Hyperactivity and impulsivity in childhood associated with increased risk of social isolation

Hyperactivity and impulsivity in childhood associated with increased risk of social isolation

Hyperactivity and impulsivity in childhood associated with increased risk of social isolation

Research led by the Social, Genetic & Developmental Psychiatry (SGDP) Centre at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, has found that children who show heightened hyperactivity or impulsivity have an increased risk of experiencing social isolation as they get older.

a young girl holding a leaf

The study, published in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) Open, investigated the associations between symptoms of Attention-Deficit Hyperactivity Disorder (ADHD) and social isolation throughout childhood.

Using data from the Environmental Risk (E-Risk) Longitudinal Twin Study, mother- and teacher-reported social isolation and ADHD symptoms of hyperactivity/impulsivity and inattention were measured in 2232 British children at ages five, seven, 10 and 12.

Researchers found that children who showed increased ADHD symptoms had a greater risk of becoming isolated later in childhood. When investigating the two sets of ADHD symptoms separately, they found children who were more hyperactive were at increased risk of experiencing social isolation as they got older. Whereas symptoms of inattention alone were not associated with social isolation.

“Using data from a large longitudinal study, we found that children who showed ADHD symptoms in childhood – particularly hyperactivity or impulsivity – were more likely to experience social isolation later on.”

Katherine Thompson

PhD student at the SGDP Centre and lead author of the study

Katherine Thompson continued: “Negative interactions with their peers may lead children with ADHD to become withdrawn, rejected, lonely and isolated. A focus on combating negative biases around neurodiversity in schools and local communities could help reduce experiences of social isolation for these children. Our findings suggest that social isolation should be carefully assessed in children with ADHD and that they could benefit from interventions aimed at increasing social participation and easing social challenges.”

Previous research suggested that socially isolated children could be at risk for heightened symptoms of ADHD. However, this new research finds that this is not the case. Here, the researchers used more complex methods to account for each individual’s pre-existing characteristics and accurately assess both directions of the association between ADHD symptoms and social isolation within the same model.

“Research suggests children with ADHD symptoms can find it difficult to register social cues and establish friendships. These social difficulties can be detrimental to many forms of physical and mental health. Our study highlights the importance in enhancing peer social support and inclusion for children with ADHD, particularly in school settings.”

Professor Louise Arseneault

Professor of Developmental Psychology at the SGDP Centre and senior author of the study

The study received funding support from the National Institute of Child Health and Human Development and the Jacobs Foundation. Katherine Thompson is funded by the London Interdisciplinary Social Science Doctoral Training Partnership (LISS DTP) through the Economic and Social Research Council. The E-Risk Longitudinal Twin Study is funded by the UKRI Medical Research Council.

Do children with ADHD symptoms become socially isolated? Longitudinal within-person associations in a nationally representative cohort’ (Katherine Thompson, Jessica Agnew-Blais, Andrea Allegrini, Bridget Bryan, Andrea Danese, Candice Odgers, Timothy Matthews, and Louise Arseneault) was published in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) Open (DOI: 10.1016/j.jaacop.2023.02.001).

For more information, please contact Patrick O’Brien (IoPPN’s Senior Media Officer).

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Co-occurring parental depression symptoms in infancy linked with child emotional difficulties in early adolescence

Co-occurring parental depression symptoms in infancy linked with child emotional difficulties in early adolescence

Co-occurring parental depression symptoms in infancy linked with child emotional difficulties in early adolescence

New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London has found when one parent experiences guilt as a symptom of depression during their child’s infancy, it triggers depression symptoms in the other parent and goes on to impact the child’s emotional wellbeing.

a young girl holding a leaf

The paper, published in the British Journal of Psychiatry, found that when one parent experienced the specific depression symptom, guilt, during their child’s infancy, this activated symptoms of depression in the other parent and had a further knock-on effect on child emotional wellbeing during early adolescence.

Researchers studied 4,492 mother–father–child trios from the Avon Longitudinal Study of Parents and Children (ALSPAC), a large group of 14,000 families in England. Parents self-reported their depression symptoms when their child was 21 months old, and mother-reported child emotional difficulties were measured when the child was age nine, 11 and 13.

The findings suggest that specific symptom ‘cascades’ from parent, to parent, to child, are central for co-occurring depression in parents and increased vulnerability in children, providing potential targets for interventions.

Alex Martin, research associate at King’s IoPPN and lead author of the study said: “Symptoms of depression can often co-occur in mothers and fathers, and together can have a substantial impact on their child’s emotional wellbeing. However, little is understood about symptom-level mechanisms underlying the co-occurrence of depression symptoms in families.”

“Our study used network analysis – a method which identifies clusters of traits and analyses how they influence one another – to identify specific symptoms that can pass between parents and are associated with later child emotional difficulties. We found that guilt, in particular, appeared to ‘cascade’ from parent, to parent, to child.”

Alex Martin

research associate at King’s IoPPN and lead author of the study

Alex Martin continued: “Becoming a parent is one of the biggest transitions most people will experience. Of course, most people want to be the best parent they can which can create a huge pressure, sometimes manifesting in overwhelming feelings of guilt. Our findings suggest that these feelings may have a long-lasting negative impact on children as they grow up.”

When exploring the impact of parental depression symptoms on later child emotional wellbeing, the researchers found that, for mothers, guilt, anhedonia (the inability to feel pleasure), panic and sadness were highly connected with child emotional difficulties. The authors propose that this may be explained in part by the impact of depression on mothers’ parenting and the transmission of depressive thinking styles from mothers to their children.

For fathers, only the symptom of feeling overwhelmed was directly associated with child emotional difficulties. However, guilt and anhedonia in fathers appeared to be indirectly associated with child emotional difficulties when mothers were also experiencing these same symptoms.

By investigating mother and father depression at the symptom level, the researchers identified specific symptoms that may play a role in mutually reinforcing and activating depression symptoms between parents. When experienced by one parent, thoughts about self-harm also triggered and reinforced depression symptoms in the other parent but did not go on to impact the child’s later emotional wellbeing.

Professor Ted Barker, Professor in Development and Psychopathology at King’s IoPPN and senior author on the study, said: “The symptom of feeling guilty seems to play a particularly important role in familial transmission of depression, acting as a reinforcing bridge between parents, and providing a pathway from father to mother to child.”

“Guilt, as well as the other symptoms identified in this study, may therefore provide clinical targets when depression co-occurs between parents. By reducing these influential symptoms, it may reduce the activation of the wider network of depression between parents.”

Professor Ted Barker

Professor in Development and Psychopathology at King’s IoPPN and senior author on the study

This study was funded by the Eunice Kennedy Shriver National Institute of Child Health & Human Development and the Economic and Social Research Council.

For more information, please contact Amelia Remmington (IoPPN Communications and Engagement Officer).

Mother and father depression symptoms and child emotional difficulties: a network model (Alex F. Martin, Barbara Maughan, Deniz Konac and Edward D. Barker) (DOI: 10.1192/bjp.2023.8) was published in the British Journal of Psychiatry.

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Is ADHD being over-diagnosed?

Is ADHD being over-diagnosed?

Is ADHD being over-diagnosed?

In conversation with Sarah Montague on BBCRadio4 World at One, Professor Emily Simonoff and Professor Dinesh Bhugra explain that although ADHD is more common in adults than we previously thought, it must be diagnosed by a professional with expertise in adult ADHD.

a young girl holding a leaf

Professor Simonoff, Director of the King’s Maudsley Partnership, said: “It may be helpful for some people to complete online screening questionnaires to help them determine if some of the things they’re experiencing might be related to ADHD, but the next step would be to get a professional opinion.”

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New mental health research project for young people in India

New mental health research project for young people in India

New mental health research project for young people in India

Funding has been awarded by Grand Challenges Canada for a new global mental health project which aims to co-design and evaluate a bilingual web-based storytelling intervention intended to reduce anxiety, depression and social disability for young people aged 16-24 years in India.

a young girl holding a leaf

The 2-year project, called ‘Baatcheet’ (Hindi for ‘conversation’), is supported by an award from the ‘Global Mental Health Grand Challenge: Mental Health and Wellbeing of Young People’ scheme, launched in December 2022.

Baatcheet will be led by the non-profit organisation Sangath, one of India’s leading mental health research institutions. Dr Daniel Michelson, Clinical Senior Lecturer at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), will lead King’s contributions to the project with Pattie Gonsalves as Principal Investigator/Project Director in India.

India comprises 20% of the entire global population of 16-24-year-olds. Young people in this age group are the earliest adopters of digital applications worldwide, with uptake and sustained use strongly determined by cost and usability of technologies.

“We’re delighted to take forward the Baatcheet project with support from Grand Challenges Canada, funding from the Government of Canada and in partnership with Sangath in India. Sangath and King’s have a long track record of collaboration and this project will harness the expertise of both partners in scalable, mental health practice innovations.

Dr Daniel Michelson

Clinical Senior Lecturer at the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN)

Baatcheet builds on Dr Michelson’s and Ms Gonsalves’ work across several Wellcome-funded public engagement and research projects in India (PRIDE, It’s Ok To Talk and Mann Mela) over the last seven years. Self-care approaches, including the use of personal narratives, have featured prominently in these adolescent mental health initiatives. A related Wellcome-commissioned systematic review looks at evidence for the therapeutic benefits of young people’s self-disclosure about mental health problems.

Following from this evidence, the Baatcheet research team have opted for a simplified digital platform that is appropriate for harnessing the intimacy and immediacy of storytelling.

“We will establish a digital storytelling platform – designed with and for young people – that can help users to better understand and respond to their own mental health difficulties. This approach has the potential to strengthen self-management and reduce self-stigma in a group of highly stressed and disadvantaged young people.

Dr Daniel Michelson

Clinical Senior Lecturer at the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN)

Baatcheet will incorporate the mental health narratives of young people from low-income communities in New Delhi into a user-friendly website. Participants will be offered structured support to engage with the story-based content. The innovation is intended to improve mental health and social outcomes by building capacity for reflective self-care and enhancing a sense of personal control that is particularly lacking for chronically stressed and socially marginalised young people.

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Parenting intervention improves behaviour in autistic children and reduces parental stress

Parenting intervention improves behaviour in autistic children and reduces parental stress

Parenting intervention improves behaviour in autistic children and reduces parental stress

New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London shows that ‘Predictive Parenting’, a group-based behavioural parenting intervention for parents of autistic children reduces children’s emotional and behavioural difficulties as well as parental stress in the long term.

a young girl holding a leaf

The study, published in the Journal of the American Academy of Child and Adolescent Psychiatry, followed-up parents of autistic children during the 2020 COVID-19 lockdown to investigate the longer-term effects of the intervention that was first delivered pre-pandemic .

Predictive Parenting provides parents with information about autism and combines it with hands-on, active skills training to help them better understand and manage common co-occurring difficult emotions and behaviour.

Researchers conducted follow-up questionnaires and interviews with 49 parents of autistic children who participated in the Autism Spectrum Treatment and Resilience (ASTAR) pilot trial in 2017-18. Parents were randomly assigned to receive either the Predictive Parenting intervention or Psychoeducation (information about autism and signposting to resources without specific guidance on managing emotions or behaviour).

Parents who received Predictive Parenting reported a significant reduction in child irritability and parenting stress during the COVID-19 pandemic, two years after the intervention. In contrast, child irritability and parenting stress reported by those who received Psychoeducation had returned to pre-intervention levels two years later. The findings show that Predictive Parenting may be a viable intervention to support children with autism and their families.

“The COVID-19 pandemic and ensuing lockdown provided uniquely disruptive conditions to see how families with autistic children were adapting to a change in their routines. We re-contacted parents who took part in our pre-pandemic pilot trial to assess the longer-term impact of the Predictive Parenting intervention, and see how these families were coping during the pandemic.

Dr Melanie Palmer

Research Associate at King’s IoPPN and the study’s joint first author with Dr Virginia Carter Leno

Dr Melanie Palmer, Research Associate at King’s and the study’s joint first author with Leno, said,

“Our study shows that Predictive Parenting provided families with useful tools that were effective two years later during the unprecedented circumstances of the pandemic.”

In the follow-up questionnaires and interviews, parents shared positive feedback on both interventions and reported utilising strategies from Predictive Parenting during the COVID-19 lockdowns.

The findings suggest that Predictive Parenting may have a positive impact on child behaviour and parenting stress in the longer-term. The strategies taught in Predictive Parenting may be particularly beneficial during periods of uncertainty and stress such as the COVID-19 pandemic, as it aimed to help parents promote predictability. It is also noted that during the COVID-19 lockdowns, parents and children spent more time together so using strategies during this time may have had greater impact.

Professor Emily Simonoff, Interim Director of the King’s Maudsley Partnership for Children and Young People’s Mental Health and senior author on the paper, said: “Our initial pilot trial, which was completed two years before the pandemic began, showed favourable but not statistically significant outcomes for those parents in Predictive Parenting in comparison to Psychoeducation immediately after the intervention was completed. The findings of this follow-up study are welcome as any beneficial effects of many interventions tend to erode over time. Here we found increasing benefits at follow-up which suggests that some families need time to embed new strategies into their home routine for this to translate to improvements in child behaviour. This is a promising intervention for some of the most common co-occurring problems experienced by parents of autistic children. Now, we want to confirm our findings in a large-scale clinical trial.”

A parent who participated in the study said: “Trying to break down why they’re doing something has been really helpful. Before I would be stressed out because I don’t understand [his behaviour]. Now I take a step back and think ‘OK, why is he doing this?’. Then from there I can react a bit better. I have more patience and can figure out, ‘OK is it attention?’, then I need to spend some time with him. It has helped a lot.”

Another parent said: “There was just a single route that she wanted to take [to school]. One of the specific successes for me was I started introducing slight differences in route and that worked. When we were home during the lockdown and even subsequently, we used to go for walks and it was good to see that she continued saying ‘let’s explore a new route’. So that has been a very positive thing.”

The study was led by researchers at the IoPPN and involved clinicians from South London and Maudsley NHS Foundation Trust and the Newcomen Centre at the Evelina Children’s Hospital. It was funded by the National Institute for Health and Care Research (NIHR) with additional support from the Maudsley Charity. Professor Emily Simonoff and Professor Andrew Pickles (another co-author) are supported by the NIHR Maudsley Biomedical Research Centre and are NIHR Senior Investigators.

‘Effects of a parenting intervention for emotional and behavioral problems in young autistic children under conditions of enhanced uncertainty: Two-year follow-up of a pilot randomized controlled trial cohort (ASTAR) during the UK COVID-19 pandemic’ (Melanie Palmer, Virginia Carter Leno, Victoria Hallett, Joanne Mueller, Lauren Breese, Andrew Pickles, Vicky Slonims, Stephen Scott, Tony Charman, Emily Simonoff) was published in the Journal of the American Academy of Child and Adolescent Psychiatry (DOI:10.1016/j.jaac.2022.09.436).

For more information, please contact Patrick O’Brien (Senior Media Officer).

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New framework aims to unlock the potential for social media research into young people’s mental health

New framework aims to unlock the potential for social media research into young people’s mental health

New framework aims to unlock the potential for social media research into young people’s mental health

Research led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London proposes a new framework to empower young people in providing informed consent to social media data access by researchers to better understand the relationship between social media and young people’s mental health.

a young girl holding a leaf

The paper, published today in Frontiers in Psychiatry, lays out four core elements to facilitate regulated, confidential access for researchers to social media data in order to make long-term progress toward improved public mental health.

Social media data offers unique insights into the details of a user’s online activities. Currently, ‘enhancing user experience’ is the main factor that social media platforms apply in determining if access to data is granted. However, accredited researchers’ use of social media platform data does not usually improve user experience in the commercial sense, rather it has the potential for wider public health benefits. As a result, researchers rely either on self-reported social media use (which is not accurate) or on study participants requesting a copy of their own social media data and providing this to researchers in a non-user-friendly way.

Access to social media data will help researchers understand the interactions and perceptions of users and provide insight into mental health and wellbeing. The new framework, developed in collaboration with a lived experience advisor, psychiatrists and researchers, proposes four core elements to facilitate secure and regulated researcher access to data:

    1. Determining research need: Qualified researchers at accredited universities intending to use social media data to understand and improve young people’s mental health should co-produce their research with patients, carers and members of the public to justify the rationale for data access.
    2. Ethical approval and informed consent: Participants should always be empowered to understand why and how their data will be used for research. This should be in accessible formats which service user groups co-produce with researchers.
    3. Data access and analysis: Robust data management guidelines and well-defined accountability of individual institutions should be established. Having a trained service user group with lived experience involved in data analysis can realign researchers’ misinterpretations and challenge the ways in which findings are reported.
    4. Open dissemination: It is recommended for peer review to be conducted before data collection and public dissemination, emphasising the importance of the research question and the quality of methodology. Lived experience advisers or service user researchers should be included in the creation of any documents, briefings and research papers arising from the research to promote accessibility, transparency and collaboration for the public and academic community.

Co-production with user and stakeholder groups is the cross-cutting theme incorporated into each of the four elements. Researchers should work collaboratively with those with lived experience, carers and members of the public to first identify the research priorities and then co-produce research protocols and methods.

“We know social media has an impact on young people’s mental health and wellbeing, but there is not enough evidence to determine who is affected, how and to what extent. Although social media has strengthened communication networks for many, the dangers posed to at-risk young people are serious. It is important that we unlock social media data’s potential for research and use this data for societal good. We hope this framework will be a ‘call to action’ to stimulate social media platforms, policy makers, researchers, users and stakeholder groups to make positive changes by collaborative working.”

Dr Rina Dutta

Reader in Suicidology and Psychiatry and Consultant Psychiatrist at King’s IoPPN and South London and Maudsley NHS Foundation Trust and the study’s senior author

Proposed framework to facilitate regulated, confidential access for researchers to social media data to investigate young people’s mental health.

This work was supported by UK Research and Innovation (UKRI), Medical Research Foundation, Medical Research Council and the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre.

Maximizing the positive and minimizing the negative: Social media data to study youth mental health with informed consent (Daniel Leightley, Amanda Bye, Ben Carter, Kylee Trevillion, Stella Branthonne-Foster, Maria Liakata, Anthony Wood, Dennis Ougrin, Amy Orben, Tasmin Ford, Rina Dutta) was published in Frontiers in Psychiatry (DOI: 10.3389/fpsyt.2022.1096253)

For more information, please contact Franca Davenport, Communications and Engagement Manager (part-time), NIHR Maudsley Biomedical Research Centre, franca.davenport@kcl.ac.uk Tel: +44(0) 7976 918968.

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