Prenatal Cannabis Exposure Linked to Altered Brain Reward Processing and Psychotic Experiences in Youth
Children exposed to cannabis before birth showed blunted brain reward responses that predicted psychotic-like experiences, with effects tracked across 4 years in over 11,000 youth.
Quick Facts
What This Study Found
Prenatal cannabis exposure (652 youth) was longitudinally associated with psychotic-like experiences, mediated by blunted striatal activation during reward anticipation — a marker of disrupted endocannabinoid-dopamine function.
Key Numbers
11,368 youth at baseline; 652 with prenatal cannabis exposure; effects tracked across 4 years at 22 US sites; all effect sizes |β|>0.5 with FDR-corrected significance.
How They Did This
Longitudinal prospective study analyzing task-related fMRI data from the ABCD Study at baseline (N=11,368), 2-year (n=7,928), and 4-year (n=2,982) follow-ups, examining reward anticipation neural responses.
Why This Research Matters
This provides a biological mechanism linking prenatal cannabis exposure to later psychosis risk — disrupted reward processing in the developing brain may be the bridge between in-utero exposure and adolescent mental health outcomes.
The Bigger Picture
With prenatal cannabis use rising alongside legalization, understanding how fetal exposure alters brain development has urgent public health implications for prevention messaging and early intervention.
What This Study Doesn't Tell Us
Prenatal exposure based on maternal report, which may underestimate true exposure; ABCD cohort may not be fully representative; fMRI measures are indirect indicators of neural function.
Questions This Raises
- ?Could early reward-processing interventions mitigate psychosis risk in prenatally exposed children?
- ?Is there a dose-response relationship between prenatal cannabis exposure level and neural disruption?
Trust & Context
- Key Stat:
- Evidence Grade:
- Large prospective longitudinal study from the premier US adolescent brain development cohort with neuroimaging biomarkers and multi-year follow-up.
- Study Age:
- Published in 2026 from the ongoing ABCD Study, representing the most current large-scale data on prenatal cannabis effects.
- Original Title:
- Altered Neurobehavioral Reward Response Predicts Psychotic-Like Experiences in Youth Exposed to Cannabis Prenatally.
- Published In:
- Biological psychiatry, 99(2), 165-174 (2026)
- Authors:
- Amir, Carolyn M(3), Ghahremani, Dara G(4), Chang, Sarah E(2), Cooper, Ziva D, Bearden, Carrie E
- Database ID:
- RTHC-08080
Evidence Hierarchy
Frequently Asked Questions
Can cannabis use during pregnancy affect a child's brain development?
This study of over 11,000 children found that prenatal cannabis exposure was linked to altered brain reward processing and increased psychotic-like experiences tracked over 4 years.
What are psychotic-like experiences in children?
These include unusual perceptual experiences, paranoid thoughts, or magical thinking that don't meet full psychosis criteria but indicate disrupted brain development and elevated future risk.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-08080APA
Amir, Carolyn M; Ghahremani, Dara G; Chang, Sarah E; Cooper, Ziva D; Bearden, Carrie E. (2026). Altered Neurobehavioral Reward Response Predicts Psychotic-Like Experiences in Youth Exposed to Cannabis Prenatally.. Biological psychiatry, 99(2), 165-174. https://doi.org/10.1016/j.biopsych.2025.05.019
MLA
Amir, Carolyn M, et al. "Altered Neurobehavioral Reward Response Predicts Psychotic-Like Experiences in Youth Exposed to Cannabis Prenatally.." Biological psychiatry, 2026. https://doi.org/10.1016/j.biopsych.2025.05.019
RethinkTHC
RethinkTHC Research Database. "Altered Neurobehavioral Reward Response Predicts Psychotic-L..." RTHC-08080. Retrieved from https://rethinkthc.com/research/amir-2026-altered-neurobehavioral-reward-response
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.