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Katherine Thompson continued: “Negative interactions with their peers may lead children with ADHD to become withdrawn, rejected, lonely and isolated.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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Let’s Talk About It: Eating Disorders Awareness Week 2023

Let’s Talk About It: Eating Disorders Awareness Week 2023

Let’s talk about it: Eating Disorders Awareness Week 2023
Organised by the charity BEAT, National Eating Disorder Awareness Week highlighted the realities of living with an eating disorder. This year it took place on the 27th February – 5th March 2023.

Approximately 1.25 million people in the UK have an eating disorder. Throughout the week, we shared information and tips to support parents and carers on the many eating disorders affecting children and young people’s mental health.

What is an eating disorder?

Children’s mental health has never been so critical, this week offered a vital opportunity to reflect on how we can support young people.

Last year, NHS Digital found 12.9% of 11 to 16 year olds and 60.3% of 17 to 19 year olds had possible eating problems but what is an eating disorder?

An eating disorder is a mental health condition where you use the control of food to cope with feelings and other situations. Unhealthy eating behaviours may include eating too much or too little or worrying about your weight or body shape.

Anyone can get an eating disorder, but teenagers between 13 and 17 are mostly affected. Are you supporting a child with an eating disorder or need support yourself? Watch the videos below to see four ways you can support a child or young person with an eating disorder.

As part of the Mind of the Matter series, Professor Ulrike Schmidt from King’s College London, discussed how eating disorders have manifested in groups of people over the pandemic, exposed health inequalities and a disparity in access to treatment – you can find the full video below.

With treatment, most people can recover from an eating disorder. Cassius, an ex-service user, shared his story of recovery adding that “Recovery is more than possible. It happened, and it’s made me who I am today.”

What are the different types of eating disorders?

Anorexia Nervosa

Anorexia can cause severe physical problems because of the effects of starvation on the body. If you’re worried about a child or young person’s eating habits, weight or shape – the best way forward is to get help and support early.

 

Binge Eating Disorder (BED)

There are a number of ways that binge eating disorder can impact a young person’s life. Often (though not always) it can cause weight gain, and in terms of physical health, can be associated with high blood pressure, high cholesterol, type 2 diabetes and heart disease.

 

Bulimia

There are several reasons that someone might develop bulimia, and many factors that can contribute but know that just being there for them can also play a crucial role in helping them to get better. If you’re worried about someone you know, even if only some of the signs are present, you should still seek help immediately, as this gives the best chance of recovery.

What is EDIFY?

EDIFY (Eating Disorders: Delineating Illness and Recovery Trajectories to Inform Personalised Prevention and Early Intervention in Young People) is a four year project, led by researchers at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s which aims to revolutionise how eating disorders are perceived, prevented and treated in young people.

By combining the arts and science, researchers will build a detailed picture of why young people develop eating disorders, how they progress over time and what we can do to help.

The EDIFY project, involving over 1000 participants, ensures young people with lived experience of eating disorders are at the heart of the project, serving as advisors and co-producers throughout.

Through this work we will expand professional and public perceptions of eating disorders, share under-represented voices and encourage advances in policy and clinical practice.

In their PaperMate series, the EDIFY team speak to eating disorders researchers about recent projects, such as the experiences of men and the impact of COVID.

What is FREED?

FREED is the First episode Rapid Early intervention for Eating Disorders service for 16 to 25-year-olds who have had an eating disorder for three years or less.

Young people getting help for their eating disorder through FREED are given rapid access to specialised treatment which gives special attention to challenges we know young people face during these years of their life, and in the early stages of an eating disorder.

Originally developed at South London and Maudsley NHS Trust and King’s IoPPN, the Health Innovation Network and Academic Health Science Network have since supported Mental Health Trusts across the country to adopt FREED. More than 2,000 young people nationally have benefitted from the service since 2020, with an initial evaluation suggesting FREED can reduce waiting times by 32% for assessment and 41% for treatment

Most recently, in her BBC documentary Zara McDermott: Disordered Eating, Zara met with our experts and service users at FREED to explore disordered eating. Filming took place at Maudsley Hospital in Summer 2022.

The new FREED-Mobile study, which is now recruiting, is exploring whether online resources could help young people in their decision to seek support for eating difficulties to help facilitate early intervention.

We want to encourage everyone who thinks they may have an eating disorder to seek help, as it is possible to get better. Wherever someone may be on their journey, there is hope and help out there.  Thank you to Zara for coming to visit us and spending time with people who have used our services.

Giulia Di Clemente and Charmaine Kilonzo

Senior Psychologist and Psychology Practitioner, Eating Disorders Service

External Support:

Beat – Eating Disorders: https://www.beateatingdisorders.org.uk/

 

Kooth: https://www.kooth.com/

 

First Steps: https://firststepsed.co.uk/

 

 

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New Executive Dean of the IoPPN

New Executive Dean of the IoPPN

New Executive Dean of the IoPPN

Professor Matthew Hotopf CBE has been appointed as Executive Dean of the Institute of Psychiatry, Psychology and Neuroscience (IoPPN) from 1 September 2023.

a young girl holding a leaf

Professor Hotopf is a Professor of General Hospital Psychiatry, a consultant liaison psychiatrist, and Director of The National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre (BRC).

As an alumnus of King’s College London, Professor Hotopf has a rich history with the university as a student and a valued member of staff. Matthew joined King’s as a Senior Lecturer in Psychiatry at Guy’s King’s and St Thomas’ School of Medicine in 1998, establishing an eminent career which includes roles within King’s Health Partners (KHP) and at the IoPPN. He has held his current role of Vice Dean of Research at the IoPPN, since 2017 and led the IoPPN’s return to the Research Excellence Framework (REF) 2021.

“Matthew has demonstrated outstanding leadership and successful delivery of critical projects for King’s, such as REF2021 for the IoPPN and the Directorship and renewal of the NIHR Maudsley Biomedical Research Centre. He is an exemplar at managing complex partnerships across research, healthcare services, policy, industry, funding and clinical care. Matthew is a great motivator, encouraging both staff and students to fulfil their potential. I am looking forward to Matthew leading the IoPPN into its next chapter.” – Professor Shitij Kapur, President & Principal of King’s College London.

David Bradley, Chief Executive of South London and Maudsley NHS Foundation Trust, said:  “I am delighted that Professor Matthew Hotopf, CBE, has been appointed as Executive Dean of IoPPN. Matthew is bringing a wealth of experience across research, leadership, and educational skills. I know his experience will help us improve our services at South London and Maudsley and his leadership at IoPPN will make a hugely positive contribution to our work.” 

Matthew trained in epidemiology at the London School of Hygiene and Tropical Medicine and in Psychiatry at the Maudsley. He has broad research interests including using epidemiological and novel mobile health methods to interrogate the relationship between mental and physical health. He has a national research profile as a member of the REF and inaugural chair of the NIHR’s Translational Research Collaboration in Mental Health.

“It is a huge honour to be appointed as Executive Dean of IoPPN. There are many great opportunities ahead for us to advance neuroscience and mental health, and inspire the next generation through our education, training and research.” – Professor Matthew Hotopf CBE, Vice Dean of Research, Institute of Psychiatry, Psychology & Neuroscience (IoPPN)

Matthew’s awards include a CBE for services to Psychiatric Research in June 2018 and the Academy of Psychosomatic Medicine’s 2016 Wayne Katon Research Award. He is also a NIHR Senior Investigator and Fellow of the Academy of Medical Sciences.

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Let’s Connect: Children’s Mental Health Week 2023

Let’s Connect: Children’s Mental Health Week 2023

Let’s Connect: Children’s Mental Health Week 2023

Children’s Mental Health Week is an annual event led by Place2Be which is dedicated to raising awareness about children and young people’s mental health. This year it took place on the 6th – 12th February 2023.

a young girl holding a leaf

Throughout the week, the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London shared some of the world-leading research happening across the Institute to raise awareness for some of the risk and protective factors associated with childhood mental health difficulties.

Day 1: Partnering for better children’s mental health

Children’s mental health has never been so critical. Before the pandemic, one in nine children had a probable mental health disorder. In 2022, this figure was at one in six and, for young people aged 17-19, one in four. Children’s Mental Health Week offers an important opportunity to reflect on what’s being done to support young people, and what we can do better.

The King’s Maudsley Partnership for Children and Young People brings together clinical and academic excellence in a unique collaboration between the UK’s largest NHS provider of specialist CAMHS services, South London and Maudsley NHS Foundation Trust, and the leading child and adolescent mental health research team in Europe at King’s College London – supported by the Maudsley Charity and leading philanthropists.

The partnership, which will be based at the new Pears Maudsley Centre for Children and Young People, will allow clinicians and researchers to collaborate even more closely to find new ways to predict, prevent and treat mental health disorders. This will enable us to translate research into practical treatments to benefit young people locally, nationally and across the globe in the shortest possible time.

Day 2: Protecting young people’s wellbeing on social media

Although smartphones are useful, there is concern about their effect on mental health and wellbeing. For example, studies have found that night-time use is related to poor sleep as well as mood changes. However, we don’t know exactly how social media and smartphone use can impact on mental health, including self-harm, nor do we know how usage can change in association with changes in mental health.

The 3S-YP study (Social Media, Smartphone Use and Self-Harm In Young People) aims to understand how social media and smartphone use are associated with changes in mental health and wellbeing in young people over the course of a year. The findings will help us learn when and what type of support would be useful for young people who are experiencing difficulties.

The study is led by Dr Rina Dutta in partnership with YoungMinds and funded by the Medical Research Council and Medical Research Foundation.

For Safer Internet Day and Children’s Mental Health Week, Dr Dutta shares her top three tips for young people to protect their wellbeing while using social media:

  1. Think about where you charge your devices. Charge them outside your bedroom to avoid the temptation to use them at night.
  2. Diversify your social media & keep communication open. Use a diverse range of platforms. Parents and young people should try to have conversations about what those platforms are and why they are appealing.
  3. Balance social media use with other everyday things. Don’t forget to go outdoors, play sports or cook!

Learn more about the 3S-YP study and hear Dr Rina Dutta’s top tips for young people in the video below:

Day 3: How does childhood social isolation impact mental health?

Katie Thompson, PhD Student at the Social, Genetic and Developmental Psychiatry (SGDP) Centre at King’s, explains how social isolation levels can vary across childhood, and discusses which children are most at risk of developing poor mental health later in life.

Her research, published in JCPP Advances last May, found that socially isolated children are more likely to experience ADHD symptoms and loneliness as young adults despite other risk factors in childhood.

Using data from the Environmental Risk (E-Risk) Longitudinal Twin Study, researchers examined social isolation through childhood and identified three types of developmental progression which were associated with emotional and behavioural challenges before and after the onset of isolation.

The study revealed that the experience of social isolation in childhood was associated with a range of difficulties in adulthood, even when the isolation itself had reduced. The findings suggest that childhood social isolation can indicate co-occurring mental health difficulties, which can be used to guide intervention in young people.

Watch the video below to learn more about Katie’s research, and what she’s currently working on:

Day 4: Listening to the voices of neurodivergent young people

Dr Myrofora Kakoulidou, Post-Docoral Researcher at the IoPPN, shared some of the work she is doing on the ‘My Emotions and Me’ sub-stream of the RE-STAR project (Regulating Emotions – Strengthening Adolescent Resilience). Through her research, Dr Kakoulidou is trying to understand what factors contribute to young people’s learning and wellbeing to help develop evidence-based school interventions.

RE-STAR is a four-year, interdisciplinary programme, led by Professor Edmund Sonuga-Barke, which brings together science and arts to understand emotional difficulties in neurodivergent young people in order to help develop effective support.

Many young people with ADHD and autistic traits develop depression during adolescence – but we currently don’t know which individuals are at risk, what underlying processes increase that risk or, perhaps most importantly, the best way to intervene to increase resilience to reduce that risk.

RE-STAR aims to address these gaps by testing the specific role of emotion regulation difficulties, commonly observed in young people with neuroatypicalities, in driving developmental pathways to depression.

For decades, the voices of neurodivergent young people have been neglected. RE-STAR puts young people with ADHD and autism at the heart of research.”

Dr Myrofora Kakoulidou

Post-Doctoral Researcher at King's IoPPN

Find out more about Dr Myrofora Kakoulidou’s work on the RE-STAR project:

Day 5: How can fathers impact children’s mental health?

Thirty years ago, fathers spent just 15-30 minutes a day with their children. Today, it is more like two hours. However, fathers’ increasing involvement with their children is not always well represented in developmental research and family policy. With changes in family roles, fathers may have a crucial role to play in improving child wellbeing. Alex Martin, Research Associate at the IoPPN, explores some of her research in this area and explains the protective role fathers can have in her Children’s Mental Health Week blog.

Her team at the Developmental Psychopathology Lab investigated whether the relationships between fathers and their partners (father-mother relationship), and fathers and their children (father-child relationship), can reduce the risk of adverse mental health outcomes in children when mothers are experiencing postnatal depression symptoms.

They found both the father-mother and the father-child relationships were important; when both relationships were strong, risk of emotional and behavioural outcomes in children was reduced by around 10%. But what do these findings mean? Read more about Alex’s research, the role of father’s in child wellbeing, and what needs to be done to improve children’s mental health in her blog.

Understanding very early brain development with the Brain Imaging in Babies Study

Did you know that in the first year of life your brain triples in size?

The Brain Imaging in Babies Study (BIBS) aims to improve understanding of how a baby’s brain develops from before birth, up until 3-4 years of age. Working with children from a variety of backgrounds and communities, they use a combination of state-of-the-art diagnostic tools such as MRI scans alongside traditional behavioural assessments to capture the earliest information on infant brain development.

The BIBS team are focusing on how brains develop in babies who go on to have conditions such as autism spectrum conditions (ASC) and ADHD, and how different factors might influence brain development, such as levels of vitamin D, stress and infections (such as COVID-19) in mothers. To date, they have recruited 470 families, and aim to collect data at the very beginning of children’s lives. They have conducted 21 fetal scans, 234 neonatal scans and 128 six month scans.

The study is being co-led by Professor Grainne McAlonan, Theme Lead for Child Mental Health and Neurodevelopmental Disorders at the NIHR Maudsley BRC and Professor of Translational Neuroscience at the IoPPN. It is part of the EU-AIMS project – the largest mental health study in Europe.

Watch a short video about the project below:

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