Artificial intelligence estimates of childhood brain age predict teenage coping skills

The physical maturation of a child’s brain can predict their subsequent emotional coping strategies, revealing fresh ways early development shapes mental health. Researchers found that having a structurally older brain in late childhood is tied to a habit of hiding emotions in early adolescence, while generalized hyperactivity symptoms do not predict this specific behavior. The findings were recently published in the journal Translational Psychiatry.

Human emotion regulation develops over many years and relies on a combination of lived experiences and physical brain growth. Adaptive coping strategies are consistently linked to resilience and better overall mental health outcomes. In contrast, maladaptive strategies, such as constantly suppressing outward emotional expressions, are often tied to mood disorders and social difficulties.

The ability to regulate feelings is governed by specific neural networks. Areas related to emotional control, such as the prefrontal cortex, undergo slow maturation throughout early childhood and adolescence. As these higher-level regions develop, they exert increasing control over deeper brain areas that generate immediate emotional reactions, like the amygdala.

Attention-deficit hyperactivity disorder is highly heterogeneous, meaning it looks different from person to person. However, many individuals with the condition experience emotional difficulties alongside the core symptoms of inattention and impulsivity. Some imaging studies have suggested that the disorder is characterized by a delay in overall brain maturation.

It has been difficult to establish exactly how physical brain differences map onto specific emotional habits over time. Lead author Kristóf Ágrez, a researcher at the HUN-REN Research Centre for Natural Sciences in Hungary, and his colleagues wanted to investigate this relationship. They set out to determine if the gap between a child’s actual chronological age and the apparent physical age of their brain could predict future emotional control.

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To test this, the research team utilized a metric known as the brain-predicted age difference. They applied an artificial intelligence program to structural magnetic resonance imaging scans. This specific machine learning program was trained on over fifty thousand brain scans to recognize typical age-related patterns in brain structure.

The algorithm reviews a new scan and estimates the person’s age based purely on physical brain characteristics. Researchers then subtract the participant’s actual chronological age from the algorithm’s age estimate. A positive number indicates that the brain appears structurally older than the person’s biological age.

The team analyzed data from the Adolescent Brain Cognitive Development Study, a nationwide project in the United States. Their final sample included 2,711 children who underwent brain scans and behavioral assessments. At the start of the data collection, the children were nine or ten years old.

Three years after the initial scans, the children completed self-report questionnaires assessing their emotional regulation habits. The researchers focused on two distinct coping strategies. One strategy was cognitive reappraisal, which involves changing how one thinks about a stressful situation to lessen its emotional impact. The other was expressive suppression, which involves intentionally hiding the outward signs of an emotion once it has already flared up.

The results showed that the brain-predicted age difference correctly predicted later expressive suppression. Specifically, children whose brains looked older than their chronological age at baseline reported higher levels of emotion suppression three years later in early adolescence. The physical appearance of the brain did not, however, predict the use of cognitive reappraisal.

In adult populations, an older looking brain is almost always a sign of atypical degeneration, often linked to cognitive decline or memory diseases. In children and teenagers, the interpretation of brain age is slightly different, as it is heavily influenced by the onset of puberty. Still, an atypically accelerated developmental trajectory can confer risk for later mental health challenges. This explains why a physically mature looking brain might correspond with maladaptive coping habits rather than healthy ones.

This split finding aligns with the physical mechanics of the brain. Expressive suppression relies on relatively simple neural processes to block outward reactions. Cognitive reappraisal demands much more cognitive effort and heavily engages the dorsolateral prefrontal cortex to actively reframe a narrative.

The researchers also looked at whether parent-reported symptoms of attention-deficit hyperactivity disorder predicted these emotional habits. They wanted to know if a behavioral diagnosis offered predictive power beyond the physical brain scan. They found that baseline hyperactivity and attention problems did not predict expressive suppression.

In the context of the broader statistical model, the behavioral symptoms simply did not track with the eventual use of emotional suppression. Any relationship between the behavioral disorder symptoms and later emotion suppression was not statistically significant. This suggests that the precocious physical maturation of the brain was a better indicator of this specific coping mechanism.

To ensure the accuracy of their results, the team accounted for a wide range of alternative explanations. They adjusted their mathematical models for variables like intelligence, behavioral inhibition, pubertal maturation, race, and sex assigned at birth. They also factored in whether the children were taking psychiatric medications, as many common prescriptions directly alter emotion regulation circuitry.

Even after these adjustments, the physical age of the brain remained a consistent predictor of emotional suppression. Chronological age and the use of psychiatric medications also consistently predicted emotional suppression across the different statistical models. The researchers note that chronological age essentially acts as a proxy for social experience, which heavily shapes emotional development.

The study has a few limitations regarding its sample and tools. Acquiring high-quality magnetic resonance imaging scans requires participants to lie very still. Children who tend to move around a lot during scanning were excluded because motion blurs the final images.

This exclusion of kids with high physical movement means the final group might be slightly less representative of children with severe hyperactivity. Additionally, the machine learning tool used to calculate brain age was primarily trained on scans from adults and older individuals. Future artificial intelligence models tuned specifically for pediatric populations might yield even more tailored results.

Despite these limitations, the research highlights a tangible link between childhood brain development and teenage coping skills. Because emotional suppression is associated with disorders like anxiety and depression, understanding its physical origins could aid in early risk detection. The project ultimately validates the concept of calculated brain age as a practical tool for developmental neuroscience.

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.