Cited by 397Functional Brain Connectivity StudiesStress Responses and CortisolChild Abuse and Trauma

Developmental pathways to amygdala–prefrontal function and internalizing symptoms in adolescence

Open access
Burghy, Cory A, Stodola, Diane E, Ruttle, Paula L, Molloy, Erin K, Armstrong, Jeffrey M, Oler, Jonathan A, Fox, Michelle E, Hayes, Andrea S +4 more·2012·Nature Neuroscience

Abstract

Early life stress (ELS) and function of the hypothalamic-pituitary-adrenal axis predict later psychopathology. Animal studies and cross-sectional human studies suggest that this process might operate through amygdala-ventromedial prefrontal cortex (vmPFC) circuitry implicated in the regulation of emotion. Here we prospectively investigated the roles of ELS and childhood basal cortisol amounts in the development of adolescent resting-state functional connectivity (rs-FC), assessed by functional connectivity magnetic resonance imaging (fcMRI), in the amygdala-PFC circuit. In females only, greater ELS predicted increased childhood cortisol levels, which predicted decreased amygdala-vmPFC rs-FC 14 years later. For females, adolescent amygdala-vmPFC functional connectivity was inversely correlated with concurrent anxiety symptoms but positively associated with depressive symptoms, suggesting differing pathways from childhood cortisol levels function through adolescent amygdala-vmPFC functional connectivity to anxiety and depression. These data highlight that, for females, the effects of ELS and early HPA-axis function may be detected much later in the intrinsic processing of emotion-related brain circuits.

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Crossref · 10.1038/nn.3257

Cites

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Statistics

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Claims the paper makes

0 of 21 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In partial correlations for the total sample, adolescent amygdala-vmPFC fcMRI was significantly positively correlated with adolescent depression.

    “and significantly positively correlated with adolescent depression.”
    Quote in the paperSubstantial claim
  • Findingown data

    In the total sample, ELS and childhood late afternoon cortisol were significantly positively associated.

    “Bivariate Pearson-r (two-tailed) correlations for the total sample revealed a significant positive association between ELS and childhood late afternoon cortisol”
    Quote in the paperSubstantial claim
  • Findingown data

    Childhood late afternoon cortisol was inversely associated with adolescent amygdala-vmPFC functional connectivity measured 14 years later.

    “childhood cortisol was negatively correlated with functional connectivity estimates between the left amygdala and a voxel cluster in the vmPFC (peak t-statistic: t(56) = −5.97, R2 = 0.36, FDR-corrected p = 0.01).”
    • Also stated in: § ELS, Childhood Cortisol, and Adolescent fcMRI · plain
      “Higher late afternoon cortisol levels during childhood were associated with decreased amygdala-vmPFC fcMRI fourteen years later”
    • Also stated in: § ELS, Childhood Cortisol, and Adolescent fcMRI · plain
      “and a significant inverse association between childhood cortisol and adolescent amygdala-vmPFC fcMRI (Table 2).”
    Quote in the paperSubstantial claim
  • Findingown data

    Gender significantly moderated both pathways in the SEM.

    “Further, gender significantly moderated both pathways.”
    Quote in the paperSubstantial claim
  • Findingown data

    The mediating effect of childhood cortisol on the association between ELS and adolescent amygdala-vmPFC fcMRI was marginally significant (Indirect Est = −0.06, p = 0.09).

    “the mediating effect of childhood cortisol was marginally significant (Indirect Est = −0.06, p = 0.09).”
    Quote in the paperSubstantial claim
  • May combine two claims. 26
  • Classified as probably not a substantial claim. 8
  • The quote only partly states this claim. 1
  • May combine two claims.

    Findingown data

    The second moderated mediation SEM for anxiety demonstrated good fit and accounted for 64.6% of variance in adolescent anxiety symptoms.

    “This model (Figure 3) demonstrated good fit and accounted for 64.6% of the variance in adolescent anxiety symptoms.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    The structural equation model for fcMRI showed excellent fit and accounted for 39.1% of variance in fcMRI.

    “This model (Figure 2) showed excellent fit and accounted for 39.1% of the variance in fcMRI.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    No voxel-wise relations were detected between amygdala-vmPFC fcMRI and either adolescent basal cortisol or current life stress.

    “No voxel-wise relations were detected between amygdala-vmPFC fcMRI estimates and either adolescent basal cortisol or current life stress, suggesting that the observed effects were specific to childhood late afternoon basal cortisol function, not current stress or cortisol levels.”
    • Also stated in: § Discussion · plain
      “Despite their temporal proximity, concurrent measures of adolescent life stress and cortisol were not significantly associated with amygdala-vmPFC resting-state fcMRI”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    The modified depression model demonstrated improved fit and accounted for 56.2% of variance in depression.

    “This modified model demonstrated improved fit and accounted for 56.2% of the variance in depression (Figure 5).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    The parallel moderated mediation model for depression demonstrated good fit, but gender did not moderate the path from fcMRI to depression, so that pathway was omitted.

    “Although this model demonstrated good fit, gender did not moderate the path from fcMRI to depression and thus, that pathway was omitted”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Alternative models with reversed positions of anxiety symptoms and fcMRI had decreased fit and poor model fit.

    “For both of these alternative models, the fit statistics were decreased and the model fit was poor”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Use of over-the-counter medications was not associated with observed childhood cortisol levels (r = −0.11, p = 0.40).

    “The use of these medications was not associated with observed cortisol levels (r = −0.11, p = 0.40).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    When depressive symptoms and amygdala-vmPFC were transposed in an alternative model, fit statistics decreased and model fit was poor.

    “when depressive symptoms and amygdala-vmPFC were transposed in an alternative model, the fit statistics were decreased and the model fit was poor”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    The reversed structural equation model with depression and fcMRI transposed had unacceptable fit (Chi2 = 25.44, p < 0.05, RMSEA = 0.25, CFI = 0.66) and no mediational effect (Indirect Est = 0.02, p = 0.61).

    “when depressive symptoms and amygdala-vmPFC were transposed in a subsequent model, the fit statistics were reduced to unacceptable levels (Chi2 = 25.44, p < 0.05, RMSEA = 0.25, CFI = 0.66) and there was no mediational effect (Indirect Est = 0.02, p = 0.61).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Omitting the gender pathway from the depression model improved fit (Chi2 = 7.56, p > 0.05, RMSEA = 0.07, CFI = 0.97) and accounted for 56.2% of the variance in depression.

    “When that pathway was omitted, the final model demonstrated improved fit (Chi2 = 7.56, p > 0.05, RMSEA = 0.07, CFI = 0.97) and accounted for 56.2% of the variance in depression”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationown data

    Significant associations between childhood cortisol and adolescent internalizing symptoms suggested that amygdala-vmPFC fcMRI might mediate, especially for females.

    “Further, significant associations between childhood cortisol and adolescent internalizing symptoms suggested that amygdala-vmPFC fcMRI might play a mediating role, especially for females.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationown data

    For females only, greater ELS forecast higher childhood afternoon basal cortisol, and that cortisol in turn forecast lower amygdala-vmPFC functional connectivity.

    “For females only, higher levels of ELS predicted increased levels of childhood afternoon basal cortisol, which, in turn, predicted decreased amygdala-vmPFC functional connectivity.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The temporal ordering of ELS, childhood cortisol, and adolescent fcMRI is sufficient to infer mediation.
  • May combine two claims.

    Interpretationown data

    Resting function of this circuit forecasts both anxiety and depression symptoms, with stronger effects in females.

    “The functional status of this circuitry at rest predicts both anxious and depressive symptoms and displays strong gender differences with the effects stronger in females.”
    Quote in the paperSubstantial claim
  • May combine two claims. The quote only partly states this claim.

    Interpretationown data

    The model suggests that early stress raises basal cortisol, which then alters emotion-regulation circuitry during adolescence.

    “Our model indicates that early life stress increases basal cortisol, which in turn modulates emotion regulation circuitry in adolescence.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The observed associations are not due to unmeasured confounding.
  • May combine two claims.

    Premisecitation

    MDD resting-state data show vmPFC and limbic hyperactivity and greater connectivity between medial prefrontal regions and an affective network including amygdala.

    “Resting-state data from samples with major depressive disorders demonstrate hyperactivity in the vmPFC and limbic structures (e.g., amygdala, bed nucleus of the stria terminalis [BNST])25, as well as increased connectivity between medial prefrontal regions (including the vmPFC) and other networks including an affective network to which the amygdala is interconnected26.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [25] Northoff, G., Wiebking, C., Feinberg, T. & Panksepp, J. The 'resting-state hypothesis' of major depressive disorder—a translational subcortical-cortical framework for a system disorder. Neurosci. Biobehav. Rev. 35, 1929–1945 (2011). source

      Not checked in the free run.

    • cites [26] Sheline, Y.I. et al. The default mode network and self-referential processes in depression. Proc. Natl. Acad. Sci. USA 106, 1942–1947 (2009). source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Children with elevated maternal stress in infancy are more likely to show higher afternoon basal cortisol later in childhood, which is linked to more mental health symptoms two years later.

    “our group finds that children exposed to elevated levels of maternal stress in infancy are more likely to display higher afternoon basal cortisol levels later in childhood, which, in turn, is associated with increased mental health symptoms two years later4.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Essex, M.J., Klein, M.H., Cho, E. & Kalin, N.H. Maternal stress beginning in infancy may sensitize children to later stress exposure: effects on cortisol and behavior. Biol. Psychiatry 52, 776–784 (2002). source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    In females, infancy ELS was linked to higher childhood cortisol, and higher childhood cortisol forecast more negative amygdala-vmPFC fcMRI at age 18.

    “These findings establish a compelling developmental sequence whereby, in females, exposure to ELS during infancy was associated with higher levels of cortisol in childhood, and higher levels of cortisol at this early age predicted more negative amygdala-vmPFC fcMRI at age 18.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Higher early-life cortisol is linked to poorer emotion regulation, lower social competence, and later anxiety and depression symptoms.

    “Increased cortisol levels early in life are associated with poor emotion regulation, less social competence, and later symptoms of anxiety and depression2,3.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [2] Gunnar, M. & Quevedo, K. The neurobiology of stress and development. Annu. Rev. Psychol. 58, 145–173 (2007). source

      Not checked in the free run.

    • cites [3] Essex, M.J. et al. Influence of early life stress on later hypothalamic-pituitary-adrenal axis functioning and its covariation with mental health symptoms: a study of the allostatic process from childhood into adolescence. Dev. Psychopathol. 23, 1039–1058 (2011). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The childhood cortisol assay had a detection limit (ED80) of 0.03 μg/dL.

    “The detection limit of the assay (ED80) was 0.03 μg/dL”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The childhood cortisol assay had mean inter-assay variation of 7.4% and intra-assay variation of 3.8%.

    “with mean inter- and intra-assay variations of 7.4% and 3.8% respectively.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationown data

    In females, early stress and cortisol may imprint the brain in ways detectable in adolescent resting connectivity of an emotion-regulation circuit, and variation in this circuit matters for adolescent anxiety and depression.

    “our findings imply that, in females, ELS and early cortisol function may leave an imprint on the brain that can be detected in adolescent resting-state connectivity within a circuit important for emotion regulation, and variation in the function of this circuit plays an important role in adolescent anxiety and depressive symptoms.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    ELS may prime these individual differences, and effect timing and size can differ by gender.

    “These individual differences may be primed by exposure to early life stress (ELS), and the timing and magnitude of these effects can vary by gender4.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Essex, M.J., Klein, M.H., Cho, E. & Kalin, N.H. Maternal stress beginning in infancy may sensitize children to later stress exposure: effects on cortisol and behavior. Biol. Psychiatry 52, 776–784 (2002). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The adolescent cortisol assay had mean intra-assay variation of 3.5% and inter-assay variation of 5.1%.

    “with calibrator range of 0.012 – 3.000 μg/dL and mean intra- and inter-assay coefficients of variation of 3.5% and 5.1% respectively.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Task fMRI work suggests vmPFC top-down regulation of amygdala, and amygdala-vmPFC coupling relates to trait anxiety in task and resting studies.

    “task-based fMRI studies of emotion regulation suggest that the vmPFC is involved in top-down regulation of the amygdala, and functional coupling of the amygdala and vmPFC is related to trait anxiety in both task-related and resting-state studies13,14,15.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [13] Kim, M.J. et al. The structural and functional connectivity of the amygdala: from normal emotion to pathological anxiety. Behav. Brain Res. 223, 403–410 (2011). source

      Not checked in the free run.

    • cites [14] Kim, M.J., Gee, D.G., Loucks, R.A., Davis, F.C. & Whalen, P.J. Anxiety dissociates dorsal and ventral medial prefrontal cortex functional connectivity with the amygdala at rest. Cereb. Cortex 21, 1667–1673 (2011). source

      Not checked in the free run.

    • cites [15] Veer, I.M. et al. Endogenous cortisol is associated with functional connectivity between the amygdala and medial prefrontal cortex. Psychoneuroendocrinology 37, 1039–1047 (2012). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Evening cortisol is less likely to be affected by minor differences in collection time.

    “consistent with previous work demonstrating that evening cortisol is less likely to be impacted by small differences in collection time19,38.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [19] Pruessner, J.C. et al. Stress regulation in the central nervous system: evidence from structural and functional neuroimaging studies in human populations-2008 Curt Richter Award Winner. Psychoneuroendocrinology 35, 179–191 (2010). source

      Not checked in the free run.

    • cites [38] Michels, N. et al. Negative life events, emotions and psychological difficulties as determinants of salivary cortisol in Belgian primary school children. Psychoneuroendocrinology 37, 1506–1515 (2012). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The MacArthur Health and Behavior Questionnaire is a well-validated measure of mental health, physical health, and social and academic functioning.

    “the adolescent version of the MacArthur Health and Behavior Questionnaire33 (HBQ), a well-validated measure of mental health, physical health, and social and academic functioning.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33] Essex, M.J. et al. The confluence of mental, physical, social, and academic difficulties in middle childhood. II: Developing the MacArthur Health and Behavior questionnaire. Am. Acad. Child Adolesc. Psychiatry 41, 588–603 (2002). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationcitation

    This result extends prior suggestions that females are more sensitive to ELS effects on neuroendocrine function and show stronger epigenetic responses to early social environment.

    “extends previous work suggesting that females may be more sensitive to the effects of ELS on neuroendocrine function11 and work showing that females may also show more robust epigenetic changes in response to early social environmental factors37.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [11] Weinstock, M. Gender differences in the effects of prenatal stress on brain development and behaviour. Neurochem. Res. 32, 1730–1740 (2007). source

      Not checked in the free run.

    • cites [37] Murgatroyd, C. & Spengler, D. Epigenetic programming of the HPA axis: early life decides. Stress 14, 581–589 (2011). source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    ELS may sensitize HPA-axis feedback circuitry, producing atypical basal cortisol and structural/functional changes in amygdala and vmPFC.

    “Other work suggests that aspects of ELS may sensitize the neural circuitry that regulates HPA-axis feedback resulting in atypical basal cortisol levels (e.g., heightened or blunted cortisol function2,3), as well as structural and functional changes in brain regions involved in affective reactivity and regulation, such as the amygdala5 and ventromedial prefrontal cortex (vmPFC)6,7.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [2] Gunnar, M. & Quevedo, K. The neurobiology of stress and development. Annu. Rev. Psychol. 58, 145–173 (2007). source

      Not checked in the free run.

    • cites [3] Essex, M.J. et al. Influence of early life stress on later hypothalamic-pituitary-adrenal axis functioning and its covariation with mental health symptoms: a study of the allostatic process from childhood into adolescence. Dev. Psychopathol. 23, 1039–1058 (2011). source

      Not checked in the free run.

    • cites [5] Lupien, S.J. et al. Larger amygdala but no change in hippocampal volume in 10-year-old children exposed to maternal depressive symptomatology since birth. Proc. Natl. Acad. Sci. USA 108, 14324–14329 (2011). source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    HPA-axis dysregulation is linked to many adverse physical and psychological outcomes.

    “Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is related to many adverse physiologic and psychological outcomes1.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] McEwen, B.S. Stress, adaptation, and disease: allostasis and allostatic load. Ann. NY Acad. Sci. 840, 33–44 (1998). source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The depression-related connectivity results differ from the anxiety results and align with prior reports of greater connectivity between medial prefrontal and emotion circuits.

    “Our findings on relations between amygdala-vmPFC resting-state fcMRI and depression stand in marked contrast to those for anxiety and they are consistent with recent findings that show increased connectivity between medial prefrontal and emotion circuits26.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [26] Sheline, Y.I. et al. The default mode network and self-referential processes in depression. Proc. Natl. Acad. Sci. USA 106, 1942–1947 (2009). source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Subject motion, adolescent basal cortisol, and current life stress did not contribute significant variance to the relation between childhood cortisol and amygdala-vmPFC connectivity, nor did they appreciably change it.

    “None contributed significant variance to the observed relations between childhood cortisol and amygdala-vmPFC connectivity, nor did they appreciably change these findings (individual β’s ranged from −0.014 to −0.066, NS).”
    Quote in the paperSubstantial claim
31 of 31
  • The paper relies on this without support.

    The observed associations are not due to unmeasured confounding.

    “Our model indicates that early life stress increases basal cortisol, which in turn modulates emotion regulation circuitry in adolescence.”
  • The paper relies on this without support.

    The temporal ordering of ELS, childhood cortisol, and adolescent fcMRI is sufficient to infer mediation.

    “These results, and the temporal ordering of the variables, suggested that the associations of ELS and childhood cortisol with adolescent amygdala-vmPFC fcMRI might reflect a moderated mediational process.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Atypical presentations of these same stress-response systems have implications for understanding emotion dysregulation and a range of internalizing and externalizing symptoms.

    “and recent data suggest that atypical presentations of these same systems have implications for understanding emotion dysregulation (Miller et al. 2017b, Tottenham et al. 2010) and a range of both internalizing and externalizing symptoms (Burghy et al. 2012, Chen et al. 2015, Nederhof et al. 2015, Slavich & Irwin 2014).”

    From Adolescent Suicide as a Failure of Acute Stress-Response Systems. (2019) · cites this paper as Burghy et al. 2012

    The Discussion links early-life stress and altered cortisol and emotion-regulation circuitry to adolescent anxiety and depressive symptoms. The Results say externalizing symptoms were used as a control variable, not examined as an outcome of those systems. Burghy et al. therefore support the internalizing portion of the attributed claim, but not the externalizing portion; page numbers were unavailable in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured
  • Current conceptualization of how childhood adversity affects neural development focuses almost exclusively on stress pathways and allostatic load.

    “Current conceptualization of the impact of childhood adversity on neural development has focused almost exclusively on stress pathways and allostatic load (Burghy et al., 2012; Cohen et al., 2013).”
  • The mPFC and amygdala have extensive bidirectional connections and often function together.

    “Although mPFC and amygdala have extensive bidirectional connections and often function in tandem (110, 116, 117), these mPFC findings on greater left responding under conditions of deprived care are suggestive but have yet to be extended to amygdala structure or function.”
  • Recent work suggests that prefrontal-amygdalar functional connectivity can be influenced by early adversity.

    “Likewise, recent work suggests that prefrontal-amygdalar functional connectivity can be influenced by early adversity43-44.”

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Authors
Burghy, C. A., Stodola, D. E., Ruttle, P. L., Molloy, E. K., Armstrong, J. M., Oler, J. A., Fox, M. E., Hayes, A. S., Kalin, N. H., Essex, M. J., Davidson, R. J., & Birn, R. M.
Affiliations
University of Wisconsin–Madison (US)
Corresponding author
Burghy, Cory A
Venue
Nature Neuroscience
Published
2012-11-11
Volume
15
Issue
12
Pages
1736-1741
ISSN
  • 1097-6256 (ISSN-L)
  • 1546-1726
OpenAlex
W2165478810
Cited by
397
References
46
Citations by year
2026: 11 · 2025: 16 · 2024: 17 · 2023: 14 · 2022: 21 · 2021: 34 · 2020: 34 · 2019: 33 · 2018: 31 · 2017: 34 · 2016: 40 · 2015: 43 · 2014: 39 · 2013: 28 · 2012: 2
FWCI
18.36
Type
journal article
Language
en
Open access
Locations
  • Nature Neuroscience (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Canadian Institutes of Health Research
  • National Heart, Lung, and Blood Institute (T15HL097789)
  • National Institute of Mental Health (P50MH052354, R01MH044340, P50MH084051, R01MH043454)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30HD003352)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords
early life stress, resting-state functional connectivity, hypothalamic-pituitary-adrenal axis, adolescent anxiety, adolescent depression, internalizing problems, sex differences, emotion regulation, developmental pathways
MeSH terms
Adolescent, Adolescent Behavior, Amygdala, Anxiety, Depression, Female, Humans, Hydrocortisone, Male, Neural Pathways, Prospective Studies, Stress, Psychological, Prefrontal Cortex

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