Conscious memories of childhood maltreatment contribute to psychopathology

Conscious memories of childhood maltreatment contribute to psychopathology

Conscious memories of childhood maltreatment contribute to psychopathology

New analysis from the Institute of Psychiatry, Psychology & Neuroscience at King’s College London has found that an individual’s conscious recollection of child maltreatment is strongly associated with psychopathology.

The research, published in JAMA Psychiatry, analysed studies of both ‘retrospective’ and ‘prospective’ measures of childhood maltreatment, and their association with psychopathology – a collection of symptoms ranging from internalising problems like depression and anxiety to externalising problems such as antisocial behaviour and substance abuse.

Retrospective measures refer to first-person, subjective recollections of childhood events, while prospective measures typically refer to third-person accounts of childhood events, such as from parental testimony or official records.

In a meta-analytic review of 24 studies covering 15,485 individuals, psychopathology was more strongly associated with retrospective measures of childhood maltreatment than prospective measures, suggesting that it is the personal memories of abuse or neglect at a young age and the meanings we attached to them that may contribute to psychopathology later in life.

Child maltreatment encompassed a range of traumatic experiences between birth and the age of 18, including physical, sexual and emotional abuse; or physical or emotional neglect.

Researchers found that the associations between retrospective measures of child maltreatment and psychopathology were particularly strong when the assessment of psychopathology was based on self-reports and focused on emotional disorders such as depression or anxiety.

Furthermore, retrospective reports of emotional abuse showed stronger associations with psychopathology compared to retrospective reports of other types of maltreatment.

Researchers suggest that the findings could have important implications for the treatment of mental health issues that stem from childhood maltreatment. In particular, it highlights the potential role of autobiographical memories of childhood maltreatment, which has not been explored in dominant theories on the outcomes of maltreatment.

Psychoanalytic and physical theories of mental ill-health generally focus on unconscious memories that cannot be accessed by a person’s voluntary recollection. In contrast, our findings support theories that one’s individual interpretation of events, conscious remembering, and the associated thought patterns are more strongly linked with psychopathology than the mere events themselves.”
Dr Jessie Baldwin PhD

Visiting Researcher, IoPPN and Senior Research Fellow, UCL

Our results indicate that evidence-based treatment for trauma-related psychopathology, such as trauma-focused cognitive behavioural therapy, and novel memory therapeutics may hold the key to softening the impact of childhood maltreatment on mental health.”
Miss Oonagh Coleman

PhD Student, King's IoPPN

The role of autobiographical memory in psychopathology has been largely underappreciated outside the work on Post-Traumatic Stress Disorder (PTSD). Advancements in this area can provide novel insights into prevention and treatment for the broad range of psychological disorders emerging after traumatic experiences in childhood.”
Professor Andrea Danese MD

Professor of Child & Adolescent Psychiatry , King's IoPPN

The study’s authors note that the associations between retrospective measures of child maltreatment and psychopathology might be inflated, particularly for emotional disorders, due to recall bias. For example, evidence suggests that increases in depressive symptoms over time may lead to small increases in retrospective reports of maltreatment. However, other recent research from the team suggests that recall bias is unlikely to explain the findings, suggesting that individuals’ memories of maltreatment may contribute to the development of psychopathology.

This research was possible thanks to funding from the Wellcome Trust, Mental Health Research UK, Medical Research Council, National Institute for Health Research Biomedical Research Centre at South London, Maudsley NHS Foundation Trust, and the Medical Research Council.

Prospective and Retrospective Measures of Child Maltreatment and their Association With Psychopathology (Jessie R. Baldwin, PhD; Oonagh Coleman, MSc; Emma R. Francis, PhD; Andrea Danese, MD, PhD) (DOI: 10.1001/jamapsychiatry.2024.0818) was published in JAMA Psychiatry.

For more information, please contact George Fenwick (Senior Communications and Engagement Officer)

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£2.5m to roll-out Advance Choice Documents

£2.5m to roll-out Advance Choice Documents

£2.5m to roll-out Advance Choice Documents

A new project led by researchers at the Trust of South London and Maudsley and the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, will result in the largest implementation and study of Advance Choice Documents in Europe. For this project, the Maudsley Charity has committed over £2.5m in funding.

a young girl holding a leaf

By the end of the two-year project, the team aims to have Advance Choice Document resources in use across mental health services in the South London and Maudsley NHS Foundation Trust. An extensive implementation study will also be delivered which will, alongside tested resources, provide the basis for a ‘recipe book’ for Advance Choice Documents to support other trusts in using them across the country.

Advance Choice Documents are written when someone is well and set out how they would like to be treated during a future mental health crisis or relapse. Their introduction was recommended in the 2018 Independent Review of the Mental Health Act and by the parliamentary committee on the draft of the mental health bill in 2023.  Research has shown they can reduce detentions under the Mental Health Act and improve relationships with mental health professionals.

Black people are disproportionately likely to be detained under the Mental Health Act and there is a lack of trust in mental health services in this community. Wider adoption of Advance Choice Documents has the potential to help address these issues.

The new project builds on the success of the recent Advance Statement for Black African and Caribbean project (AdStAC) where researchers and clinicians at the IoPPN and South London and Maudsley NHS Foundation Trust have been working to improve Black service users’ experiences in mental health services by co-producing and testing resources for the implementation of Advance Choice Documents.

The new project will roll out and evaluate the use of Advance Choice Documents across the South London and Maudsley NHS Foundation Trust for anyone who has been detained under the Mental Health Act. This includes children and adolescents who will be treated at the new Pears Maudsley Centre for Children and Young People, set to open in south London in 2025.

“Reducing detentions of our service users under the Mental Health Act has been a Trust-wide priority, together with the PCREF priorities of reducing racial disparities in detentions under the Mental Health Act, as we know we have a disproportionate number of Black men detained on our inpatient wards. From our work on the AdStAC project, we know that Advance Choice Documents are more than just medical preferences; it’s about capturing the essence of a person—their values, their hopes, their fears. With this new funding from Maudsley Charity, we can get Advance Choice Documents offered to service users Trust-wide.”

Nathalie Zacharias

Director of Therapies, South London and Maudsley NHS Foundation Trust

Rebecca Gray, Chief Executive of Maudsley Charity, said:

“We are absolutely delighted to support this new, large-scale project which builds on the earlier work of this impressive team and has relevant lived experience at the centre of its design. Many people with a severe mental illness report that they have too little control and voice in the care they receive. These concerns are particularly high for Black patients, who are disproportionately impacted by severe mental illness and for whom we know trust in mental health services is not high.

“This project has the potential to address these issues and push the needle forward on the use of Advance Choice Documents across the country.”

Professor Claire Henderson, Clinical Professor of Public Mental Health at King’s IoPPN and Honorary Consultant Psychiatrist at South London and Maudsley NHS Foundation Trust, said: 

“Having worked on multiple research projects on these types of documents since the late 1990s, I am very happy to have the support of the Trust and Maudsley Charity to make Advance Choice Documents available to people who have previously been detained under the Mental Health Act, and in particular Black people, who experience disproportionately high rates of detention.”

Lorna, who is a carer and advocate for her son Ryan, who lives with psychosis said:

“I don’t want my son to be sectioned. I want to keep him well, so an Advance Choice Document is what we need. What will make him unwell would probably be him not taking his medication.

“I’m just hoping for a system where you put my son’s name in and the ideal thing is they’ll know where Ryan lives, that they’ll know to contact me or to contact somebody that will know what the next steps are.

“I think I know my son better than the health care professionals. I’ve felt through the journey I was never listened to. The big thing would be that reassurance that he would be taken care of in the way he wants to be taken care of even if I’m not there.”

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IoPPN researchers find lonely secondary school students less likely to gain employment in adulthood

IoPPN researchers find lonely secondary school students less likely to gain employment in adulthood

IoPPN researchers find lonely secondary school students less likely to gain employment in adulthood

New research has found that there is a direct socioeconomic impact of loneliness in early adolescence.

a young girl holding a leaf

New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, in partnership with the University of Greenwich, has found that there is a direct socioeconomic impact of loneliness in early adolescence.

The research, published in Social Science and Medicine, found that lonely young adults are more likely to be out of education, employment, or training (NEET) and consider themselves less employable and lower on the economic ladder than their less lonely peers.

Sourcing data from the Environmental Risk (E-Risk) Longitudinal Twin Study, researchers followed the progress of 2,232 individuals born in England and Wales during 1994-1995. Participants were assessed at ages 12, 18 and 26 for levels of loneliness, as well as being asked to rate their social status. Participants’ employment status and employability were assessed at age 18.

Researchers found that young adults who had experienced loneliness earlier on in life experienced difficulties in young adulthood, even if they were no longer lonely. Researchers suggest that this demonstrates that loneliness impacts a person’s long term economic prospects and suggests that addressing loneliness in early adolescence could yield economic benefits through increased productivity.

“While there are clear impacts of loneliness on mental health from an early age, our study demonstrates that loneliness also negatively impacts a person’s employment prospects. We’ve shown that, from an early age, loneliness can have knock on effects on a person’s ability to compete in the job market. This not only harms a person’s chances in life, but also has direct costs to the economy.”

Bridget Bryan

PhD student at King’s IoPPN and the study’s lead author

Previous research in this field has suggested a two-way relationship between loneliness and social standing. By using data collected over time, this research showed that feeling lonely negatively influenced a person’s social standing down the line, but social standing did not affect their future loneliness.

“Our research is one of very few studies reporting on the impact of loneliness years later. If we are to create effective prevention strategies, we need to continue collecting data in order to unravel the long-term outcomes of loneliness at various stages of life.

“We need more longitudinal data to unravel the long-term outcomes of loneliness at various stages of life. This can offer insight for developing prevention strategies.”

Professor Louise Arseneault

Professor of Developmental Psychology at King’s IoPPN

The study’s researchers argue that their findings highlight the importance of effectively tackling loneliness in order to help both the individual and society.

“While we should never forget that loneliness impacts people of all ages, our research suggests that reducing loneliness in children and young people could yield benefits both for their own employment prospects and for the economy more widely.”

Dr Timothy Matthews

Lecturer in Psychology at University of Greenwich

This study was possible thanks to funding from the Colt Foundation and the Medical Research Council, with additional support from the National Institute of Child Health and Human Development and by the Jacobs Foundation.

The socioeconomic consequences of loneliness: evidence from a nationally representative longitudinal study of young adults (DOI 10.1016/j.socscimed.2024.116697) (Bridget T. Bryan, Katherine N. Thompson, Sidra Goldman-Mellor, Terrie E. Moffitt, Candice Odgers, Sincere Long Shin Soa, Momtahena Uddin Rahman, Jasmin Wertz, Timothy Matthews, Louise Arseneault) was published in Social Science and Medicine.

For more information, please contact Patrick O’Brien (Media Manager, King’s IoPPN

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Dr Clark features in film exploring homophobia in football with Rylan

Dr Clark features in film exploring homophobia in football with Rylan

Dr Clark features in film exploring homophobia in football with Rylan

Opening in 2025, our Pears Maudsley Centre for Children and Young People will change the story on mental health and transform the lives of children and young people. Based on the South London and Maudsley site, the centre has been developed through a unique partnership between King’s College London’s Institute of Psychiatry, Psychology & Neuroscience, Maudsley Charity and the Trust led by Consultant Psychiatrist & Clinical Director of CAMHS, Dr Bruce Clark.

a young girl holding a leaf

In the run up to the opening, Dr Clark, has featured in the documentary Rylan: Football, Homophobia and Me hosted by Rylan Clark, This Morning and Radio 2 presenter.

In the film, Rylan, who suffered abuse as a child for being gay, speaks to footballers to explore why homophobia remains such a big problem in the game.

Reflecting on his love of football, Rylan discusses how safe he feels continuing to support the game given the common use of homophobic attitudes in the game such as on the terraces.

He also talks about his mental health struggles and the severe homophobic bullying he experienced including multiple skull fractures.

Speaking to Dr Clark, Rylan said that ‘in a sick way’ he is almost glad the attack happened as it taught him to never treat anyone badly.

Dr Clark, who filmed with Rylan at the Maudsley Hospital, says:

“It was a pleasure to be part of such an important and well-received documentary that shines a light on the mental health of young people who experience marginalisation and homophobic bullying.”

Participation in this documentary, aired during LGBTQ+ History month, sits alongside other initiatives the Trust are undertaking to celebrate the rich tapestry of LGBTQ+ experiences within our community. 

Rylan: Football, Homophobia and Me is available on TNT1 via on-demand platform Discovery +, Sky, Virgin and Amazon Prime. 

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Children’s Mental Health Week 2024

Children’s Mental Health Week 2024

Children’s Mental Health Week 2024 Blog

Children’s Mental Health Week, ran from 5 February – 11 February. The theme  this year was My Voice Matters. The theme was about empowering children and young people by providing them with the tools they need to express themselves.

This week we celebrated Place2Be’s Children’s Mental Health Week. Place2Be wants all children and young people, whoever they are, and wherever they are in the world, to be able to say – and believe – “My Voice Matters”.

We used the opportunity to showcase how we as a Partnership encourage young people to use their voices across our services. If you missed any of our content, we’ve summarised it all below.

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Monday 5 February

Our wonderful service user Catherine brillantly expressed their vision for Children’s Mental Health Week through art!

Meet Oak, our amazing service user. Oak explains the importance and benefits of using your voice. Express yourself, be heard – whether through sign language or art.  ‘My Voice Matters’ is about empowering children and young people by providing them with the tools they need to express themselves.

Tuesday 6 February

Breaking the silence with a goal in mind! ⚽

This #ChildrensMentalHealthWeek Anton Ferdinand tackles the stigma around #mentalhealth with the same passion he brought to the pitch. Now, his new dream team includes his little ones, teaching them that their voices can shine as brightly as the stadium lights. ✨

Remember, it’s okay to talk about how you feel—every voice counts in this game!

Wednesday 7 February

Raised in Peckham, Anton Ferdinand is no stranger to the unique challenges faced by young people in London. Discover how our transformative Partnership and the innovative Pears Maudsley Centre have inspired him.

We were pleased to be featured by NHS Providers in their latest insightful blog. The latest blog feature shines a light on how collaborative design and service user-led innovation can lead to transformational changes in healthcare.

Our dedication to pioneering young people’s mental health services has received recognition, and it’s all thanks to the core of our mission: the young individuals, families, and carers who have been integral to the co-creation of the Pears Maudsley Centre. Our commitment to listening to and incorporating their perspectives is not just something we talk about; it has been at the very core of our design process.

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Thursday 7 February

On Thursday, our amazing Inpatient CAMHS Team held a successful ‘CAMHS Fete’ held for our young service users at our Bethlem Royal Hospital.

The event was held to celebrate Children’s Mental Health Week and had an amazing turn out. Thank you to all the young people, staff (humans and dogs alike), and various therapy animals who attended – even during the rain. Our young people were encouraged to creatively express the theme of the week #MyVoiceMatters. T-shirts, meaningful messages and artwork on megaphones designed by current inpatients were displayed proudly for all to see.

Meet is Kay*. She took part in the DISCOVER programme, our award-winning schools-based workshop programme supporting 16-18 year olds to manage stress and worry.

This week, she’s used her voice to support others deal with the aftereffects of grief.  Listen to her full story and find out more about the DISCOVER Programme

*Kay is a pseudonym used to protect her anonymity. In the video, her words are spoken by an actor.

In his third video of the week, Anton Ferdinand opens up about his mental health journey through grief after the passing of his mum . His powerful story of seeking support teaches empathy and strength.

Friday 8 February

“Speaking out doesn’t make you weak”

In his final video for the week, Anton Ferdinand reminds us to use our voices and ask for help when we need support with our mental health. 

Saturday 8 February

Art in healthcare spaces goes beyond decoration. It has the power to create a sense of calm and promote wellbeing for all who walk through the Pears Maudsley Centre doors when they open. Participation and engagement from those with lived experience is vital to ensuring our service users benefit from therapeutic artwork.

Discover how Naz helped shape our arts strategy.

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My Voice Matters: The Young People’s Art Group

My Voice Matters: The Young People’s Art Group

My Voice Matters: The Young People’s Art Group

The role of art has become part of wider discussions in relation to the design of healthcare environments as it can create an increased sense of calm, ambience, and impact positively on staff and service users’ wellbeing. Participation and engagement from those with lived experience is vital to ensuring our service users benefit from therapeutic artwork.

Taken from Marcus Coates’ workshop

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A new arts programme was developed with the Bethlem Gallery and includes site-specific artwork which will be displayed across the building. The Young People’s Art Group, a group of young people with lived experience of mental health conditions, was formed for this project and took a leading role in appointing the artists for each commission for the centre and providing feedback directly to the artist at each stage of their artwork.

The commissioned artists, Bethany Williams, Marcus Coates, Sahra Hersi, Sarah Carpenter and Carlos Cortes have also held workshops with several young people using our services and are currently preparing their final artwork to be installed at the Centre.

One of the young people to take part in The Young People’s Art Group was Naz. Most recently Naz edited text for pears Maudsley artwork interpretation to make text more accessible for young people. Speaking on her numerous involvements in the project, she explained:

“”I felt as if I’ve been encouraged to share my voice and had my opinions heard and given value during the participation work, I’ve taken part in. Participation work has been an important part of my recovery since I was 16 years old as it’s helped me set goals and achieve them and keep my mind occupied with something productive and purposeful. It has led me to many new and exciting opportunities and pushed me out of my comfort zone.”

Taken from Sahra Hersi’s workshop

“The most recent participation project I’ve taken part in is the Young People’s Art Group for Pears Maudsley. Exploring wellbeing and art is something that really interests me as I’d love to be an art therapist and art has always been something that has brought me a lot of comfort and helped me express myself during difficult times. I felt as if my voice mattered when I helped choose the artists who created the display cabinets for the Pears Maudsley Centre and when I was invited to speak at a roundtable discussion at the Science Gallery on behalf of the Young People’s Art Group.”

“In the past, I’ve also done participation work with other charities and organisations including one that helped me learn debating skills. It was a really enjoyable experience that still means a lot to me as debate training helped me feel more confident and learn to advocate for myself and express my needs and have open discussions about mental health. I feel debate training has opened a lot of doors for me and has been a stepping stone in the journey of participation work I’m involved in now, collaborating with Pears Maudsley and even continuing my participation work in a professional setting.

Taken from Bethany Williams’ workshop

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