Bullied teens' brains show chemical change associated with psychosis

Researchers have found that adolescents being bullied by their peers are at greater risk of the early stages of psychotic episodes and in turn experience lower levels of a key neurotransmitter in a part of the brain involved in regulating emotions. The finding suggests that this neurotransmitter — a chemical messenger that transmits nerve impulses for communication by a nerve cell — may be a potential target for pharmaceutical interventions aimed at reducing the risk of psychotic disorders.

Psychosis is a mental state characterized by loss of contact with reality, incoherent speech, and behavior, and typically hallucinations and delusions seen in psychiatric disorders such as schizophrenia.

Recent studies investigating links between neurological and psychiatric features of certain disorders have found that individuals who experience their first episode of psychosis or have schizophrenia that remains treatable, have lower-than-normal levels of glutamate, a neurotransmitter in the brain’s anterior cingulate cortex (ACC) region. The ACC is known to play a crucial role in regulating emotions, decision-making and cognitive control, while glutamate is the most abundant neurotransmitter in the brain and is involved in a wide range of functions, including learning, memory, and mood regulation.

Alterations in glutamate levels have been implicated in various psychiatric disorders, including schizophrenia, depression and anxiety, and so measuring ACC glutamate levels can provide valuable insights into the mechanisms of the nervous system underlying these disorders and their treatment.

However, until now, changes in glutamate levels in the ACC in those individuals at high risk of psychosis, and the relationship between this and the effects of bullying in adolescents, and indeed adults, has remained unclear.

For this study Japanese researchers used magnetic resonance spectroscopy, or MRS, a type of radiological imaging applied to depict brain structure and function, to measure glutamate levels in the ACC region of adolescents. They then measured the glutamate levels at a later point, allowing them to assess changes over time, and compare these changes to experiences with bullying, or lack thereof, as well as with any intention on the part of those experiencing bullying to seek help.

Bullying victimization was tracked via questionnaires. The researchers then used formalized psychiatric measurement to assess experiences of bullying victimization based on those questionnaires, such as tallying the frequency and assessing the nature of events involving physical or verbal aggression. The researchers also used the questionnaires to capture their impact on overall mental health.

They found that bullying was associated with higher levels of subclinical psychotic experiences in early adolescence — those symptoms come close to psychosis but do not meet the full criteria for a clinical diagnosis of a psychotic disorder, such as schizophrenia. These symptoms or experiences can include hallucinations, paranoia or radical alterations in thinking or behavior and can have a significant impact on well-being and functioning, even in the absence of a psychotic disorder diagnosis.

What the researchers say: “Studying these subclinical psychotic experiences is important for us to understand the early stages of psychotic disorders and for identifying individuals who may be at increased risk for developing a clinical psychotic illness later on,” the lead author said

Crucially, the researchers found that higher levels of these subclinical psychotic experiences were associated with lower levels of anterior cingulate glutamate in early adolescence.

“First and foremost, anti-bullying programs in schools that focus on promoting positive social interactions and reducing aggressive behaviors are essential for their own sake and to reduce the risk of psychosis and its subclinical precursors,” the researchers explained. “These programs can help create a safe and supportive environment for all students, reducing the likelihood of bullying and its negative consequences.”

I personally have doubts about this approach due to research into the genetics of bullies and victims (see “So, what” below).

Another potential intervention is to provide support and resources for adolescents who have experienced bullying victimization. This might include counseling services, peer support groups and other mental health resources that can help adolescents cope with the negative effects of bullying and develop resilience.

So, what? This is interesting research. The idea that glutamate plays a part in the development of psychosis as a result of bullying ties in with earlier research which showed that lower levels of glutamate were responsible for some forms of bullying and antisocial behavior.

Other recent research has shown, also, that genetics play a large part in people becoming both bullies and victims and that the genes responsible for the drive to be a leader and the propensity to become a bully are, essentially, the same.

If bullying can lead to psychosis in victims in adolescence, I see no reason why the same should not be true in adulthood, or even old age—particularly if the victim has the genetic propensity to a bully’s target.