Conceptualising Child and Adolescent Mental Health and Wellbeing Neurodevelopment: An Integrative Brain Networks Framework

Innovative integrative approaches are needed to address the current child and adolescent mental health crisis. This review presents a new transdiagnostic preventative framework for conceptualising mental health and wellbeing (MHW) neurodevelopment in childhood and adolescence - The Neurodevelopmental Theory of Mental Health and Wellbeing Capacities (NDeTeC). The NDeTeC specifies two key neuro-cognitive-affective capacities underpinning MHW, together with their associated brain networks, positioned in a developmentally fine-grained and socially-contextualised perspective on MHW. The first capacity focuses on self-regulation and identifies neurodevelopmental processes underlying adaptive managing of thoughts, emotions and behaviours - including emotional awareness and regulation of distractions, reactivity, rumination and worry. This capacity is associated with adaptive patterns of connectivity in salience-executive-default mode networks, reward network and the Hypothalamus-Pituitary Axis. The second capacity, called the self-world capacity, specifies and integrates relational processes of MHW underpinning a connected, flexible, ethically-grounded and purposeful sense of self, which are associated with shared humanity, connectedness and prosocial agency. This capacity is linked to adaptive connectivity patterns in mentalizing, empathy, prosociality and default mode networks. The review outlines how the NDeTeC framework can enable integration of different MHW constructs and associated approaches to guide improvements in long-term MHW support for children and adolescents.