Fig. 2: Conceptual model linking aspects of the pubertal transition with risk for suicidal thoughts and behaviors.

Experiences of early adversity affect the programming and development of endocrine and neural systems which undergo significant maturation during puberty. Puberty-related changes in ovarian, gonadal, and other related hormones shape the neural circuits underlying social cognition, emotion regulation, and impulse control (which include structures such as the amygdala, hippocampus, striatum, anterior cingulate cortex, and portions of prefrontal cortex). Alterations in these circuits may partially explain the ways in which changes in sex hormones are linked with the emergence of suicidal thoughts and behaviors during adolescence. Moderators of these processes, including a neurobiological sensitivity to ovarian hormones, experience of ongoing life stressors, and underlying mental disorders, are highlighted in red.