New parenting app reduced child emotional difficulties during COVID-19 pandemic

New parenting app reduced child emotional difficulties during COVID-19 pandemic

by | Jul 27, 2023 | Research

New parenting app reduced child emotional difficulties during COVID-19 pandemic

New research finds a novel parenting smartphone app, developed by researchers at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London and South London and Maudsley NHS Foundation Trust, reduced child emotional problems during the COVID-19 pandemic.

Published in the Journal of Medical Internet Research (JMIR), the Supporting Parents And Kids Through Lockdown Experiences (SPARKLE) trial – a collaboration between King’s and the University of Oxford – investigated whether Parent Positive was effective in reducing child emotional and conduct problems and improving parents’ own wellbeing, and whether improvements were achieved in a cost-effective way.

Researchers followed 646 parents with children aged between four and 10 between May and July 2021, with 320 receiving access to Parent Positive compared with 326 who did not. They found that Parent Positive reduced child emotional problems after both one and two months of access to the app, compared to not having app access at all. This was found to be a cost-effective way of reducing children’s emotional problems.

We believe our study is the first clinical trial of a parenting support app designed specifically to support parents during the COVID-19 pandemic. In response to the pandemic and subsequent lockdowns, we quickly developed Parent Positive to help mitigate the impact on children’s emotional and conduct problems. We found that, on average, families who had access to the app reported reduced child emotional problems compared to those who did not. The findings highlight that, if implemented across the general UK population, Parent Positive could have the potential to make a significant contribution to reducing child emotional problems.

Dr Melanie Palmer

Postdoctoral Research Associate at King’s IoPPN and first author of the JMIR article

The COVID-19 lockdowns presented parents with some extraordinary challenges. Getting face-to-face support to them using traditional approaches was very challenging during this period. The results from the SPARKLE trial highlight the potential of digital approaches as a way of disseminating advice and support to parents that can produce tangible results. We are hopeful that this approach can have many uses in the post-COVID world in providing a resource to families in underserved or marginalised communities or utilised as part of first-line interventions in hard pressed services.

Professor Edmund Sonuga-Barke

Professor of Developmental Psychology, Psychiatry & Neuroscience at King’s IoPPN and Principal Investigator on SPARKLE

Contrary to the researchers’ expectations, access to the app did not lead to significant improvements in child conduct problems, despite the advice on managing difficult behaviours it provided. Researchers also found no evidence that those who had access to the app experienced less parent psychological distress, parental child-related worries, or family conflict than those who did not. In fact, there was an increase in child-related parental worries after two-months. The researchers explain that this may be due to the difficulties related to changing parenting styles and routines, or the increase in awareness of good parenting practices leading to insecurity about their parenting skills.

The researchers collaborated with parents of young children across all aspects of the study to better understand their views on how the app could address their support needs. They are now co-developing the app further to improve usability, increase engagement and improve the positive effects for parents and their children.

SPARKLE was funded by the UK Research and Innovation Economic and Social Research Council (UKRI-ESRC).

‘The effectiveness of a universal digital parenting intervention designed and implemented during the COVID-19 pandemic: Evidence from a rapid implementation randomised controlled trial within a cohort’ (Melanie Palmer, Nicholas Beckley-Hoelscher, James Shearer, Katarzyna Kostyrka-Allchorne, Olly Robertson, Marta Koch, Oliver Pearson, Petr Slovak, Crispin Day, Sarah Byford, Kimberley Goldsmith, Polly Waite, Cathy Creswell & Edmund J S Sonuga-Barke) was published in the Journal of Medical Internet Research (DOI: 10.2196/44079).

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

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

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

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?

by | Feb 8, 2023 | Research

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.

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Listen on BBC Sounds (36:13 minutes)

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

by | Jan 30, 2023 | Research

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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