The difference between a child’s chronological age and the apparent age of their brain can predict whether they will rely on unhelpful emotional coping strategies a few years later. A new analysis suggests that a discrepancy in brain maturation during late childhood is linked to a later tendency to bottle up feelings, while attention-deficit/hyperactivity disorder symptoms do not offer any additional predictive power. These insights were published in the journal Translational Psychiatry.
Learning to manage sudden surges of emotion is a normal part of growing up. This process is driven by the gradual development of brain networks that connect the emotional centers deep inside the brain to the self-control regions located behind the forehead. As these neural pathways mature, children typically become better at soothing themselves and reacting appropriately to frustration.
When this brain maturation process occurs at an atypical pace, children can experience lasting difficulties with emotional regulation. Some psychiatric conditions, 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 struggle to moderate their responses, which can lead to social and academic challenges.
To better understand the biological origins of these emotional tendencies, researchers rely on a metric known as the brain-predicted age difference. This measurement is calculated using artificial intelligence. A machine learning algorithm reviews tens of thousands of magnetic resonance imaging scans to learn what a typical brain looks like at any given age.
When researchers feed a new brain scan into the algorithm, the computer estimates the person’s age based on their brain structure. The gap between this computer-generated guess and the child’s actual birth date creates a quantifiable score. A brain that looks notably older or younger than the individual’s chronological age can indicate an atypical developmental trajectory.
Lead researcher Kristóf Ágrez, a scientist at the HUN-REN Research Centre for Natural Sciences in Budapest, Hungary, and his colleagues wanted to know if this brain age gap could forecast later emotional habits. They also wanted to determine if observable behavioral problems associated with attention-deficit/hyperactivity disorder simply overlap with this brain metric or if they act as a separate predictor of emotional regulation.
The researchers utilized data from the Adolescent Brain Cognitive Development Study, a massive ongoing research initiative in the United States. They examined records from 2,711 children who underwent brain scans at around ten years of age. Three years later, when the participants were entering early adolescence, the children completed questionnaires about how they handle intense feelings.
The research team focused on two specific emotional strategies. The first strategy is cognitive reappraisal, which involves changing how one thinks about a stressful situation to reduce its emotional sting. This is generally considered an adaptive, healthy way to manage stress.
The second strategy is expressive suppression. This involves hiding outward signs of an emotion once a reaction has already begun, often referred to as bottling up feelings. Relying heavily on expressive suppression is widely considered maladaptive. This strategy is consistently linked to prolonged stress and an increased risk for mood disorders.
To ensure their analysis was accurate, the researchers controlled for a variety of external factors that might influence emotional maturity. They adjusted their statistical models to account for the children’s actual chronological age, their sex assigned at birth, and their physical stage of puberty. They also factored in whether the children were taking any psychotropic medications, as these drugs directly alter brain chemistry and emotional reactivity.
The analysis revealed that a greater gap between a child’s actual age and their predicted brain age at age ten predicted a higher reliance on expressive suppression at age thirteen. An atypical rate of brain maturation directly correlated with a child’s later tendency to hide their emotions.
When the researchers looked at cognitive reappraisal, they found no such link. Neither the brain age gap nor the presence of attention-deficit/hyperactivity disorder symptoms predicted whether a child would use the healthier strategy of rethinking a stressful situation. Cognitive reappraisal requires advanced mental flexibility, and the researchers suspect it relies on different neural mechanisms than the simpler act of suppressing an outward reaction.
The team then looked at the parent-reported behavioral problems to see if they offered any extra predictive weight. Children with attention-deficit/hyperactivity disorder often experience emotional outbursts and difficulty managing feelings. The researchers anticipated that these specific behavioral symptoms might help identify which children would struggle with expressive suppression.
The statistical analysis showed that once the brain age gap was factored in, behavioral problems did not help predict the tendency to suppress emotions. The underlying brain maturation pace appeared to be the primary driver of this specific coping habit in the studied population. The presence of behavioral symptoms did not provide any extra clues about the children’s future reliance on expressive suppression.
These results validate the use of brain age estimation as a window into developmental risks. Expressive suppression is known to play a role in the development and maintenance of numerous mental health conditions, including anxiety, depression, and substance use disorders. Identifying the biological markers that precede these habits can help scientists map out how early brain development sets the stage for psychological vulnerabilities.
While the study relied on a large and diverse sample, the researchers noted a few important caveats. Evaluating brain scans requires the images to be highly clear. The researchers had to exclude participants whose scans were blurry due to movement in the machine.
Children with severe hyperactivity or impulse control issues are often the ones who struggle most to stay perfectly still during a brain scan. By excluding those blurred scans, the final group of participants may have been slightly less representative of extreme clinical cases. It remains possible that in a more severely affected population, behavioral symptoms might act as an independent predictor of emotional regulation habits.
Another consideration involves the artificial intelligence tool used to guess the participants’ brain ages. The algorithm was originally trained on a dataset of more than 50,000 brain scans, but the vast majority of those images came from adults over the age of forty-five.
While the program is highly accurate, an algorithm trained exclusively on developing brains might catch even more subtle nuances in preteen maturation. Future studies will likely utilize machine learning models built specifically around thousands of teenage brain scans as new pediatric datasets become available to scientists.
By continuing to track these children as they progress through high school, researchers hope to see if these patterns hold steady over time. Tracking the association between brain anatomy and daily coping skills will eventually help medical professionals design better, highly personalized interventions for young people at risk for prolonged mental health struggles.
The study, “Assessing the association between ADHD and brain maturation in late childhood and emotion regulation in early adolescence,” was authored by Kristóf Ágrez, Pál Vakli, Béla Weiss, Zoltán Vidnyánszky, and Nóra Bunford.
