A systematic review of adrenarche as a sensitive period in neurobiological development and mental health

Abstract

Substantial hormonal and neurobiological changes occur during puberty, and are widely argued to render this period of life a sensitive period in terms of risk for mental health problems. However, there is a paucity of research focusing on adrenarche, the earlier phase of pubertal development. Furthermore, there is a limited understanding of the association between adrenarche and neural development during this phase of life. We systematically reviewed research examining human adrenarcheal development as operationalized by hormonal levels of DHEA and DHEA-S, in relation to indices of mental health (Systematic Review 1). We then reviewed the limited amount of literature that has examined the association between adrenarcheal development and brain structure or function (Systematic Review 2). In general, studies showed that earlier timing of adrenarche was associated with greater mental health symptoms, and there is emerging support that brain development plays a role in this relationship. However, several methodological inconsistencies were noted. We propose that future research in this area test a theoretical model of adrenarche as a sensitive period of neurobiological development, whereby timing of exposure to hormones interacts with brain development, biological sex, and psychosocial stress to influence environmental sensitivity and risk for mental health problems through adolescence.

Keywords: Adrenarche; Brain development; Mental health; Puberty; Sensitive periods.

Fig. 1

Procedure used for study selection in Systematic Review 1 (Adrenarche and mental health).

Fig. 2

Procedure used for study selection in Systematic Review 2 (Adrenarche and Brain Structure/Function).

Fig. 3

Proposed model of adrenarche as a potential sensitive period of neurobiological and psychosocial development.