Neuroimaging Markers of Resiliency in Youth at Clinical High Risk for Psychosis: A Qualitative Review

Teresa Vargas*, Katherine S.F. Damme, Arielle Ered, Riley Capizzi, Isabelle Frosch, Lauren M. Ellman, Vijay A. Mittal

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations


Psychotic disorders are highly debilitating and constitute a major public health burden. Identifying markers of psychosis risk and resilience is a necessary step toward understanding etiology and informing prevention and treatment efforts in individuals at clinical high risk (CHR) for psychosis. In this context, it is important to consider that neural risk markers have been particularly useful in identifying mechanistic determinants along with predicting clinical outcomes. Notably, despite a growing body of supportive literature and the promise of recent findings identifying potential neural markers, the current work on CHR resilience markers has received little attention. The present review provides a brief overview of brain-based risk markers with a focus on predicting symptom course. Next, the review turns to protective markers, examining research from nonpsychiatric and schizophrenia fields to build an understanding of framing, priorities, and potential, applying these ideas to contextualizing a small but informative body of resiliency-relevant CHR research. Four domains (neurocognition, emotion regulation, allostatic load, and sensory and sensorimotor function) were identified and are discussed in terms of behavioral and neural markers. Taken together, the literature suggests significant predictive value for brain-based markers for individuals at CHR for psychosis, and the limited but compelling resiliency work highlights the critical importance of expanding this promising area of inquiry.

Original languageEnglish (US)
Pages (from-to)166-177
Number of pages12
JournalBiological Psychiatry: Cognitive Neuroscience and Neuroimaging
Issue number2
StatePublished - Feb 2021


  • Biomarker
  • Clinical high risk for psychosis
  • Magnetic resonance imaging
  • Neuroimaging
  • Resilience
  • Schizophrenia

ASJC Scopus subject areas

  • Clinical Neurology
  • Biological Psychiatry
  • Cognitive Neuroscience
  • Radiology Nuclear Medicine and imaging


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