@article {1658624,
	title = {Poverty, Cortical Structure, and Psychopathologic Characteristics in Adolescence},
	journal = {JAMA Network Open},
	volume = {5},
	number = {11},
	year = {2022},
	pages = {1-12},
	abstract = {
	IMPORTANCE Childhood poverty has been associated with increased internalizing and externalizing\&nbsp;problems in adolescence, a period of peak onset for psychiatric problems. The underlying neural\&nbsp;mechanisms remain unclear because longitudinal studies of poverty, brain structure, and changes in\&nbsp;psychiatric symptoms are lacking.



	OBJECTIVE To examine whether structural differences in cortical regions mediate the association\&nbsp;between household poverty and change in psychiatric symptoms in early adolescence.



	DESIGN, SETTING, AND PARTICIPANTS This longitudinal cohort study used baseline and 1-year\&nbsp;follow-up data from the Adolescent Brain Cognitive Development Study. Children aged 9 to 10 years\&nbsp;in the US were enrolled between September 1, 2016, and October 15, 2018. Data analysis was\&nbsp;performed from August 13, 2021, to September 30, 2022.



	EXPOSURES Household poverty as measured by income-to-needs ratio, which incorporates family\&nbsp;income and adjusts for family size as a percentage of the federal poverty level.



	MAIN OUTCOMES AND MEASURES Mediators were children{\textquoteright}s cortical surface area, thickness, and



	volume, obtained usingmagnetic resonance imaging. Internalizing and externalizing problems at



	1-year follow-up were outcomes measured by maternal report using the Child Behavior Checklist.\&nbsp;Analyses were adjusted for baseline psychiatric problems and sociodemographic variables, including\&nbsp;sex, race and ethnicity, parental educational level, and study site.



	RESULTS Of the 7569 children (mean [SD] age, 9.91 [0.62] years; 3970 boys [52.5\%]) included in\&nbsp;the analysis, 1042 children (13.8\%) lived below the poverty threshold between 2016 and 2018.\&nbsp;Poverty was associated with increased externalizing symptoms score at 1-year follow-up (b = 1.57;\&nbsp;95\%CI, 1.14-1.99), even after adjustment for baseline externalizing symptoms (b = 0.35; 95\%CI,\&nbsp;0.06-0.64). The longitudinal associations of poverty with increases in externalizing problems over\&nbsp;time were mediated by reductions in surface area in multiple cortical regions that support executive\&nbsp;functioning (middle frontal gyrus), decision-making (lateral orbitofrontal cortex), visual processing\&nbsp;(fusiform gyrus), auditory processing (transverse temporal gyrus), and emotion and language\&nbsp;processing (superior temporal gyrus).



	CONCLUSIONS AND RELEVANCE The findings of this study suggest that childhood poverty is\&nbsp;associated with increases in externalizing problems, but not internalizing problems, over time in early\&nbsp;adolescence. This association is mediated by reductions in cortical surface area across numerous\&nbsp;brain regions. These findings highlight potential neurobiological mechanisms underlying the link\&nbsp;between poverty and the emergence of externalizing problems during early adolescence.

},
	url = {https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2799026?utm_campaign=articlePDF\&utm_medium=articlePDFlink\&utm_source=articlePDF\&utm_content=jamanetworkopen.2022.44049},
	author = {Kim, Hannah H. and McLaughlin, K. and Chibnik, Lori B and Koenen, Karestan C. and Timelier, Henning}
}
