Editorial: The Future of Safety Signal Learning as a Biomarker of Risk and Treatment Target for Trauma-Related Psychopathology in Youth.

Abstract

More than two-thirds of youth will experience at least 1 traumatic event.¹ Ongoing conflicts and increasingly pervasive natural disasters attributable to climate change signal that this number is on the rise.^2,3 There is a significant need for trauma-informed interventions to mitigate the severity, chronicity, and cost of the physical and mental health effects of trauma (eg, cardiometabolic diseases, posttraumatic stress, anxiety, and depression). While such evidence-based interventions do exist, a significant proportion of youth do not respond to treatments such as cognitive-behavioral therapy, and globally an even larger proportion are unable to access treatment.⁴ Thus, there is a great need to identify and optimize new and existing trauma-informed treatment strategies through mechanism-focused research. In this issue, Kribakaran et al.⁵ explored safety signal learning and its neural underpinnings in 102 youths (ages 9-19; 46 girls), approximately half (n = 52) of whom were exposed to interpersonal trauma. They identified age- and exposure-related differences in brain regions and circuits related to threat detection (eg, centromedial amygdala), context processing (eg, anterior hippocampus), and regulation (eg, subgenual anterior cingulate cortex), with implications for risk of posttraumatic stress disorder and treatment across developmental stages. The findings push the needle forward regarding our understanding of the neurobiological underpinnings of aberrant learning processes in youth exposed to trauma and generate new questions regarding individual differences attributable to structural factors such as racism, as well as developmental questions requiring longitudinal testing.