Narrative Review: A Neurobiological Perspective on Resilience in Youth.

Objective: Children and adolescents are faced with multiple factors that may pose risks for development of psychiatric morbidity. These include both inherited and environmental factors such as a family history of depression or experiencing adversity. However, not all individuals who have such risks develop illness, due to resilience factors that effectively provide protection from risk. The topic of resilience has received much attention in research in recent years. Its importance lies in improving our theoretical understanding of protection from illness and may also pave the way for psychoeducation to families and intervention for youth. Method: Understanding the neurobiology underlying resilience may reveal brain-based methods to protect mental health. Relevant literature from 2008 to 2023 was searched for neuroimaging studies that demonstrated youth outcomes linked with fewer psychiatric symptoms or better functioning in the face of psychiatric risks. Results: This narrative review summarizes current evidence pertaining to the neurobiological underpinnings of resilience, including anatomical, functional, and genetic perspectives of the hippocampus, amygdala, prefrontal and cingulate cortices, white matter tracts, and related networks in youth with environmental or inherited psychiatric risks. In addition, a functional and developmental overview of the involved regions is provided for a comprehensive understanding. Avenues for further research are also discussed. Conclusion: Psychiatric resilience in youth is linked with multiple neurobiological and genetic features. This evidence could be leveraged toward identification and intervention development to protect mental health in the face of risks. Clinical guidance: • When constructing clinical case formulations, it is important to include both risk and resilience factors, to reflect parallels in the structure and function of the brain.• In psychoeducation with youth and families, consider inclusion of evidence indicating neurobiological strengths to promote better outcomes.• Functional aspects of the brain, including neurobiology underlying resilience needs to be studied and targeted to develop effective prevention and intervention programs.