The difference between a child’s chronological age and their apparent brain age can predict whether a child will rely on unhelpful emotional coping strategies years later. A new analysis suggests that discrepancies in brain maturation in late childhood are associated with a later tendency to bottle up emotions, but symptoms of attention-deficit/hyperactivity disorder confer no additional predictive power. These insights were published in the journal Translational Psychiatry.
Learning how to control sudden surges of emotion is a normal part of growing up. This process is driven by the gradual development of brain networks that connect emotional centers deep in the brain with self-regulatory areas located behind the forehead. As these neural pathways mature, children typically become better at calming themselves and responding appropriately to frustration.
When this brain maturation process occurs at an abnormal pace, children can experience lasting difficulties regulating their emotions. Some psychiatric disorders, such as attention-deficit/hyperactivity disorder, are characterized by a delay in this expected biological timeline. Children with this condition often experience intense emotions and have trouble regulating their reactions, which can lead to social and academic difficulties.
To better understand the biological origins of these emotional tendencies, researchers rely on a measure known as the brain-predicted age difference. This measurement is calculated using artificial intelligence. Machine learning algorithms review tens of thousands of magnetic resonance imaging scans to learn what a typical brain looks like at a particular age.
When researchers feed new brain scans into an algorithm, the computer estimates a person’s age based on their brain structure. The gap between this computer-generated guess and the child’s actual date of birth creates a quantifiable score. If a person’s brain appears significantly older or younger than their chronological age, it may indicate an atypical developmental trajectory.
Lead researcher Kristof Agrez, a scientist at the Hunlen Natural Science Research Center in Budapest, Hungary, and his colleagues wanted to know whether this difference in brain age could predict later emotional habits. They also wanted to determine whether observable behavioral problems associated with attention-deficit/hyperactivity disorder simply overlap with this brain indicator or serve as separate predictors of emotion regulation.
The researchers used data from the Adolescent Brain Cognitive Development Study, a large-scale research initiative currently underway in the United States. They examined the records of 2,711 children who underwent brain scans around the age of 10. Three years later, when the participants entered early adolescence, the children completed a questionnaire about how they cope with intense emotions.
The research team focused on two specific emotional strategies. The first strategy is cognitive reappraisal. This involves changing the way you think about stressful situations and reducing emotional distress. This is generally considered to be an adaptive and healthy way to manage stress.
The second strategy is expression suppression. This involves hiding the outward signs of the emotion after the reaction has already begun, and is often referred to as trapping the emotion. Heavy reliance on expressive suppression is widely considered to be maladaptive. This strategy is consistently associated with increased risk of long-term stress and mood disorders.
To ensure the analysis was accurate, the researchers controlled for a variety of external factors that could influence emotional maturity. They adjusted the statistical model to account for the child’s actual chronological age, sex assigned at birth, and physical stage of puberty. We also took into account whether the children were taking any psychotropic medications, since psychotropic medications directly alter brain chemistry and emotional responses.
The analysis revealed that the greater the difference between a child’s chronological age and their predicted brain age at age 10, the greater their dependence on expressive suppression at age 13. Abnormal rates of brain maturation directly correlated with children’s tendency to hide their emotions later in life.
When researchers looked at cognitive reappraisal, they found no such association. Neither brain age differences nor the presence or absence of attention-deficit/hyperactivity disorder symptoms predicted whether children would adopt a healthier strategy of rethinking stressful situations. Cognitive reappraisal requires a high degree of mental flexibility, and researchers suspect that it relies on different neural mechanisms than the simple act of suppressing external reactions.
The team then looked at parent-reported problem behaviors to see if they provided additional predictive weight. Children with attention-deficit/hyperactivity disorder often experience emotional outbursts and difficulty controlling their emotions. The researchers anticipated that these specific behavioral symptoms might help identify which children were suffering from expressive suppression.
Statistical analysis showed that once brain age differences were taken into account, behavioral problems were no longer predictive of a tendency to suppress emotions. The underlying pace of brain maturation appears to be a major factor in this particular coping habit in the study population. The presence of behavioral symptoms did not provide specific clues as to whether children would rely on expressive suppression in the future.
These results validate the use of brain age estimation as a window into developmental risk. Expressive suppression is known to be involved in the development and maintenance of many mental health conditions, including anxiety, depression, and substance use disorders. Identifying biological markers that precede these habits can help scientists map out how early brain development sets the stage for psychological vulnerability.
Although the study was based on a large and diverse sample, the researchers noted some important caveats. To evaluate brain scans, the images need to be very clear. Researchers had to exclude participants whose scans were blurry due to movement within the machine.
Children with severe hyperactivity or impulse control issues often have the most trouble staying completely still during brain scans. Excluding those blurred scans may have made the final participant group slightly less representative of extreme clinical cases. It remains possible that behavioral symptoms serve as independent predictors of emotion regulation habits in more severely affected populations.
Another consideration involves the artificial intelligence tools used to estimate participants’ brain age. The algorithm was initially trained on a dataset of more than 50,000 brain scans, with the majority of those images coming from adults over 45 years old.
Although the program is highly accurate, algorithms trained only on the developing brain may capture even more subtle nuances in pre-teen development. As new pediatric datasets become available to scientists, future research may specifically utilize machine learning models built around thousands of teen brain scans.
The researchers hope to continue tracking these children through high school to see whether these patterns remain stable over time. Tracking the association between brain anatomy and everyday coping skills will ultimately help health professionals design more appropriate and individualized interventions for young people at risk of long-term mental health problems.
The study, “Assessing the association between ADHD and brain maturation in late childhood and emotional regulation in early adolescence,” was authored by Kristof Agrez, Pal Vakri, Bela Weiss, Zoltan Vidnjanski, and Nora Bamford.
