are the neurobiological mechanisms by which SDoH confers risk for psychopathology, especially in early childhood. Growing evidence suggests that adverse forms of SDoH begin to impact the developing brain from the earliest points in development, including in-utero. Brain-wide associations have been found for brain structure and function, especially in regions that subserve socioemotional and cognitive functions. While most studies have shown SDoH-related delays in brain development and psychopathology risk, a small collection of studies have also shown that SDoH has been related to accelerated brain maturation. These latter findings potentially suggest adaptive or compensatory mechanisms that enhance resilient mental health outcomes in the context of adversity. Future directions include the need for randomized interventions designed to enhance development that target the modifiable SDoH and related socio-environmental factors during distinct periods of brain plasticity. The recruitment and retention of socially diverse research participants, to more precisely elucidate the impacts of SDoH on the developing brain in children experiencing different environments, are also needed.
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