Peer rejection is a significant risk factor for adolescent depression, but most studies have examined their associations treating them as unitary constructs. Considering their conceptional complexity, our study employs network analysis to examine the associations between different types of peer rejection and specific depressive symptoms at the dimension level and their changes from the general population to clinical samples. A total of 23,995 adolescents from general population (primary dataset, 11,577 males, age = 13.90 ± 2.19) were recruited through online advertisements. The network of peer rejection and depressive dimensions was first constructed in this sample, followed by comparisons across age- and sex-stratified subsamples. In addition, separate network analyses were performed in clinically depressed adolescents (n = 610, 155 males, age = 14.86 ± 1.96) and a subsample of high-risk adolescents from the general population (n = 7,523, 3,416 males, age = 14.53 ± 2.09), and subsequently a network comparison test was performed between them. The edge between ignore and anhedonia exhibited the highest bridge expected influence in the primary dataset, the clinical depression and high-risk adolescent groups. Adolescents in different age and sex groups showed distinct patterns of specific edges within the dimension-level networks. Clinically depressed adolescents exhibited significantly stronger network connections than high-risk adolescents, particularly the edges between insult and interpersonal problems and between ignore and anhedonia. Ignore and anhedonia were crucial bridges connecting peer rejection to adolescent depression, and the connection was stronger in clinically depressed adolescents. These findings may provide a theoretical basis for guiding future research on interventions targeting peer relationships in adolescent depression.

Communication apprehension is a common fear related to social situations and is thought to be linked to negative self-evaluation. However, the neuroanatomical mechanisms underlying communication apprehension, both in general communication apprehension and in specific communication contexts (such as interpersonal communication, group discussion, meetings and public speaking), have not been fully explored. Our study used voxel-based morphometry to investigate the relationship between gray and white matter volumes and communication apprehension in a large sample of university students (n = 647, age = 19.66 ± 1.35, 468 females). We found that communication apprehension was highest in public speaking compared to the other three communication contexts. General communication apprehension was associated with gray matter volume in the ventromedial prefrontal cortex and the right anterior temporal gyrus, both of which are part of the default mode network and are believed to be involved in self-referential processing. The four specific contexts also exhibited associations with certain brain regions and shared similarities with general communication apprehension. Additionally, we identified a unique association of communication apprehension in the public speaking with reduced corpus callosum volume. These findings provide insights into the neural correlates of communication apprehension and suggest that interventions aiming at improving self-evaluation may help alleviate communication apprehension in young adults.

Abstract Background Self-compassion has shown to be an effective emotion regulation strategy, but its neural mechanisms remain understudied in adolescents with depression who suffer from social exclusion. This study employed event-related potentials to investigate the psychophysiological mechanisms underlying impaired self-compassion in adolescents with depression during social exclusion. Methods Thirty-seven adolescents with major depressive disorder (age = 16.46 ± 2.02) and thirty-two demographically matched healthy controls (age = 16.54 ± 2.29) completed a social exclusion scenario imagination task. This task presented participants with social exclusion scenarios, asking them to imagine themselves as the excluded individual and subsequently rate their negative emotions. The regulation session required participants to use self-compassionate statements to regulate their emotional responses while imagining and rate how much self-compassion they have engaged in; the non-regulation required them not to use those statements and rate their negative emotions immediately following imagination. EEG signals were recorded during the task, and the late positive potential (LPP) was analyzed to examine the neural responses associated with self-compassion regulation following social exclusion. Results Compared with the non-regulation condition, both groups showed less negative emotion during the self-compassion regulation condition. Adolescents with depression exhibited significantly lower self-compassion ratings than healthy controls, and showed a significantly smaller decrease in negative emotions. Higher self-compassion ratings were correlated with greater emotion regulation effect, particularly in adolescents with depression. Furthermore, LPP amplitudes were significantly higher in adolescents with depression than in healthy controls during both regulation and non-regulation conditions. Conclusions Adolescents with depression were characterized by impairment in using self-compassion to downregulate negative emotions when confronted with social exclusion. LPP amplitudes were consistently elevated in adolescents with depression, underscoring their potential as a critical focus for psychophysiologically-informed therapies.

Background Major depressive disorder (MDD) is a clinically and neurobiologically heterogeneous disorder typically emerging in adolescence. Delineating MDD subtypes with distinguishing neurobiological substrates and clinical profiles is a promising strategy for guiding precise diagnosis and treatments. Methods In this study, we included 152 adolescents with first-episode MDD and 140 demographically matched healthy controls. All participants underwent brain imaging scans and comprehensive neurocognitive assessments. Based on brain morphometric features of gray matter and subcortical volume, the Heterogeneity through Discriminative Analysis (HYDRA) was conducted to identify potential MDD subtypes. We then compared clinical characteristics, morphometric features, white matter microstructure, functional connectivity, and neurocognitive performance between the subgroups and healthy controls to elucidate the profiles of identified subtypes. Result Two robust distinct neuroanatomical subtypes were identified. Subtype 1 showed widespread cortical and subcortical gray matter reduction, manifesting as decreased cortical thickness, cortical volume, surface area, and subcortical volume, along with poorer white matter integrity. Subtype 2 exhibited preserved gray matter morphology and less pronounced white matter disruptions. Moreover, both subtypes demonstrated hypo- and hyperconnectivity among the visual, sensorimotor, default mode, and attention networks, and the differences were more pronounced in subtype 2. Furthermore, both subtypes showed significant cognitive impairments, and subtype 2 specifically performed worse in reward related emotion processing. Conclusion This study identified two robust subtypes of adolescent MDD with divergent brain morphology, white matter, functional connectivity and cognitive profiles, reflecting the clinical and neurobiological heterogeneity inherent in this disorder. These findings hold promises for subtype-based approaches to advance diagnosis and treatment.

Childhood and adolescence are marked by protracted developmental remodeling of cortico-cortical structural connectivity. However, the spatiotemporal variability of white matter connectivity development across the human connectome and its relevance to cognition and psychopathology remains unclear. Using diffusion MRI data from three independent developmental cohorts spanning youth, we identified a robust divergence in structural connectivity maturation along a predefined sensorimotor-association (S-A) connectional axis during youth ( http://connectcharts.cibr.ac.cn ). This developmental continuum ranged from early childhood increases in sensorimotor-sensorimotor connectivity strength to late adolescent increases in association-association connectivity strength, with the transition occurring around age 15. The S-A connectional axis also captured spatial variations in the associations between structural connectivity and both higher-order cognition and general psychopathology. Moreover, group-level developmental trajectories of structural connectivity differed by cognitive and psychopathological levels, with psychopathological effects predominantly observed in association connections. These findings delineate a spatiotemporal continuum of structural connectivity development during youth, providing a normative reference for quantifying developmental variability in psychiatric disorders.

BACKGROUND:Non-suicidal self-injury (NSSI) is a common high-risk behavior in adolescents and it occurs in various psychiatric disorders, especially major depressive disorder (MDD). It remains largely unknown whether and which brain functional networks contribute to NSSI across youth mental disorders. METHODS:This study analyzed brain functional data acquired from 156 adolescents (MDD + NSSI group, n = 44, age = 15.32 ± 1.51; MDD-NSSI group, n = 32, age = 15.36 ± 1.96; healthy controls, n = 80, age = 15.92 ± 2.72). NSSI behavior, four NSSI functions (internal and external emotion regulation, social influence and sensation seeking), as well as the addictive feature were assessed using the Ottawa Self-injury Inventory. Using support vector machine recursive feature elimination classification and regression models, we investigated the brain functional networks that predicted NSSI. External validations were performed in an ADHD cohort (n = 40) and a transdiagnostic psychiatric cohort (n = 40). RESULTS:The brain networks related to NSSI behavior were mainly composed of inter-network connections between the fronto-parietal, motor, limbic, basal ganglia networks. These networks were also associated with it four functions and the additive feature. Notably, the fronto-parietal network was involved in all NSSI components. External validations in both the ADHD and the transdiagnostic cohorts validated the associations of these functional networks with NSSI severity. CONCLUSIONS:Our results demonstrate that the fronto-parietal, motor, limbic and basal ganglia networks play key roles in NSSI among youth with psychiatric disorders, offering insights into potential brain targets for prevention and intervention.

Non-suicidal self-injury (NSSI) is a prevalent mental problem among children and adolescents, cutting across psychiatric disorders. Studies in specific disorders such as depression and ADHD have revealed associations with alterations in brain regions responsible for reward processing and emotion regulation. However, it remains largely unknown whether such associations are shared among different disorders. Here, we aimed to examine brain structural and functional associations with NSSI in a transdiagnostic psychiatric cohort of children and adolescents. A total of 386 patients (age = 10.72 +/- 3.53, range = 5.04 to 21.22) diagnosed primarily with ADHD, autism and generalized anxiety disorder from the Healthy Brain Network study were included. Using linear regression models, we examined brain volumes (N = 386) and functional connectivities (N = 277) associated with NSSI and whether potential alterations could moderate/mediate the links between internalizing/externalizing symptoms and NSSI. We found that increased severity of NSSI was associated with decreased bilateral putamen volumes, and reduced connectivities of the left putamen with bilateral regions of temporoparietal junction and of the right putamen with the left temporoparietal junction, demonstrating the role of putamen in NSSI behavior. Moreover, some of these associations played moderating roles: in patients with lower putamen volumes or weaker functional connectivities, increased internalizing/externalizing symptoms were associated with higher NSSI severity. Our findings suggest that transdiagnostic NSSI is linked to structural alterations and functional dysfunctions in putamen, highlighting that putamen may serve as a neural marker of NSSI and as a potential target for neuromodulation treatments across mental conditions.

Non-suicidal self-injury (NSSI) has high prevalence among adolescents with mood disorders and is accompanied by cognitive impairments. Most existing studies have examined their impairments on single cognitive domains. It remains unclear which cognitive deficits are associated with adolescent NSSI and its functions and addictive features, from a multidimensional perspective. A total of 161 adolescents diagnosed with first-episode major depressive disorder (MDD) and 137 healthy controls were recruited between June 2020 and December 2024. Participants were divided into three groups: adolescents with MDD and NSSI (MDD + NSSI, n = 84, age = 15.47 ± 1.59), those with MDD and without NSSI (MDD–NSSI, n = 77, age = 16.11 ± 2.16), and healthy controls (HCs, n = 137, age = 15.92 ± 3.13). NSSI behavior and its four common functions (internal emotion regulation, external emotion regulation, social influence, and sensation seeking) as well as the addiction feature, were assessed using the Ottawa Self-injury Inventory. Cognitive domains such as emotion recognition, cognitive control, working memory, and reward processing were assessed using an in-house Cognitive Assessment Battery. Data were analyzed via ANOVA, logistic regression, and multiple linear regression. Both the MDD + NSSI and MDD–NSSI groups showed significantly greater cognitive dysfunctions compared to the HCs. Logistic regression models indicated that cognitive domains such as memory, cognitive control, reward processing, delay discounting, and time perception were significantly associated with the presence of NSSI among adolescents with MDD. Multiple linear regression analyses further revealed that emotion recognition, working memory, cognitive control, and reward processing were significantly related to NSSI functions and the addictive features. Our results showed that NSSI behaviors, its functions, and addictive features are all associated with multidimensional cognitive dysfunctions. These findings highlight the clinical relevance of implementing thorough, multidomain cognitive evaluations in adolescents with NSSI. Not applicable.

Major Depressive Disorder (MDD) is a prevalent mental health condition with significant societal impact. Structural magnetic resonance imaging (sMRI) and machine learning have shown promise in psychiatry, offering insights into brain abnormalities in MDD. However, predicting treatment response remains challenging. This study leverages inter-brain similarity from sMRI as a novel feature to enhance prediction accuracy and explore disease mechanisms. The method’s generalizability across adult and adolescent cohorts is also evaluated. The study included 172 participants. Based on remission status, 39 participants from the Hangzhou Dataset and 34 from the Jinan Dataset were selected for further analysis. Three methods were used to extract brain similarity features, followed by a statistical test for feature selection. Six machine learning classifiers were employed to predict treatment response, and their generalizability was tested using the Jinan Dataset. Group analyses between remission and non-remission groups were conducted to identify brain regions associated with treatment response. Brain similarity features outperformed traditional metrics in predicting treatment outcomes, with the highest accuracy achieved by the model using these features. Between-group analyses revealed that the remission group had lower gray matter volume and density in the right precentral gyrus, but higher white matter volume (WMV). In the Jinan Dataset, significant differences were observed in the right cerebellum and fusiform gyrus, with higher WMV and density in the remission group. This study demonstrates that brain similarity features combined with machine learning can predict treatment response in MDD with moderate success across age groups. These findings emphasize the importance of considering age-related differences in treatment planning to personalize care. Clinical trial number: not applicable.

Purpose: To examine the brain morphological characteristics of 2-to-4-year-olds with ASD, including cortical and subcortical regions, and to investigate their associations with clinical behaviors. Methods: A total of 43 toddlers with ASD aged 2–4 years, 44 age- and gender- matched toddlers with developmental delay (DD) and 18 typically developing (TD) children were recruited. All participants underwent whole-brain high-resolution MRI and clinical assessments. Brain structural data were analyzed using Surface-Based Morphometry with FreeSurfer. Linear mixed-effects models were employed to identify differences in brain regions between groups and to explore their links with clinical behaviors. Results: Compared to TD group, ASD group demonstrated increased cortical thickness and volume, particularly within the frontal and parietal brain regions (FDR, p < 0.05). When compared to DD, ASD group exhibited a distinction in the increased cortical volume within the posterior frontal lobe and middle-post cingulate (FDR, p < 0.05). DD children had increased cortical thickness and cortical volume in the superior parietal gyrus compared to TD (FDR, p < 0.05). In the ASD + DD group, increased cortical thickness of the superior frontal sulcus was correlated with lower adaptive behavior, while reduced nucleus accumbens volume and increased cortical thickness of the superior frontal sulcus and precentral sulcus were associated with decreased language development (FDR, p < 0.05). Conclusion: Our study found widespread brain abnormalities in young children with ASD, notably altered cortical volume and thickness in frontal and parietal lobes. These findings may serve as important indicators of altered brain development trajectories in this population.

BACKGROUND:Adolescence is a period marked by high vulnerability to onset of depression. Neuroimaging studies have revealed considerableatrophy of brain structure in patients with major depressive disorder (MDD). However, the causal structural networks underpinning gray matter atrophies in depressed adolescents remain unclear. This study aimed to examine the initial gray matter alterations in MDD adolescents and investigate their causal relationships of abnormalities within brain structural networks. METHODS:First-episode adolescent patients with MDD (n = 80, age = 15.57 ± 1.78) and age- and sex-matched healthy controls (n = 82, age = 16.11 ± 2.76) were included. We analyzed T1-weighted structural images using voxel-based morphometry to identify gray matter alterations in patients and the disease stage-specific abnormalities. Granger causality analysis was then conducted to construct causal structural covariance networks. We also identified potential pathways between the causal source and target. RESULTS:Compared to controls, MDD patients with shorter illness duration showed gray matter atrophy in localized brain regions such as ventral medial prefrontal cortex (vmPFC), anterior cingulate cortex, and insula. With a prolonged course of MDD, gray matter atrophy extended to widespread brain areas. Causal network results demonstrated that early abnormalities had positive effects on the default mode, frontoparietal networks, and reward circuits. Moreover, vmPFC demonstrated the highest out-degree value, possibly representing the initial source of brain abnormality in adolescent depression. CONCLUSIONS:These findings revealed the progression of gray matter atrophy in adolescent depression and demonstrated the directional influences between initial localized alterations and subsequent deterioration in widespread brain networks.

A growing focus is on optimizing learning outcomes by supporting metacognitive monitoring, enabling learners to self-assess and adjust their learning strategies. Our goal is to support children in enhancing their metacognitive monitoring skills-the ability to precisely assess and regulate their learning processes. Research shows that targeted strategies can help children improve their skills, provided their imprecise metacognitive monitoring performance (MMP) is identified. However, conventional approaches for identifying imprecise MMP often have low performance and fail to provide the precision needed for effective interventions. To address this, we aim to leverage deep learning to analyze facial expressions as a means of estimating MMP. By interpreting subtle facial expressions, our proposed deep learning approach offers a promising alternative to conventional approaches, enabling more precise and timely estimations of MMP. Our provisional findings suggest significant implications for tailoring strategies for learners' metacognitive monitoring.1

ObjectiveType 2 diabetes mellitus (T2DM) over time predisposes to inflammatory responses and abnormalities in functional brain networks that damage learning, memory, or executive function. The hippocampus is a key region often reporting connectivity abnormalities in memory disorders. Here, we investigated peripheral inflammatory responses and resting-state functional connectivity (RSFC) changes characterized of hippocampal subregions in type 2 diabetes-associated cognitive decline (T2DACD).MethodsThe study included 16 patients with T2DM, 16 patients with T2DACD and 25 healthy controls (HCs). Subjects were assessed for cognitive performance, tested for the expression of inflammatory factors IL-6, IL-10 and TNF-α in peripheral serum, underwent resting-state functional magnetic resonance imaging scans, and analyzed for RSFC using the hippocampal subregions as seeds. We also calculated the correlation between cognitive performance and RSFC of hippocampal subregion, and analyzed the significantly altered RSFC values of T2DACD for Receiver Operating Characteristic (ROC) analysis.ResultsT2DACD patients showed a decline in their ability to complete cognitive assessment scales and experimental paradigms, and T2DM did not show abnormal cognitive performance. IL-6 expression was increased in peripheral serum in both T2DACD and T2DM. Compared with HCs, T2DACD showed abnormalities RSFC of the left anterior hippocampus with left precentral gyrus and left angular gyrus. T2DM showed abnormalities RSFC of the left middle hippocampus with right medial frontal gyrus, right anterior and middle hippocampus with left precuneus, left anterior hippocampus with right precuneus and right posterior middle temporal gyrus. Compared with T2DM, T2DACD showed abnormalities RSFC of the left posterior hippocampus and right middle hippocampus with left precuneus. In addition, RSFC in the left posterior hippocampus with left precuneus of T2DACD was positively correlated with Flanker conflict response time (r=0.766, P=0.001). In the ROC analysis, the significantly altered RSFC values of T2DACD achieved significant performance.ConclusionsT2DACD showed a significant decrease in attentional inhibition and working memory, peripheral pro-inflammatory response increased, and abnormalities RSFC of the hippocampal subregions with default mode network and sensory-motor network. T2DM did not show a significant cognitive decline, but peripheral pro-inflammatory response increased and abnormalities RSFC of the hippocampus subregions occurred in the brain. In addition, the left precuneus may be a key brain region in the conversion of T2DM to T2DACD. The results of this study may provide a basis for the preliminary diagnosis of T2DACD.

Metacognitive monitoring involves evaluating one’s own thought processes and knowledge. In recent efforts to design serious games for educational purposes, scaffolds for the metacognitive monitoring process have been provided to help pupils achieve higher learning outcomes. In preliminary studies on the affects experienced in learning process, relationships between facial expressions and metacognitive monitoring performance (MMP) are revealed. As scaffolds are designed to avoid increasing cognitive load and disrupting the learning process, our research aims to automatically scaffold the metacognitive monitoring process through facial expressions without disturbing pupils’ learning process. We conducted a large-scale user study with pupils and collected their facial expressions while they performed the metacognitive monitoring process. So far, we built the video dataset (Affect2Metacognition) to train and test state-of-the-art neural networks for MMP identification. In addition, we proposed a strategy for scaffolding pupils’ metacognitive monitoring process, which is based on identifying their MMPs through facial expressions. In the long term of our research, we will analyse the impact of this strategy on pupils’ learning outcomes.

Background Childhood trauma is a pivotal risk factor for adolescent depression. While the association between childhood trauma and depression is well-established, the mediating role of self-concept has not been acknowledged. Specifically, limited attention has been paid to how childhood maltreatment impacts adolescent depression through physical and social self-concept, both in clinical and community samples. This study aims to investigate how distinct and cumulative childhood trauma affects adolescent depression, as well as the potential mediating role of self-concept in their relationships. Methods We recruited 227 depressed adolescents (dataset 1, 45 males, age = 15.34 ± 1.96) and 574 community adolescents (dataset 2, 107 males, age = 16.79 ± 0.65). Each participant was assessed on five subtypes of childhood trauma severity, cumulative trauma index, physical and social self-concept, and depression. Mediation models were tested separately in the clinical and community samples. Results Clinically depressed adolescents experienced a higher level of trauma severity, a greater number of trauma subtypes, and had lower levels of physical and social self-concept compared to community adolescents. Analyses on childhood trauma severity and cumulative trauma index jointly indicated that physical and social self-concept played mediation roles in the relationships between childhood trauma experiences and depression. Moreover, the mediating effects of self-concept were stronger in depressed adolescents when compared to community samples. Conclusions Our findings suggest that physical and social self-concept play mediating roles in the pathway linking childhood trauma and adolescent depression, particularly in clinically depressed individuals.

BACKGROUND:Hippocampal disruptions represent potential neuropathological biomarkers in depressed adolescents with cognitive dysfunctions. Given heterogeneous outcomes of whole-hippocampus analyses, we investigated subregional abnormalities in depressed adolescents and their associations with symptom severity and cognitive dysfunctions. METHODS:MethodsSeventy-nine first-episode depressive patients (ag = 15.54 ± 1.83) and 71 healthy controls (age = 16.18 ± 2.85) were included. All participants underwent T1 and T2 imaging, completed depressive severity assessments, and performed cognitive assessments on memory, emotional recognition, cognitive control, and attention. Freesurfer was used to segment each hippocampus into 12 subfields. Multivariable analyses of variance were performed to identify overall and disease severity-related abnormalities in patients. LASSO regression was also conducted to explore the associations between hippocampal subfields and patients' cognitive abilities. RESULTS:Depressed adolescents showed decreases in dentate gyrus, CA1, CA2/3, CA4, fimbria, tail, and molecular layer. Analyses of overall symptom severity, duration, self-harm behavior, and suicidality suggested that severity-related decreases mainly manifested in CA regions and involved surrounding subfields with disease severity increases. LASSO regression indicated that hippocampal subfield abnormalities had the strongest associations with memory impairments, with CA regions and dentate gyrus showing the highest weights. CONCLUSIONS:Hippocampal abnormalities are widespread in depressed adolescents and such abnormalities may spread from CA regions to surrounding areas as the disease progresses. Abnormalities in CA regions and dentate gyrus among these subfields primarily link with memory impairments in patients. These results demonstrate that hippocampal subsections may serve as useful biomarkers of depression progression in adolescents, offering new directions for early clinical intervention.

This study aimed to investigate the associations of childhood trauma and its facets with depressive symptoms in depressed adolescents during the post COVID-19 epidemic, and explore the potential mediating role of social peer rejection in these associations. A total of 413 adolescents with depressive disorders completed the Chinese version of the Child Trauma Questionnaire Short Form, the Social Peer Rejection, and the Children's Depression Inventory. Childhood trauma (beta = 0.42, p < 0.01) and social peer rejection (beta = 0.18, p < 0.01) were positively related to depressive symptoms, after adjustment for demographic factors. Furthermore, social peer rejection partly mediated the relationship between childhood trauma and depressive symptoms, and the mediation effect ratio was 17.0% (p < 0.001). This study found that childhood trauma and social peer rejection are both risk factors for depressive symptoms, and social peer rejection played a mediating role in the relationship between childhood trauma and depressive symptoms.

Background: Adolescent mental health is influenced by various adverse environmental conditions. However, it remains unclear how these factors jointly affect adolescent depression. This study aimed to use network analysis to assess the associations between different environmental factors and depressive symptoms in adolescents and to identify key pathways between them.Methods: This study included 610 adolescents with depression from inpatient and outpatient units recruited between March 2020 and November 2021. The mean age was 14.86 +/- 1.96, with no significant difference be- tween males (n=155, 15.10 +/- 2.19) and females (n=455, 14.78 +/- 1.88). Depressive symptoms were measured using the Children's Depression Inventory, and individual risk environment factors included childhood trauma, social peer and family risk factors. Network features, including network centrality, stability, and bridge cen- trality, were investigated.Results: Anhedonia and self-esteem were found to be more central in depressive symptoms. Insult experiences from the social peer and emotional abuse experience from childhood were more central environmental factors. Childhood trauma experiences were more related to adolescent depressive symptoms compared to family and peer factors. Bridge analyses identified emotional abuse, emotional neglect and physical neglect as the main bridges linking environment risk to depressive symptoms. Limitations: This was a cross-sectionally designed study, which limited its ability to examine longitudinal dynamic interactions between environmental factors and adolescent depressive symptoms.Conclusions: Our findings suggested that childhood trauma experiences might have greater psychological impacts on adolescent depression than family and social peer environments, and should be considered as crucial targets for preventing severe depressive moods.

BACKGROUND:Adult studies have reported atypicalities in the hippocampus and subfields in patients with schizophrenia (SCZ) and major depressive disorder (MDD). Both affective and psychotic disorders typically onset in adolescence, when human brain develops rapidly and shows increased susceptibility to adverse environments. However, few in vivo studies have investigated whether hippocampus subfield abnormalities occur in adolescence and whether they differ between SCZ and MDD cases.METHODS:We recruited 150 adolescents (49 SCZ patients, 67 MDD patients, and 34 healthy controls) and obtained their structural images. We used FreeSurfer to automatically segment hippocampus into 12 subfields and analyzed subfield volumetric differences between groups by analysis of covariance, covarying for age, sex, and intracranial volume. Composite measures by summing subfield volumes were further compared across groups and analyzed in relation to clinical characteristic.RESULTS:SCZ adolescents showed significant volume reductions in subfields of CA1, molecular layer, subiculum, parasubiculum, dentate gyrus and CA4 than healthy controls, and almost significant reductions, as compared to the MDD group, in left molecular layer, dentate gyrus, CA2/3 and CA4. Composite analyses showed smaller volumes in SCZ group than in healthy controls in all bilateral composite measures, and reduced volumes in comparison to MDD group in all left composite measures only.CONCLUSIONS:SCZ adolescents exhibited both hippocampal subfield and composite volumes reduction, and also showed greater magnitude of deviance than those diagnosed with MDD, particularly in core CA regions. These results indicate a hippocampal disease process, suggesting a potential intervention marker of early psychotic patients and risk youths.

Objective:This study aims to explore the relationship between non-suicidal self-injurious (NSSI) behaviors and childhood trauma and peer rejection in adolescents with depressive disorders and, to examine whether childhood trauma and peer rejection can predict NSSI behaviors in these adolescents.Methods:A total of 412 depressed adolescents (263 with NSSI and 149 without NSSI) were included in the test data set, while another 161 depressed adolescents (99 with NSSI and 62 without NSSI) were in the validation set. This study firstly analyzed the differences in the scores of the Children's Depression Inventory (CDI), Childhood Trauma Questionnaire (CTQ), and Social Peer Rejection Scale (SPR) between the two groups using the test set. Then, a hierarchical logistic regression model was used to analyze the independent effects of these environmental factors on NSSI behaviors and to determine the diagnostic model. Finally, the diagnostic model was applied using the validation data set to calculate the actual predictive efficacy of the model.Results:Compared to those without NSSI, adolescent patients with NSSI showed significantly higher scores in CDI ( t=10.04, P<0.001), CTQ ( t=9.11, P<0.001), SPR ( t=5.30, P<0.001), and their subscale scores. Then, the scores of the low self-esteem factor of CDI ( OR=1.12, P=0.002), the emotional neglect factor of CTQ ( OR=1.08, P=0.037), and the insult factor ( OR=1.10, P=0.050) and somatic aggression factor ( OR=0.89, P=0.049) of SPR were significantly associated with NSSI behaviors. The diagnostic model was well established (area under the ROC curve=0.84, P<0.001). In addition, in the validation data set, the diagnostic model had a significant predictive effect (area under the ROC curve=0.85, P<0.001). Conclusion:Childhood emotional neglect and peer insult might be crucially influential factors triggering NSSI behaviors among adolescents with depressive disorders. Childhood trauma and peer rejection were of considerable importance when diagnosing and predicting the development of NSSI behaviors in depressive adolescents.