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IoPPN researchers awarded Wellcome funding for mental health research

by | May 10, 2023 | News

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IoPPN researchers awarded Wellcome funding for mental health research
£2.45 million Wellcome funding has been awarded to research programmes at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) for children and young people’s mental health research.

The programme, led by IoPPN principal investigator Dr Daniel Michelson a received Wellcome Mental Health Award, alongside two other programmes at the IoPPN. The awards sit under the umbrella of Wellcome’s new Mental Health Challenge programme.

Dr Daniel Michelson has been awarded £2.45 million to undertake a ‘Mechanistic trial of problem-solving and behavioural activation for youth depression’ (METROPOLIS). This programme, which is part of the King’s Maudsley Partnership for Children and Young People, will investigate the effectiveness and mechanisms of brief, first-line psychotherapies to reduce symptoms of depression among disadvantaged university students in New Delhi, incorporating an innovative peer-to-peer counselling approach.

I’m delighted to receive this award on behalf of an outstanding international team. The funding will enable us to conduct one of the largest-ever mental health intervention trials for young people in India, which is home to 20% of all 18-24-year-olds worldwide. Scalable early interventions are urgently needed during this key developmental period when many mental health problems first occur. University settings pose unique challenges and stresses, especially for ‘first-generation’ learners who make up a significant part of the student population across India.

Dr Daniel Michelson

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

Dr Michelson is a Clinical Senior Lecturer in the Department of Child and Adolescent Psychiatry at the IoPPN. The new Award builds on Dr Michelson’s experience as Clinical Academic Director for the ‘Premium for Adolescents’ school mental health programme in India, also funded by Wellcome (2016-22). Dr Michelson additionally works on developing and evaluating psychosocial interventions for under-served children, young people and families in the UK and is an Honorary Consultant Clinical Psychologist at South London and Maudsley NHS Foundation Trust.

Daniel Stahl, Professor of Medical Statistics and Statistical Learning at the IoPPN, will work with Dr Michelson on the programme alongside co-investigators from Sangath, India’s leading mental health research non-governmental organisation; O.P. Jindal Global University, a top-ranked research-intensive university in New Delhi; Youth for Mental Health, a youth-led social enterprise focused on student mental health in India; and Brighton and Sussex Medical School. Dr Michelson’s team is supported by a wider group of international collaborators from the USA (Harvard Medical School, Loma Linda University & UCLA) and India (the National Institute of Mental Health and Neurosciences).

Young people with relevant lived experience will be front and centre in the leadership and delivery of the programme, including a variety of youth-led activities to engage students from marginalised groups.

Dr Daniel Michelson

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

The grant is funded under the Wellcome ’Looking Backwards, Moving Forward: understanding how interventions for anxiety, depression, and psychosis work’ grant scheme which is part of their new strategic focus on mental health as a key global health challenge. This call focuses on investigating the causal mechanisms underpinning the ‘active ingredients’ of effective interventions for anxiety, depression and psychosis. Active ingredients are those that drive resolution or reduction of symptoms, are well-defined and link to specific hypothesised mechanisms of action. Wellcome have awarded more than £47 million to research teams to investigate what makes interventions for anxiety, depression and psychosis effective.

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

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Online cognitive training not effective in reducing ADHD symptoms

Online cognitive training not effective in reducing ADHD symptoms

by | Mar 29, 2023 | Research

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Online cognitive training not effective in reducing ADHD symptoms

A major review of research led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London and the University of Southampton, on behalf of the European ADHD Guidelines Group (EAGG), found little to no evidence that computerised cognitive training brings benefits for people with attention deficit hyperactivity disorder (ADHD).

a young girl holding a leaf

Computerised cognitive training is an online tool designed to improve cognitive processes such as short-term memory, attention and inhibitory control (the ability to control your attention, behaviour, thoughts and emotions). It has been proposed as a treatment option to help reduce symptoms of hyperactivity/impulsivity and inattention at the core of ADHD.

The review team conducted a meta-analysis of 36 randomised controlled trials (studies in which people are randomly assigned to different groups to test a specific intervention) investigating the effects of computerised cognitive training on outcomes in individuals with ADHD. The study, published in Molecular Psychiatry from the Nature Group, found that cognitive training did not lead to clinically meaningful reductions in overall ADHD symptoms or on specific hyperactivity/impulsivity symptoms. It may, however, result in a small improvement in inattention in some settings.

“We conducted the largest, most comprehensive meta-analysis of randomised control trials to date to investigate the efficacy of computerised cognitive training in reducing ADHD symptoms. Our meta-analysis revealed little to no support for the use of this cognitive training as a stand-alone intervention for ADHD symptoms. Although small, short-term effects on inattention symptoms were found, they were likely of limited clinical importance. Overall, I think it’s now time to seek out new interventions targeting different processes.”

Dr Samuel Westwood

Lecturer in Psychology Education at King’s IoPPN and lead author of the paper

In most trials, participants completed the computerised cognitive training at home. Some completed the training at school, in a laboratory, a clinic/hospital or a mixed setting (switching between multiple). There were some improvements in a limited set of cognitive processes – particularly working memory (the ability to hold in mind and manipulate information over the short term) following specific working memory training. This may be of benefit to the subset of individuals with ADHD and who also experience working memory difficulties.

The authors explain that the findings do not support the use of computerised cognitive training in its current form as a stand-alone treatment for ADHD symptoms, and that new approaches that target different processes should be explored to develop effective interventions for ADHD.

Professor Edmund Sonuga-Barke, Professor of Developmental Psychology, Psychiatry and Neuroscience at King’s IoPPN and joint senior author of the paper, said: “ADHD is a very heterogeneous condition in terms of what brain processes are implicated. It is likely that different sorts of interventions are required by different people. New and innovative approaches will be needed to move the field forward.”

Professor Samuele Cortese, Chair of the EAGG, Professor of Child and Adolescent Psychiatry at the University of Southampton and joint senior author of the paper, said: “Rigorous meta-analytic evidence such as this one is crucial to inform the development of clinical guidelines, with the ultimate goal to provide the best evidence-based treatments to individuals with ADHD”.

‘Computerized cognitive training in attention-deficit/hyperactivity disorder (ADHD): A meta-analysis of randomized controlled trials with blinded and objective outcomes’ (Samuel Westwood, Valeria Parlatini, Katya Rubia, Samuele Cortese, Edmund Sonuga-Barke, European ADHD Guidelines Group) was published in Molecular Psychiatry (DOI:10.1038/s41380-023-02000-7).

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

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

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

by | Mar 29, 2023 | Research

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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

by | Mar 22, 2023 | Research

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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

by | Mar 3, 2023 | Blog Post

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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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