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Advancing understanding of how early experiences shape the developing brain

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03/09/2026

Riley Children’s Health continues to advance pediatric behavioral health through research that clarifies the neurobiological pathways linking early adversity to later psychopathology. Kathleen Crum, PhD, a child and adolescent psychologist at Riley Children’s and investigator at Indiana University School of Medicine, is contributing important mechanistic work that informs risk stratification, early intervention, and trauma‑informed care for adolescents.

Dr. Crum has also been awarded a prestigious NIH K08 Clinical Investigator Award from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). This federally funded project examines how trauma related mental health symptoms in mothers influence the developmental trajectory and risk for alcohol use in their children. The award supports Dr. Crum’s continued efforts to identify early, modifiable pathways of risk and inform prevention strategies across generations.

Dr. Crum’s recent publications leverage neuroimaging, behavioral phenotyping, and family‑level risk variables to characterize how early life stress, trauma exposure, and familial substance use vulnerability shape neural systems involved in decision‑making, attention, and reinforcement learning.

Differential neural correlates of familial SUD risk and parental impulsivity

Family history of substance use disorder and parental impulsivity are differentially associated with neural responses during risky decision-making

This study distinguishes two clinically relevant risk pathways: inherited vulnerability and environmental/behavioral modeling. Using fMRI during a risky decision-making task, Dr. Crum and colleagues demonstrated that family history of SUD and parental impulsivity map onto distinct neural response patterns in adolescents.

Familial risk for substance use disorders appear linked to inherited differences in reward processing, while parental impulsivity shapes how youth process risk through environmental modeling. Together, these patterns point clinicians toward more refined risk assessments, especially for young people exposed to both genetic and behavioral vulnerabilities.

Trauma-related alterations in attention network connectivity

Oxytocin, PTSD, and sexual abuse are associated with attention network intrinsic functional connectivity

This work examines how trauma exposure and PTSD symptoms influence intrinsic functional connectivity within attention networks—systems frequently implicated in hypervigilance, distractibility, and dysregulated threat processing.

Trauma exposure and PTSD symptoms appear to alter attention‑network connectivity in youth, with oxytocin influencing some of these neural patterns. This suggests that attentional or externalizing symptoms in traumatized youth may arise from mechanisms distinct from primary ADHD, underscoring the importance of trauma‑informed assessment.

Profiles of early stress, behavioral symptoms and reinforcement learning

Latent profiles of substance use, early life stress, and attention/externalizing problems and their association with neural correlates of reinforcement learning in adolescents

Dr. Crum’s work in this study identifies distinct subgroups of adolescents based on early life stress exposure, behavioral symptoms, and substance use patterns and links these profiles to neural markers of reinforcement learning.

Youth exposed to high early life stress and externalizing symptoms show disrupted prediction‑error signaling, a process linked to risk‑taking and difficulty learning from consequences. Recognizing these neural patterns early may help clinicians tailor more effective, mechanism‑informed interventions for adolescents who don’t respond to standard behavioral approaches.

Across these studies, Dr. Crum’s work highlights the importance of integrating family history, trauma exposure, behavioral phenotypes, and neurobiological markers when evaluating risk in adolescents. Her research supports a precision‑oriented approach to pediatric behavioral health that moves toward a deeper understanding of the mechanisms driving vulnerability. These findings underscore the value of early identification and multidisciplinary collaboration when caring for youth with complex behavioral or trauma-related presentations.

Learn more

Check out the latest Riley Children’s Health annual report for more information about treatment, programs, novel procedures and research.



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Designated as Best Children's Hospitals by U.S. News & World Report, Ranked in 10 Specialties in 2023-24

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