partnership with developmental neuroscientists, such trials therefore offer an unprecedented opportunity to evaluate the neurobiological correlates of preventive interventions by identifying and measuring the anatomical, functional, and neural systems–level effects of those interventions. Because longitudinal studies can identify environmental influences on intervention outcomes and phenotypes over the course of disorders, preventive trials also offer a context for evaluating the hypothesized mechanisms and effects of genetic factors by examining how genetic predispositions may inhibit or enhance the effects of an intervention (an example is the study described in Chapter 4 on serotonin transporter genotype in a prevention intervention trial by Brody, Kogan, et al., 2008). Because the effect sizes of interventions are often small, this kind of information should help in tailoring an intervention to specific individuals, thereby enhancing the magnitude of its beneficial effects.
Advances in neuroscience since 1994 have contributed to the growing knowledge of the determinants of mental health, the pathogenesis of disorders, and the ways in which the determinants of those disorders can be influenced through intervention strategies. Much evidence points to the central importance of brain development during the prenatal and early postnatal periods and of nurturing care for the development of the neural systems that support healthy attachment, socialization, adaptive learning, and self-regulation throughout infancy, childhood, and adolescence. The growing knowledge base in these areas has important implications in support of strategies to promote healthy cognitive, emotional, and behavioral development and to prevent MEB disorders.
Conclusion: Environment and experience have powerful effects on modifying brain structure and function at all stages of development in young people. Intervention strategies that modify environment and experience have great potential to promote healthy development of the brain and to prevent MEB disorders.
The growth of knowledge in developmental neuroscience has been particularly rapid in the defining of the roles of genetic, epigenetics, and gene–environment interactions on brain development. First, in the field of genetics, a great deal has been learned about the specific genes and molecular pathways that cause specific but fairly rare neurodevelopmental disorders. These advances have made realistic the previously remote hope that these devastating conditions might one day be treated or prevented. These advances have helped to point the way toward similar progress in