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

The current child and adolescent mental health crisis necessitates both empirical and theoretical innovation. This review presents a new framework conceptualising mental health and wellbeing (MHW) neurodevelopment in childhood and adolescence - The Neurodevelopmental Theory of Mental Health and Wellbeing Capacities (NDeTeC) - formulated from a transdiagnostic preventative perspective. 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 distraction, reactivity, rumination and worry. This capacity is associated with the intertwined activity 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 associated with shared humanity, connectedness and prosocial agency. This capacity is linked to activity in the theory of mind, 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.