Neural correlates of resilience to trauma during adolescence: A multi‐modal study

Abstract Background Understanding resilience mechanisms is important for advancing early intervention strategies, yet research on the neurobiology of resilience in adolescents is limited. The present study examined the brain structural and resting‐state functional connectivity (rsFC) correlates of resilience to internalizing and externalizing symptoms in a large sample of adolescents. Methods We analyzed longitudinal data from 8499 adolescents (baseline mean age 9.92 ± 0.62 years) from the Adolescent Brain Cognitive Development Study. Participants were categorized as resilient, maladaptive, vulnerable, or control group based on reports of traumatic events and internalizing/externalizing symptoms 3 years later. We used multinomial regressions to examine associations of brain structure (gray matter, N = 7526; white matter, N = 6959) and rsFC ( N = 6485) with resilience. Sex differences were also investigated. Results For internalizing symptoms, increased odds of being resilient (relative to controls) were associated with postcentral gyrus thickness. For externalizing symptoms, increased odds of being resilient was associated with putamen volume (relative to being vulnerable), and rsFC between the dorsal and ventral attention networks, and between cortical networks and hippocampus (relative to controls). Sex‐interaction results implicated gray matter structure, however, robustness of these findings are limited. Conclusion Resilience in the context of internalizing symptoms in adolescence may be associated with structural alterations in cortical regions involved sensory processing. Neural correlates of resilience in the context of externalizing symptoms remain unclear as findings may reflect resilience, trauma exposure, or psychopathology. This underscores the need for further research into the neurobiological basis of resilience during adolescence.