Neural Correlates of Resilience to Trauma During Adolescence: A Multi-Modal Study

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 8,499 adolescents (baseline mean age 9.92 0.62 years) from the Adolescent Brain Cognitive Development Study. Participants were categorized as resilient, maladaptive, healthy, or vulnerable based on reports of traumatic events and internalizing/externalizing symptoms three years later. We used multinomial logistic regressions to examine associations of brain structure and rsFC with resilience. Sex differences were also investigated. Results: Increased odds of being resilient (relative to healthy) to both internalizing and externalizing symptoms were associated with rsFC between the dorsal and ventral attention networks and hippocampus. Resilience to internalizing symptoms was associated with rsFC between the cingulo-opercular network and hippocampus. We found the association of fusiform cortical area, and rsFC between cortical networks and hippocampus, with resilient group membership (relative to maladaptive) to be in opposite directions in males and females. Conclusions: Resilience to internalizing and externalizing symptoms in adolescents may be associated with rsFC of networks involved in salience detection and encoding, with some differences between males and females. However, it is unclear if our findings reflect resilience specifically, or could be better interpreted as reflecting trauma exposure or psychopathology. This underscores the need for further research into the neurobiological basis of resilience during adolescence.