Adolescent Neurodevelopment and Vulnerability to Psychosis

Abstract

Adolescence is characterized by significant changes in several domains, including brain structure and function, puberty, and social and environmental factors. Some of these changes serve to increase the likelihood of psychosis onset during this period, while others may buffer this risk. This review characterizes our current knowledge regarding the unique aspects of adolescence that may serve as risk factors for schizophrenia spectrum disorders. In addition, we provide potential future directions for research into adolescent-specific developmental mechanisms that impart vulnerability to psychosis and the possibility of interventions that capitalize on adolescents' unique characteristics. Specifically, we explore the ways in which gray and white matter develop throughout adolescence in typically developing youth as well as in those with psychosis spectrum disorders. We also discuss current views on the function that social support and demands, as well as role expectations, play in risk for psychosis. We further highlight the importance of considering biological factors such as puberty and hormonal changes as areas of unique vulnerability for adolescents. Finally, we discuss cannabis use as a factor that may have a unique impact during adolescent neurodevelopment, and subsequently potentially impact psychosis onset. Throughout, we include discussion of resilience factors that may provide unique opportunities for intervention during this dynamic life stage.

Keywords: Adolescence; Cannabis; Development; Psychosis; Schizophrenia; Social function.

Figure 1.

Protective factors, risk factors, and psychosis risk in adolescence. CBD, cannabidiol; THC, tetrahydrocannabinol. *Areas of limited research support.

Figure 2.

Cannabis use and psychosis risk in adolescence. CB1, CB₁, receptor; CB2, CB₂ receptor; CBD, cannabidiol; GABA, gamma-aminobutync acid; THC, tetrahydrocannabinol.