Project Summary
Adolescents in low-/middle-income countries (LMICs) lose substantial developmental potential from exposure to
early adversities, with an estimated 250 million children at risk of not reaching their developmental potential.
Such catastrophic loss of human potential occurs in the context of the 10/90 divide – 10% of our current scientific
knowledge is produced in or by LMICs that comprise 90% of the world’s population. This skewed evidence base
has led to a limited understanding of patterns of risk and resilience in brain development for the vast majority of
the world’s adolescents. Emotion regulation (ER), the internal and external process that modifies the experience
or expression of an emotion, is a key mediator between early adversity and outcomes, and yet, the lack of data
on ER in youth from most of the world is of concern given evidence that context shapes the socialization of
emotion. The proposed research addresses this significant mental health problem by combining a) sophisticated
data analytic techniques and b) community-guided/-participatory research applied to longitudinal multimodal
brain imaging, high-dimensional behavioral assessments, and comprehensive defining of environmental
exposures (both adverse and protective) from a well-established and deeply-characterized birth cohort of early
adolescents in Cape Town, South Africa. The goal of the present work is to create an explanatory model for the
impact of protective factors on neurodevelopmental trajectories underlying ER resilience. The premise is that
early adversities are heterogeneous, powerful events that significantly increase the risk of poor ER, but also that
resilience factors experienced during early adolescence can mitigate/ameliorate these risks. Therefore,
prediction of ER outcomes requires cutting-edge, sophisticated data analytic methods. We hypothesize that data-
driven approaches will 1) more precisely define ER behavioral profiles for adolescents living in LMICs who are
exposed to heterogeneous adversities, and 2) provide a robust explanatory model for links between resilience
factors and ER neurobehavioral trajectories. Aim 1 subtypes 525 12-13 year-old adolescents in an established
LMIC birth cohort based on early environmental exposures and then tests for neural correlates of ER behavioral
resilience (based on MRI measures of functional connectivity, task-based activity, and morphometry) accounting
for early adversity subtype. Aim 2 identifies changes in neurobiology that underlie improvements in adolescent
ER and develops an explanatory model to predict 2-year (Time2-Time1) longitudinal ER resilience trajectory
subtypes based on concurrent environmental exposures (protective and adverse), accounting for
early adversity
subtype. The inclusion of participant-sex and pubertal status will identify potential divergence in pathways across
early adolescence. We use a prospective approach together with machine learning methods with the goal of
improving precision and inclusivity in recognizing and characterizing resilience to socio-economic, structural,
health, and interpersonal adversities.