Teresa Vargas, Northwestern University

Psychotic disorders are complex, debilitating, and not very well understood. Symptoms are often debilitating, and the gaps in care are astonishing. Psychosis and severe mental illness take a toll on both an individual, and societal level. Though we experience the world on an individual level, structural, societal, and cultural features permeate everything that we do. In other words, our physical and social environments shape our every experience. Though our brains have evolved to be sensitive to the environments we inhabit, the degree of sensitivity varies by developmental stage and interacts with individual factors in ways that we do not yet fully understand. My research focuses on understanding the complex back and forth between individuals and their environments to inform prevention and intervention efforts to reduce risk for psychosis and severe mental illness.

My work so far, as a result, has aimed to understand psychosis vulnerability from both an individual and systemic lens.  Specifically, my first line of research aims to relate environmental exposures directly to vulnerability for developing a psychotic disorder. While individual-level environmental factors such as supportive parenting and childhood trauma have been extensively studied, local, regional, and country-level factors are relatively less understood within clinical science. Given that systemic inequities and environmental factors are not well understood, in a recent study I sought to establish distinct dimensions of types of structural environmental exposures. These included stimulation exposures conferring lack of safety and high attentional demands (e.g., neighborhood crime and population density), deprivation exposures constituting a lack of developmentally appropriate resources (e.g., neighborhood deprivation), and discrepancy exposures conferring feelings of social exclusion and lack of belonging (e.g., neighborhood income inequality and low ethnic density). I found evidence that these types of exposures could be meaningfully conceptualized as distinct (Vargas et al., 2021). Of note, all environmental exposure domains (measured by both objective measures such as Census-derived neighborhood characteristics, and self-report) related to psychosis vulnerability, with some exposures (e.g., deprivation) showing stronger associations relative to others. This work suggests that going beyond individual-level exposures, toward neighborhood, societal, and even cultural features, could be highly informative for psychosis vulnerability and resilience models.

My second line of research aims to dig further by identifying candidate neural and functional mechanisms through which environmental factors impact mental health across development. I have used MRI methods because I believe by allowing us a window into what is going on in our brains structurally, they allow us to understand possible lasting impacts of stress, environments, and systemic inequities. Interestingly, MRI allows us to identify relations between the brain, stress, and environments across different ages, which could help us understand how development plays a role. Particularly, I am interested in how biomarkers of types of environments and links to emergent behavior and health outcomes could aid early identification efforts. Identifying individuals who are most vulnerable to mental illness through environmental disadvantage could ultimately help us intervene earlier. At the population level, it could inform more effective allocation of prevention and intervention resources for vulnerable communities. In a recent study using a nationally representative United States sample of 9-11-year-old children, I found that these stimulation, deprivation, and discrepancy neighborhood-level features were associated with brain regions implicated in a host of cognitive, affective, and social functions (Vargas et al. 2022).  My previous work has shown that these relations hold even after accounting for more proximal, individual-level characteristics such as parental education and household income (Vargas et al., 2020). In my future research, I aim to clarify potential biomarkers and neural features that relate to different environmental factors across different developmental periods.

Understanding the systemic environmental factors that influence mental illness vulnerability is essential to the advancement of prevention and intervention-focused clinical research for vulnerable individuals, psychosis, and severe mental illness. In the future, I hope to apply my work to prevention, intervention, and health disparity-relevant translational research and advocacy. Being a SIRS Early Career Award recipient has been a highly rewarding and enriching experience, where I have had the opportunity to learn from brilliant scientists in the community as to how to achieve these goals in the service of helping individuals with psychosis, harnessing the power of collaboration to build bridges and further understanding.