Adolescent Mental Health in the Middle East and North Africa (MENA): Where Are We and Where Do We Go from Here?

Abstract

Childhood and adolescence are time periods for human brain development and growth. Neuroimaging studies show that white matter volume and integrity increases throughout childhood and adolescence, with the frontal and temporal regions of the brain undergoing pronounced changes in adolescence (Tamnes et al. 2010). Decreases in frontal and temporal gray matter volume during adolescence result from environmental influences, as well as increasing white matter, the latter being essential as a transport mechanism of vital brain connections (Giedd et al. 1999). In parallel to these physiologic changes, marked cognitive changes include increases in abstract thought and reasoning (Piaget et al. 1977), improvements in IQ and working memory (Ostby et al. 2011), better problem solving and planning (Squeglia et al. 2013), and maturation of perspective taking (Sebastian et al. 2012). These changes suggest that the human brain exhibits heightened neural plasticity during adolescence, defined as the brain ability to adapt to internal or external changes. Environmental exposures and influences during adolescence determine these changes. For example, contextual neighborhood features such as the absence of opportunities for physical activity or an abundance of vaping stores influence adolescents to exhibit health risk behaviors such as sedentary lifestyles and drug use, which in turn influence the development of health outcomes, such as obesity and mental disorders. Fuhrmann et al. (2015) highlighted adolescence as a sensitive period of development where brain changes may be particularly susceptible to environmental influences, such as drugs, social stress, or cognitive training.