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Depression, anxiety and PTSD symptoms before and during the COVID-19 pandemic in the UK. Psychol Med 2023; 53:5428-5441. [PMID: 35879886 PMCID: PMC10482709 DOI: 10.1017/s0033291722002501] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/12/2022] [Accepted: 07/19/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health is still being unravelled. It is important to identify which individuals are at greatest risk of worsening symptoms. This study aimed to examine changes in depression, anxiety and post-traumatic stress disorder (PTSD) symptoms using prospective and retrospective symptom change assessments, and to find and examine the effect of key risk factors. METHOD Online questionnaires were administered to 34 465 individuals (aged 16 years or above) in April/May 2020 in the UK, recruited from existing cohorts or via social media. Around one-third (n = 12 718) of included participants had prior diagnoses of depression or anxiety and had completed pre-pandemic mental health assessments (between September 2018 and February 2020), allowing prospective investigation of symptom change. RESULTS Prospective symptom analyses showed small decreases in depression (PHQ-9: -0.43 points) and anxiety [generalised anxiety disorder scale - 7 items (GAD)-7: -0.33 points] and increases in PTSD (PCL-6: 0.22 points). Conversely, retrospective symptom analyses demonstrated significant large increases (PHQ-9: 2.40; GAD-7 = 1.97), with 55% reported worsening mental health since the beginning of the pandemic on a global change rating. Across both prospective and retrospective measures of symptom change, worsening depression, anxiety and PTSD symptoms were associated with prior mental health diagnoses, female gender, young age and unemployed/student status. CONCLUSIONS We highlight the effect of prior mental health diagnoses on worsening mental health during the pandemic and confirm previously reported sociodemographic risk factors. Discrepancies between prospective and retrospective measures of changes in mental health may be related to recall bias-related underestimation of prior symptom severity.
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Understanding the relationship between family income and conduct problems: findings from the mental health of children and young people survey. Psychol Med 2023; 53:3987-3994. [PMID: 35311636 PMCID: PMC10317806 DOI: 10.1017/s0033291722000654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/28/2021] [Accepted: 02/18/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Children from low-socioeconomic backgrounds exhibit more behavioural difficulties than those from more affluent families. Influential theoretical models specify family stress and child characteristics as mediating this effect. These accounts, however, have often been based on cross-sectional data or longitudinal analyses that do not capture all potential pathways, and therefore may not provide good policy guidance. METHODS In a UK representative sample of 2399 children aged 5-15, we tested mediation of the effect of household income on parent and teacher reports of conduct problems (CP) via unhealthy family functioning, poor parental mental health, stressful life events, child physical health and reading ability. We applied cross-lagged longitudinal mediation models which allowed for testing of reciprocal effects whereby the hypothesised mediators were modelled as outcomes as well as predictors of CP. RESULTS We found the predicted significant longitudinal effect of income on CP, but no evidence that it was mediated by the child and family factors included in the study. Instead, we found significant indirect paths from income to parental mental health, child physical health and stressful life events that were transmitted via child CP. CONCLUSION The results confirm that income is associated with change in CP but do not support models that suggest this effect is transmitted via unhealthy family functioning, parental mental health, child physical health, stressful life events or reading difficulties. Instead, the results highlight that child CP may be a mediator of social inequalities in family psychosocial functioning.
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Mother and father depression symptoms and child emotional difficulties: a network model. Eur Psychiatry 2022. [PMCID: PMC9566781 DOI: 10.1192/j.eurpsy.2022.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Enhancing understanding of depression symptom interactions between parents and associations with subsequent child emotional difficulties will inform targeted treatment of depression to prevent transmission within families. Objectives To use a network approach to identify ‘bridge’ symptoms that reinforce mother and father depression, and whether bridge symptoms, as well as other symptoms, impact subsequent child emotional difficulties. Methods Symptoms were examined using two unregularized partial correlation network models. The study included 4,492 mother-father-child trios from a prospective, population-based cohort in the United Kingdom. Mother and father reports of depression symptoms were assessed when the child was twenty-one months old. Child emotional difficulties were reported by the mother at ages nine, eleven and thirteen years. Results Bridge symptoms mutually reinforcing mother and father depression symptoms were feelings of guilt and self-harm ideation, whereas anhedonia acted as a bridge from the father to the mother, but not vice-versa (fig.1, network 1). The symptom of feelings of guilt in mothers was the only bridge symptom which directly associated with child emotional difficulties. Other symptoms that directly associated with child emotional difficulties were feeling overwhelmed for fathers and anhedonia, sadness, and panic in mothers (fig.1, network 2). ![]()
Conclusions Specific symptom interactions are central to the co-occurrence of depression symptoms between parents. Of interest, only one of the bridge symptoms associated with later child emotional difficulties. In addition, specific symptom-to-child outcomes were identified, suggesting that different symptoms in mothers and fathers are central for increased vulnerability in children. Disclosure No significant relationships.
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Abstract
Severe irritability is one of the commonest reasons prompting referral to mental health services. It is frequently seen in neurodevelopmental disorders that manifest early in development, especially attention-deficit/hyperactivity disorder (ADHD). However, irritability can also be conceptualized as a mood problem because of its links with anxiety/depressive disorders; notably DSM-5 currently classifies severe, childhood-onset irritability as a mood disorder. Investigations into the genetic nature of irritability are lacking although twin studies suggest it shares genetic risks with both ADHD and depression. We investigated the genetic underpinnings of irritability using a molecular genetic approach, testing the hypothesis that early irritability (in childhood/adolescence) is associated with genetic risk for ADHD, as indexed by polygenic risk scores (PRS). As a secondary aim we investigated associations between irritability and PRS for major depressive disorder (MDD). Three UK samples were utilized: two longitudinal population-based cohorts with irritability data from childhood (7 years) to adolescence (15-16 years), and one ADHD patient sample (6-18 years). Irritability was defined using parent reports. PRS were derived from large genome-wide association meta-analyses. We observed associations between ADHD PRS and early irritability in our clinical ADHD sample and one of the population samples. This suggests that early irritability traits share genetic risk with ADHD in the general population and are a marker of higher genetic loading in individuals with an ADHD diagnosis. Associations with MDD PRS were not observed. This suggests that early-onset irritability could be conceptualized as a neurodevelopmental difficulty, behaving more like disorders such as ADHD than mood disorders.
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Childhood bullying victimization is associated with use of mental health services over five decades: a longitudinal nationally representative cohort study. Psychol Med 2017; 47:127-135. [PMID: 27677437 DOI: 10.1017/s0033291716001719] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Research supports robust associations between childhood bullying victimization and mental health problems in childhood/adolescence and emerging evidence shows that the impact can persist into adulthood. We examined the impact of bullying victimization on mental health service use from childhood to midlife. METHOD We performed secondary analysis using the National Child Development Study, the 1958 British Birth Cohort Study. We conducted analyses on 9242 participants with complete data on childhood bullying victimization and service use at midlife. We used multivariable logistic regression models to examine associations between childhood bullying victimization and mental health service use at the ages of 16, 23, 33, 42 and 50 years. We estimated incidence and persistence of mental health service use over time to the age of 50 years. RESULTS Compared with participants who were not bullied in childhood, those who were frequently bullied were more likely to use mental health services in childhood and adolescence [odds ratio (OR) 2.53, 95% confidence interval (CI) 1.88-3.40] and also in midlife (OR 1.30, 95% CI 1.10-1.55). Disparity in service use associated with childhood bullying victimization was accounted for by both incident service use through to age 33 years by a subgroup of participants, and by persistent use up to midlife. CONCLUSIONS Childhood bullying victimization adds to the pressure on an already stretched health care system. Policy and practice efforts providing support for victims of bullying could help contain public sector costs. Given constrained budgets and the long-term mental health impact on victims of bullying, early prevention strategies could be effective at limiting both individual distress and later costs.
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Abstract
BACKGROUND We aimed to test whether childhood bullying victimization increases risk for age-related disease at mid-life using biological markers including inflammation and adiposity, independent of other childhood risk factors and key adult variables. METHOD The present study was a 50-year prospective longitudinal birth cohort study of all births in Britain in 1 week in 1958. Exposure to bullying was assessed prospectively when participants were aged 7 and 11 years (27.7% occasionally bullied; 14.6% frequently bullied). Blood inflammation biomarkers [C-reactive protein (CRP) and fibrinogen] and adiposity [body mass index (BMI) and waist:hip ratio] were measured at age 45 years. RESULTS Participants who had been frequently bullied in childhood showed increased levels of CRP at mid-life [β = 0.07, 95% confidence interval (CI) 0.04-0.10] and higher risk for clinically relevant inflammation cut-off [CRP > 3 mg/l: 20.4% v. 15.9%, odds ratio (OR) = 1.35, 95% CI 1.12-1.64]. Women who were bullied in childhood had higher BMI than non-bullied participants and were at increased risk of being obese (BMI ≥ 30 kg/m2: occasionally bullied: 26.0% v. 19.4%, OR = 1.45, 95% CI 1.18-1.77; frequently bullied: 26.2% v. 19.4%, OR = 1.41, 95% CI 1.09-1.83). Findings remained significant when controlling for childhood risk factors (e.g. parental social class; participants' BMI and psychopathology in childhood) and key adult variables (e.g. adult social class, smoking, diet and exercise). CONCLUSIONS Bullied children show increases in risk factors for age-related disease in middle adulthood, independent of co-occurring childhood and adult risks. Given the high prevalence of bullying victimization in childhood, tackling this form of psychosocial stress early in life has the potential of reducing risk for age-related disease and its associated burden.
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Adolescent conduct problems and premature mortality: follow-up to age 65 years in a national birth cohort. Psychol Med 2014; 44:1077-1086. [PMID: 23962416 PMCID: PMC3948505 DOI: 10.1017/s0033291713001402] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 05/10/2013] [Accepted: 05/20/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Severe youth antisocial behaviour has been associated with increased risk of premature mortality in high-risk samples for many years, and some evidence now points to similar effects in representative samples. We set out to assess the prospective association between adolescent conduct problems and premature mortality in a population-based sample of men and women followed to the age of 65 years. METHOD A total of 4158 members of the Medical Research Council National Survey of Health and Development (the British 1946 birth cohort) were assessed for conduct problems at the ages of 13 and 15 years. Follow-up to the age of 65 years via the UK National Health Service Central Register provided data on date and cause of death. RESULTS Dimensional measures of teacher-rated adolescent conduct problems were associated with increased hazards of death from cardiovascular disease by the age of 65 years in men [hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.04-1.32], and of all-cause and cancer mortality by the age of 65 years in women (all-cause HR 1.16, 95% CI 1.07-1.25). Adjustment for childhood cognition and family social class did little to attenuate these risks. Adolescent conduct problems were not associated with increased risks of unnatural/substance-related deaths in men or women in this representative sample. CONCLUSIONS Whereas previous studies of high-risk delinquent or offender samples have highlighted increased risks of unnatural and alcohol- or substance abuse-related deaths in early adulthood, we found marked differences in mortality risk from other causes emerging later in the life course among women as well as men.
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Importance of grass-legume choices on cattle grazing behavior, performance, and meat characteristics. J Anim Sci 2014; 92:2309-24. [PMID: 24671584 DOI: 10.2527/jas.2013-7297] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We determined if tall fescue in a mixture with either tannin-containing sainfoin or saponin-containing alfalfa affected cattle foraging behavior, performance, meat quality, and consumer acceptance of meat. Foraging behavior, BW, and pasture biomass before and after grazing were monitored when cattle strip-grazed 3 replications of 2 treatments from May through September 2010 (12 calves/replication) and from June through September 2012 (8 calves/replication). Animals were allowed a choice between tall fescue and sainfoin (SAN) or tall fescue and alfalfa (ALF) growing in strips (fescue, legume, and fescue-legume mixture). Incidence of use (scan samples) of legumes increased from the beginning to the end of the trials (P < 0.05), suggesting that cattle learned to mix legumes with tall fescue. Scan samples and assessments of pasture biomass removal revealed greater use of sainfoin than alfalfa when both legumes were abundant in the spring (P < 0.05); that pattern reversed toward the end of the growing season (P < 0.05) as the abundance of sainfoin declined more than that of alfalfa. Intake of forage per kilogram of gain was greater for SAN than for ALF in 2010 (P = 0.0003) and showed a tendency to be greater for SAN than ALF in 2012 (P = 0.19). There were no differences in ADG between SAN and ALF in either year (1 kg/d; P > 0.05). No incidences of bloat were detected. When cattle (3 calves/treatment in 2010 and 8 calves/treatment in 2012) were slaughtered in September to assess meat quality and consumer acceptance, carcasses were lean (4% to 6% fat content of the longissimus muscle), but compared with ALF, SAN had higher marbling scores, quality grades (Select versus Standard), and back fat thicknesses (P < 0.05) in 2012. Steaks from cattle finished on SAN were redder in color than steaks from cattle finished on ALF (P < 0.05; 2012). Meat samples from SAN and ALF showed some differences in unsaturated fatty acid profiles and volatiles concentrations (P < 0.05), but consumer acceptance did not differ between SAN and ALF (P > 0.05). Thus, cattle incorporated a lower-quality grass into their diets even when legumes were available ad libitum during most grazing trials. Choices between tall fescue and legumes differing in the type of secondary compound (tannins vs. saponins) and bloating potential influenced patterns of forage use by cattle and led to differences in meat quality.
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Infant temperament and childhood psychiatric disorder: longitudinal study. Child Care Health Dev 2014; 40:292-7. [PMID: 23551256 DOI: 10.1111/cch.12054] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Temperamental characteristics emerge early in life and can shape children's development, adjustment and behaviour. We aimed to investigate the association between early infant temperament and later childhood psychiatric disorder in a community sample. METHODS This prospective, population-based study used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). In a sample of 7318 children, we investigated whether temperamental characteristics assessed at the ages of 6 months and 24 months are associated with an independent diagnosis of psychiatric disorder ascertained at age 7 years. RESULTS After adjusting for confounders, temperamental characteristics assessed at 6 and 24 months of age were associated with psychiatric disorder at age 7 years. In particular, intensity of emotional reaction at age 6 months was associated with later disorder (adjusted odds ratio = 1.56; 95% confidence interval 1.19, 2.04; P = 0.002). These associations were stronger in girls and in those children with high levels of intensity at both 6 and 24 months of age. CONCLUSIONS Temperamental characteristics involving high levels of emotional intensity within the first year of life are longitudinally associated with psychiatric disorder in mid-childhood, suggesting that the roots of psychiatric disorder may, in some cases, lie very early in life.
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Abstract
Background Adolescent mental health problems are associated with a range of adverse outcomes in adulthood but little is known about the effects on adult parenting practices. This study aimed to examine prospective associations between adolescent conduct and emotional problems and subsequent parenting behaviours in adulthood. Methods The study sample comprised 1110 members from the MRC National Survey of Health and Development. Prospective data were collected from teacher reports of conduct and emotional problems at age 13 and 15 years and adult outcome measures of parenting included intellectual environment, cognitive stimulation, coercive discipline, parental interest and parental aspiration. Results In regression models adjusted for the confounding effects of social background, cognition and education, adolescent conduct problems predicted coercive parenting behaviours in adulthood. The effects of adolescent emotional problems on the development of coercive discipline practices were explained by covariates. Likewise, the inability of parents who displayed conduct problems in adolescence to provide an intellectually stimulating home environment was fully explained by the adjustment for education. Conclusions Adolescents who exhibit conduct problems are more likely to develop coercive styles of parenting.
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Preference for tannin-containing supplements by sheep consuming endophyte-infected tall fescue hay. J Anim Sci 2013; 91:3445-56. [PMID: 23658337 DOI: 10.2527/jas.2012-5406] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Tannins may bind to alkaloids in endophyte-infected (E+) tall fescue and attenuate fescue toxicosis. To test this hypothesis, thirty-two 4-mo-old lambs were randomly assigned to 4 treatments (8 lambs/treatment) in a 2 by 2 factorial design that included a basal diet of tall fescue hay [E+ or endophyte-free (E-)] supplemented with (TS) or without (CS) bioactive Quebracho tannins. The concentration of ergovaline in E+ fed in 2 successive phases was 65 ± 21 µg/kg (Phase 1) and 128 ± 4 µg/kg (Phase 2). After exposure to hays and supplements, all lambs were offered choices between TS and CS and between E+ and E- hays. During Phase 1, lambs offered E+ consumed more hay than lambs offered E- (P = 0.03). Lambs on E+/TS displayed the greatest intake of hay and the least intake of TS (P < 0.05). During Phase 2, when the concentration of ergovaline increased, lambs offered E+ consumed less hay than lambs fed E- (P < 0.0001). Lambs on E+/CS consumed less hay than lambs on E-/CS (P = 0.02), but hay intake by lambs on E-/TS and E+/TS did not differ (P = 0.96). Lambs preferred CS to TS during preference tests (P < 0.0001) and lambs on E+/TS ingested the least amounts of supplement TS and the greatest amounts of supplement CS (P = 0.001). Lambs offered E+ displayed greater body temperatures than lambs offered E- in both phases (P < 0.05). When offered a choice among the 3 hays, lambs previously exposed to E+ preferred E+ (low content of ergovaline) > E- > E+ (greater content of ergovaline; P < 0.001). Thus, decreased concentrations of ergovaline increased rectal temperatures, and affected intake of and preference for tannins and fescue hay. Quebracho tannins did not attenuate the effects of E+ on body temperature and feed intake. Ingestion of E+ reduced intake of quebracho tannins, suggesting that alkaloids in E+ antagonized ingestion of condensed tannins.
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Associations between diurnal preference, sleep quality and externalizing behaviours: a behavioural genetic analysis. Psychol Med 2011; 41:1029-1040. [PMID: 20836908 DOI: 10.1017/s0033291710001741] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Certain aspects of sleep co-occur with externalizing behaviours in youth, yet little is known about these associations in adults. The present study: (1) examines the associations between diurnal preference (morningness versus eveningness), sleep quality and externalizing behaviours; (2) explores the extent to which genetic and environmental influences are shared between or are unique to these phenotypes; (3) examines the extent to which genetic and environmental influences account for these associations. method: Questionnaires assessing diurnal preference, sleep quality and externalizing behaviours were completed by 1556 young adult twins and siblings. RESULTS A preference for eveningness and poor sleep quality were associated with greater externalizing symptoms [r=0.28 (95% CI 0.23-0.33) and 0.34 (95% CI 0.28-0.39), respectively]. A total of 18% of the genetic influences on externalizing behaviours were shared with diurnal preference and sleep quality and an additional 14% were shared with sleep quality alone. Non-shared environmental influences common to the phenotypes were small (2%). The association between diurnal preference and externalizing behaviours was mostly explained by genetic influences [additive genetic influence (A)=80% (95% CI 0.56-1.01)], as was the association between sleep quality and externalizing behaviours [A=81% (95% CI 0.62-0.99)]. Non-shared environmental (E) influences accounted for the remaining variance for both associations [E=20% (95% CI -0.01 to 0.44) and 19% (95% CI 0.01-0.38), respectively]. CONCLUSIONS A preference for eveningness and poor sleep quality are moderately associated with externalizing behaviours in young adults. There is a moderate amount of shared genetic influences between the phenotypes and genetic influences account for a large proportion of the association between sleep and externalizing behaviours. Further research could focus on identifying specific genetic polymorphisms common to both sleep and externalizing behaviours.
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Are children of depressed mothers exposed to higher contextual, family and mother-based risks? Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)72898-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
ObjectiveIn general, depressed mothers experience greater environmental and family risks, and lead riskier lifestyles. Whether the exposure of these risks add to child maladjustment, beyond exposure to maternal depression, is an important unanswered question, and is examined in the present study.MethodIn a total of 9,000 mother-offspring pairs in the Avon Longitudinal Study of Parents and Children, we examined (i) if children of depressed mothers had higher risk exposures than children of non-depressed mothers (32 weeks gestation, child age 1.5 years); (ii) whether maternal depression increased risk for diagnoses of externalizing and internalizing disorders (child age 7.5 years); (iii) the decrease in these odds when we controlled for the risk exposures; and (iv) whether risk exposure increased the odds of a diagnosis, above the influence of maternal depression.ResultsChildren of depressed mothers were exposed to higher levels of risks and maternal depression increased the risk for diagnoses of both externalizing and internalizing disorders. The decrease in these odds was between 25–50% when controlling for child risk exposures. At the same time, risk exposures to the child significantly increased the odds of both externalizing and internalizing diagnoses, above the influence of maternal depression.ConclusionsMaladjustment in offspring of depressed mothers is influenced by risk exposures closely associated with maternal mental health, suggesting that these children are “doubly” hit by risk. It is suggested that the present results may aide in interpreting why treating depressed mothers shows certain levels of beneficial effects for children, but not complete remission.
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Abstract
BACKGROUND Data from a representative community sample were used to explore predictors of lifetime suicidality and to examine associations between distal adolescent and more proximal adult risks. METHOD Data are from a midlife follow-up of the Isle of Wight study, an epidemiological sample of adolescents assessed in 1968. Ratings of psychiatric symptoms and disorder, relationships and family functioning and adversity were made in adolescence; adult assessments included lifetime psychiatric history and suicidality, neuroticism and retrospective reports of childhood sexual abuse and harsh parenting. RESULTS A wide range of measures of childhood psychopathology, adverse experiences and interpersonal difficulties were associated with adult suicidality; associations were particularly strong for adolescent irritability, worry and depression. In multivariate analyses, substantial proportions of these effects could be explained by their association with adult psychopathology and neuroticism, but additional effects remained for adolescent irritability and worry. CONCLUSIONS Factors of importance for long-term suicidality risk are evident in adolescence. These include family and experiential adversities as well as psychopathology. In particular, markers of adolescent worry and irritability appeared both potent risks and ones with additional effects beyond associations with adult disorder and adult neuroticism.
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Abstract
BACKGROUND Developmental reading problems show strong persistence across the school years; less is known about poor readers' later progress in literacy skills. METHOD Poor (n = 42) and normally developing readers (n = 86) tested in adolescence (ages 14/15 years) in the Isle of Wight epidemiological studies were re-contacted at mid-life (ages 44/45 years). Participants completed a spelling test, and reported on educational qualifications, perceived adult spelling competence, and problems in day-to-day literacy tasks. RESULTS Individual differences in spelling were highly persistent across this 30-year follow-up, with correlations between spelling at ages 14 and 44 years of r = .91 (p < .001) for poor readers and r = .89 (p < .001) for normally developing readers. Poor readers' spelling remained markedly impaired at mid-life, with some evidence that they had fallen further behind over the follow-up period. Taking account of adolescent spelling levels, continued exposure to reading and literacy demands in adolescence and early adulthood was independently predictive of adult spelling in both samples; family social background added further to prediction among normally developing readers only. CONCLUSIONS By adolescence, individual differences in spelling and its related sub-skills are highly stable. Encouraging young people with reading disabilities to maintain their exposure to reading and writing may be advantageous in the longer term.
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Parental punitive discipline, negative life events and gene-environment interplay in the development of externalizing behavior. Psychol Med 2008; 38:29-39. [PMID: 17803832 PMCID: PMC2906398 DOI: 10.1017/s0033291707001328] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND To investigate the extent to which three putative 'environmental' risk factors, maternal punitive discipline (MPD), paternal punitive discipline (PPD) and negative life events (NLEs), share genetic influences with, and moderate the heritability of, externalizing behavior. METHOD The sample consisted of 2647 participants, aged 12-19 years, from the G1219 and G1219Twins longitudinal studies. Externalizing behavior was measured using the Youth Self-Report, MPD, PPD and exposure to NLEs were assessed using the Negative Sanctions Scale and the Life Event Scale for Adolescents respectively. RESULT Genetic influences overlapped for externalizing behavior and each 'environmental' risk, indicating gene-environment correlation. When controlling for the gene-environment correlation, genetic variance decreased, and both shared and non-shared environmental influences increased, as a function of MPD. Genetic variance increased as a function of PPD, and for NLEs the only interaction effect was on the level of non-shared environment influence unique to externalizing behavior. CONCLUSION The magnitude of the influence of genetic risk on externalizing behavior is contextually dependent, even after controlling for gene-environment correlation.
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Abstract
BACKGROUND Increased risk of affective disorder in learning disability has been reported, although the extent to which this is due to adverse social and material circumstances is uncertain and there have been potential limitations in the measurement of affective disorder. AIMS To determine risk of affective disorder in those classified with mild learning disability in the British 1946 birth cohort and to investigate whether this risk was accounted for by disadvantage in childhood and adulthood. METHOD Learning disability was defined as the equivalent of an IQ < or =69 at age 15 years. The Present State Examination at age 36 years and the Psychiatric Symptom Frequency Scale at age 43 years provided psychiatric outcome measures. RESULTS Learning disability was associated with a fourfold increase in risk of affective disorder, not accounted for by social and material disadvantage or by medical disorder. CONCLUSIONS Learning disability is strongly associated with risk of affective disorder, persisting well into midlife.
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Abstract
Recent investigations have highlighted associations between maternal smoking in pregnancy and antisocial behaviour in offspring, and suggested the possibility of a causal effect. We used data from the 1970 British birth cohort study (BCS70) to examine these links in a large. population-based sample studied prospectively from birth to age 16. We found a strong dose-response relationship between the extent of pregnancy smoking and childhood-onset conduct problems, but no links with adolescent-onset antisocial behaviours. Effects on childhood-onset conduct problems were as marked for girls as for boys, and were robust to controls for a variety of social background factors and maternal characteristics. Controls for mothers' subsequent smoking history modified this picture, however, suggesting that the prime risks for early-onset conduct problems may be associated with persistent maternal smoking--or correlates of persistent smoking--rather than with pregnancy smoking per se.
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Financial cost of social exclusion: follow up study of antisocial children into adulthood. BMJ (CLINICAL RESEARCH ED.) 2001; 323:191. [PMID: 11473907 PMCID: PMC35269 DOI: 10.1136/bmj.323.7306.191] [Citation(s) in RCA: 605] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/25/2001] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To compare the cumulative costs of public services used through to adulthood by individuals with three levels of antisocial behaviour in childhood. DESIGN Costs applied to data of 10 year old children from the inner London longitudinal study selectively followed up to adulthood. SETTING Inner London borough. PARTICIPANTS 142 individuals divided into three groups in childhood: no problems, conduct problems, and conduct disorder. MAIN OUTCOME MEASURES Costs in 1998 prices for public services (excluding private, voluntary agency, indirect, and personal costs) used over and above basic universal provision. RESULTS By age 28, costs for individuals with conduct disorder were 10.0 times higher than for those with no problems (95% confidence interval of bootstrap ratio 3.6 to 20.9) and 3.5 times higher than for those with conduct problems (1.7 to 6.2). Mean individual total costs were 70 019 pounds sterling for the conduct disorder group (bootstrap mean difference from no problem group 62 pound sterling; 898 pound sterling 22 692 pound sterling to 117 pound sterling) and 24 324 pound sterling (16 707 pound sterling; 6594 pound sterling to 28 149 pound sterling) for the conduct problem group, compared with 7423 pound sterling for the no problem group. In all groups crime incurred the greatest cost, followed by extra educational provision, foster and residential care, and state benefits; health costs were smaller. Parental social class had a relatively small effect on antisocial behaviour, and although substantial independent contributions came from being male, having a low reading age, and attending more than two primary schools, conduct disorder still predicted the greatest cost. CONCLUSIONS Antisocial behaviour in childhood is a major predictor of how much an individual will cost society. The cost is large and falls on many agencies, yet few agencies contribute to prevention, which could be cost effective.
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Adolescent psychological problems, partnership transitions and adult mental health: an investigation of selection effects. Psychol Med 2001; 31:291-305. [PMID: 11232916 DOI: 10.1017/s0033291701003403] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Marital status is a strong correlate of psychiatric morbidity in adulthood, but debate continues on how far this association reflects causal influences or selection effects based on prior psychological characteristics. METHOD Prospective data from the National Child Development Study were used to examine effects of adolescent emotional and behavioural problems on transitions into and out of first partnerships, and their implications for psychiatric morbidity at age 33. RESULTS Emotional and behavioural problems in adolescence showed systematic links with early partnership transitions (age at partnership formation, type of first partnership, and risks of first partnership breakdown). More detailed tests suggested that these effects only accounted for a modest proportion of the associations between partnership status and psychiatric morbidity at age 33. CONCLUSIONS In a non-referred community sample selection effects associated with adolescent emotional and behavioural problems appear to play only a modest role in links between partnership status and adult mental health.
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Psychological disturbance and service provision in parentally bereaved children: prospective case-control study. BMJ (CLINICAL RESEARCH ED.) 1999; 319:354-7. [PMID: 10435957 PMCID: PMC28190 DOI: 10.1136/bmj.319.7206.354] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/28/1999] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To identify whether psychiatric disturbance in parentally bereaved children and surviving parents is related to service provision. DESIGN Prospective case-control study. SETTING Two adjacent outer London health authorities. PARTICIPANTS 45 bereaved families with children aged 2 to 16 years. MAIN OUTCOME MEASURES Psychological disturbance in parentally bereaved children and surviving parents, and statistical associations between sample characteristics and service provision. RESULTS Parentally bereaved children and surviving parents showed higher than expected levels of psychiatric difficulties. Boys were more affected than girls, and bereaved mothers had more mental health difficulties than bereaved fathers. Levels of psychiatric disturbance in children were higher when parents showed probable psychiatric disorder. Service provision related to the age of the children and the manner of parental death. Children under 5 years of age were less likely to be offered services than older children even though their parents desired it. Children were significantly more likely to be offered services when the parent had committed suicide or when the death was expected. Children least likely to receive service support were those who were not in touch with services before parental death. CONCLUSIONS Service provision was not significantly related to parental wishes or to level of psychiatric disturbance in parents or children. There is a role for general practitioners and primary care workers in identifying psychologically distressed surviving parents whose children may be psychiatrically disturbed, and referring them to appropriate services.
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Abstract
BACKGROUND The Malaise Inventory is a commonly used self-completion scale for assessing psychiatric morbidity. There is some evidence that it may represent two separate psychological and somatic subscales rather than a single underlying factor of distress. This paper provides further information on the factor structure of the Inventory and on the reliability and validity of the total scale and two sub-scales. METHODS Two general population samples completed the full Inventory: over 11,000 subjects from the National Child Development Study at ages 23 and 33, and 544 mothers of adolescents included in the Isle of Wight epidemiological surveys. RESULTS The internal consistency of the full 24-item scale and the 15-item psychological subscale were found to be acceptable, but the eight-item somatic sub-scale was less reliable. Factor analysis of all 24 items identified a first main general factor and a second more purely psychological factor. Receiver operating characteristic (ROC) analysis indicated that the validity of the scale held for men and women separately and for different socio-economic groups, by reference to external criteria covering current or recent psychiatric morbidity and service use, and that the psychological sub-scale had no greater validity than the full scale. CONCLUSIONS This study did not support the separate scoring of a somatic sub-scale of the Malaise Inventory. Use of the 15-item psychological sub-scale can be justified on the grounds of reduced time and cost for completion, with little loss of reliability or validity, but this approach would not significantly enhance the properties of the Inventory by comparison with the full 24-item scale. Inclusion of somatic items may be more problematic when the full scale is used to compare particular sub-populations with different propensities for physical morbidity, such as different age groups, and in these circumstances it would be a sensible precaution to utilise the 15-item psychological sub-scale.
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Abstract
BACKGROUND Evidence on the adult adaptation of individuals with mild mental retardation (MMR) is sparse, and knowledge of the factors associated with more and less successful functioning in MMR samples yet more limited. METHOD Prospective data from the National Child Development Study were used to examine social circumstances and psychosocial functioning in adulthood in individuals with MMR and in a non-retarded comparison group. RESULTS For many individuals with MMR, living circumstances and social conditions in adulthood were poor and potential stressors high. Self-reports of psychological distress in adulthood were markedly elevated, but relative rates of psychiatric service use fell between childhood and adulthood, as reflected in attributable risks. Childhood family and social disadvantage accounted for some 20-30% of variations between MMR and non-retarded samples on a range of adult outcomes. Early social adversity also played a significant role in contributing to variations in functioning within the MMR sample. CONCLUSIONS MMR appears to be associated with substantial continuing impairment for many individuals.
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Heterogeneity of antisocial behavior: causes, continuities, and consequences. NEBRASKA SYMPOSIUM ON MOTIVATION. NEBRASKA SYMPOSIUM ON MOTIVATION 1998; 44:45-118. [PMID: 9385594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Abstract
Adoption studies are able to provide important insights into the impact of changed rearing environments for children's development. A number of studies reporting on the childhood adjustment of adoptees have found an increased risk for disruptive behaviour problems when compared with children brought up in intact families. The long-term implications of adoption for psychosocial adjustment in adult life are less clear. We have used data from the National Child Development Study (NCDS) to examine the psychosocial functioning over a number of life-domains of an unselected sample of adoptees, non-adopted children from similar birth circumstances, and other members of the cohort. Adopted women showed very positive adult adjustment across all the domains examined in this study, whilst our findings suggest some difficulty in two specific domains (employment and social support) for adopted men. Implications of the findings are discussed.
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Abstract
BACKGROUND Many social and demographic correlates of psychiatric disorder have shown marked secular changes in recent decades. This study was designed to explore some of the implications of these trends, focusing on the illustrative case of teenage motherhood. METHOD Prospective data from two British birth cohort studies (the 1946 and 1958 cohorts) were used to examine the social, educational and behavioural precursors of teenage versus older age at motherhood, and the implications of teenage motherhood for women's later marital and social circumstances and risks of psychiatric morbidity, in samples born 12 years apart. RESULTS Educational and social disadvantage were associated with similarly increased risks of teenage motherhood in both cohorts, but the findings suggested an additional association with teacher-rated adolescent conduct problems in the more recent sample. Rates of teacher-rated emotional problems were not elevated among teenage mothers in either cohort. In adult life, teenage motherhood was associated with a range of adverse social outcomes, including partnership breakdowns, large family size, and poorer housing conditions. Relative risks of these adult adversities were similar for teenage mothers in the two cohorts, but absolute levels of adversity were higher in the more recent sample, reflecting general secular changes in many of the indicators involved. In the later, but not the earlier, cohort, teenage motherhood was also associated with increased risks for psychiatric morbidity in adulthood. CONCLUSIONS The findings underline the importance of taking account of secular trends in examining the impact of psychosocial risks.
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Integrating nature and nurture: implications of person-environment correlations and interactions for developmental psychopathology. Dev Psychopathol 1997; 9:335-64. [PMID: 9201448 DOI: 10.1017/s0954579497002083] [Citation(s) in RCA: 279] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The developmental interplay between nature and nurture is discussed, with particular reference to implications for research in developmental psychopathology. The general principles include individual differences in reactivity to the environment, two-way interplay between intraindividual biology and environmental influences, and the need to consider broader social contextual features. Individuals actively process their experiences; they also act on their environment to shape and select their experiences, and individual characteristics change over time. Key findings on genetic effects include their ubiquitous influence, the multifactorial origin of most psychopathology, the involvement of several genes in most mental disorders, some genetic effects operate through dimensional risk features rather than directly on disorder, some genetic effects are dependent on gene-environment correlations and interactions, and genetic effects increase with age. Key findings on environmental effects include their ubiquitous influence, the genetic mediation of some supposed environmental effects, the importance of passive gene-environment correlations, the paucity of evidence regarding environmental effects on lifetime liability to psychopathology, the lack of understanding of environmental effects on the organism, and the importance of nonshared environmental effects. Research strategies to investigate environmental risk mediation include the range of genetically sensitive designs, migration studies, secular trend investigations, studies of nonfamilial environments, and examination of intraindividual change in relation to measured environmental alterations. Proximal processes involved in person-environment interplay are discussed in relation to person-environment interactions and evocative and active person-environment correlations.
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Abstract
Much evidence for associations between adverse experiences in childhood and personality disorder in adult life comes from retrospective accounts. This raises important questions over the reliability and validity of long-term recall. The strengths and limitations of different methods for assessing the accuracy and stability of retrospective reports are discussed. Evidence from cognitive psychology on memory and memory processes, and on the phenomenon of infantile amnesia, provides important background for assessing issues more specific to recall in studies of risk for psychopathology. Here, topics of particular concern include: memory for traumatic early experience; the effects of mood state and symptomatology on recall; recovered or false memories; and the implications of mental representations of early experience for understanding psychopathology. Current evidence suggests that while adequately reliable accounts of many early experiences can be gained using appropriate techniques, further methodological studies are needed, and investigations using retrospective methods would be wise to include corroborative evidence whenever feasible.
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Abstract
Numerous studies have reported statistical associations between adverse childhood experiences and psychopathology in adult life. A range of conceptual and methodological issues needs to be borne in mind in interpreting these findings. Methodological issues include implications of base rates of postulated risk and outcome measures, and the possibility of third variable effects. Conceptually, further evidence is needed on the aspects of early experience most likely to contribute to risk (acute vs chronic stressors: actively negative vs lack of positive experiences; and the implications of cognitive processing of events); the specificity of effects; possible mechanisms involved in mediating effects in childhood, and approaches to testing them: and factors involved in persistence into adult life. There are good reasons to assume that adverse early experience plays a contributory role in the genesis of personality disorder. However, at this stage, evidence is still limited on how this comes about.
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Abstract
Adverse childhood experiences--especially inadequacies in early parental care--are associated with elevated rates of both acute and chronic psychosocial disorders in adult life. In most instances, adverse outcomes are confined to a minority of children exposed; variations in the severity or pervasiveness of early risk, individual differences in susceptibility, and interactions with later stressors are all thus likely to be important in mediating effects. At present, knowledge of intervening processes is limited, and dependent on retrospective studies of adult samples or short-term longitudinal findings in childhood. We review current evidence on the long-term outcomes of prenatal divorce, childhood maltreatment, and institutional rearing, and on the early antecedents of depression and antisocial behaviour in adult life, to highlight possible interviewing mechanisms. Most long-term sequelae seem likely to depend on a series of shorter-term links, some running through elevated risks of continued environmental adversity, others through psychological vulnerabilities and problems in social relationships.
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Abstract
Samples of poor and normal readers were followed through adolescence and into early adulthood to assess continuities in the comorbidity between reading difficulties and disruptive behaviour problems. Reading-disabled boys showed high rates of inattentiveness in middle childhood, but no excess of teacher-rated behaviour problems at age 14 and no elevated rates of aggression, antisocial personality disorder or officially recorded offending in early adulthood. Increased risks of juvenile offending among specifically retarded-reading boys seemed associated with poor school attendance, rather than reading difficulties per se. Reading problems were associated with some increases in disruptive behaviour in their teens in girls.
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Abstract
In the late 1960s, a series of epidemiological studies of educational and behavioural problems in middle childhood was undertaken on the Isle of Wight. In 1970, similar methods were used with an inner London sample of 10-year-olds to explore area differences in prevalence rates and correlates. Members of the London cohort have since been followed-up through their teens, to assess the longer-term implications of such problems for educational attainments, early employment prospects, and adolescent behavioural difficulties. School influences on children's development also constituted a central focus of these later stages of the work. This paper draws together the main findings of the London studies to date, and includes a full list of the main publications.
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Abstract
The implications of the frequent overlap between reading and behavioural disorders in childhood are explored using follow-up findings on the secondary school progress and early work histories of four groups of boys, with an without reading retardation, and with and without behavioural disturbance. While the prognosis for the majority of the retarded readers appeared poor, certain particular features-high rates of early school leaving, unstable work records and especially depressed skill levels-characterized those with associated behavioural problems. The importance of separating out the effects of additional associated disorders and disadvantages in assessing the long-term prognosis for children with learning problems is discussed.
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