344 research outputs found
Gender differences in the comorbidity of neurological and psychological disorders in a large clinical sample of children
No full textThis study aimed to establish rates and gender patterns of 25 comorbidities in 1912 children (72% male) with a neurological disorder and a comparison group (n = 40 718, 45% male) from a large clinical records data-set in child mental health services in the UK with clinician-recorded data on neurological and psychological conditions. Obsessive-compulsive disorder, oppositional defiant/conduct disorders, autism spectrum disorders and intellectual disabilities (also known in UK health services as learning disabilities) occurred significantly more often in both boys and girls with neurological disorders than in the comparison group. Girls with neurological disorders showed a 'male-typic' comorbidity profile
Predicting ADHD symptoms and diagnosis at age 14 from objective activity levels at age 7 in a large UK cohort
No full textHyperactivity is one of the three core symptoms in children with attention deficit hyperactivity disorder (ADHD). Diagnosing ADHD typically involves self-report, third party report and observations. Objective activity data can make a valuable contribution to the diagnostic process. Small actigraphy studies in clinical samples have shown that children with ADHD move more than children without ADHD. However, differences in physical activity between children with and without ADHD have not been assessed in large community samples or longitudinally. This study used data from the Millennium Cohort Study to test whether symptoms of ADHD (parent-rating Strengths and Difficulties Questionnaire) and ADHD diagnosis at age 14 (reported by parents) could be predicted from objective activity data (measured with actigraphs) at age 7 in N = 6675 children (final N = 5251). Regressions showed that less sedentary behavior at age 7 predicted more ADHD symptoms at age 14 (β = − 0.002, CI − 0.004 to − 0.001). The result remained significant when controlled for ADHD symptoms at age 7, sex, BMI, month of birth, SES and ethnicity (β = − 0.001, CI − 0.003 to − 0.0003). ADHD diagnosis at age 14 was also significantly predicted by less sedentary behavior at age 7 (β = − 0.008). Our findings show that symptoms of ADHD can be predicted by objective activity data 5 years in advance and suggest that actigraphy could be a useful instrument aiding an ADHD diagnosis. Interestingly, the results indicate that the key difference between children with and without ADHD lies in reduced sedentary activity, i.e., times of rest
Tics as a model of over-learned behavior: imitation and inhibition of facial tics
No full textBACKGROUND: Tics are the defining feature in Tourette syndrome and can be triggered by watching tics or single voluntary movements. This automatic imitation of movements referred to as "echopraxia" has been ascribed to a failure in top-down inhibition of imitative response tendencies. Alternatively, it could be interpreted in the context of automatic overlearned behavior. To this end, we investigated 18 Tourette patients aged 28.22 years (9.44 standard deviation; 16 male) and 24 healthy controls (mean age 29.21 years [9.1 standard deviation]; 17 male) using an adapted version of an action-interference paradigm.METHODS: Patients were asked to respond to 2 different auditory tones with either a facial movement that was part of their tic repertoire (tic-like movement), or a facial movement that was not (nontic movement). Simultaneously, behaviorally irrelevant videos of the 2 same facial movements were presented, which were either compatible or incompatible with the movement executed by the patient. Movements in healthy controls were matched to those in the patients.RESULTS: Healthy participants responded faster in compatible than in incompatible trials. Tourette patients showed the same effect for nontic movements. However, their responses were equally fast in incompatible and compatible trials when the movement they were asked to execute was a tic-like movement. Error rates did not differ between the groups.CONCLUSIONS: The results suggest that tic-like movements do not occur as a consequence of a failure to inhibit motor output. Instead, tics might be considered highly overlearned behavior that can be triggered without interference by external, incompatible movement stimuli. © 2016 International Parkinson and Movement Disorder Society.</p
Mental health difficulties in early adolescence:A comparison of two cross-sectional studies in England from 2009 to 2014
No full textPurpose To examine the changes in mental health difficulties in early adolescence between 2009 and 2014 in England. Methods Analysis reports on data from two cross-sectional samples of adolescents (aged 11-13 years) collected 5 years apart in 2009 and 2014 in secondary schools across England. Samples were matched using propensity scoring, resulting in a total pooled sample of 3,366 adolescents. Mental health difficulties were reported by participants using the Strengths and Difficulties Questionnaire. Results Overall, there were similar levels of mental health difficulties experienced by adolescents in 2009 and 2014. Notable exceptions were a significant increase in emotional problems in girls and a decrease in total difficulties in boys in 2014 compared to 2009. Conclusions The increased prevalence of emotional problems in girls mirrors a trend found in other similar studies, and the results are discussed in the context of recent economic and societal changes. The small decrease in total difficulties in boys, although promising, clearly warrants further research.</p
Basic psychological needs, mental health difficulties and wellbeing in general population samples
No full textSexual Minority Health Inequities Across The Lifecourse: A Multi-Dataset Investigation
No full textLimited international research suggests sexual minority individuals may experience poorer chronic physical health than their heterosexual peers. However, little research has explored if a similar disparity is present in the UK. This thesis aims to address this gap by exploring differences in asthma and cardiometabolic disease by sexual minority status using UK longitudinal population studies. This thesis is interested in the pathways and processes by which social inequality leads to health inequalities and how the data landscape for sexual minority health limits the questions we ask. /
Methods: Using data from five UK longitudinal studies (Millennium Cohort Study (MCS), Next Steps, the British Cohort Study (BCS70), Understanding Society: the UK Household Longitudinal Study (UKHLS), and the English Longitudinal Study of Ageing (ELSA)), this thesis used individual participant data analysis to examine asthma and cardiometabolic outcomes by sexual minority status. In addition, descriptive analyses of the impact of sexuality dimension and data handling were conducted. /
Results: This thesis found sexual minority people were more likely to report asthma, but there were little to no differences in prevalence of cardiovascular disease and diabetes, risk for future cardiovascular disease and outcomes for a range of anthropometric and biomarker measures. Age, gender/sex and sexual identity had important implications for outcomes. This project also looked at how outcomes vary by dimension of sexuality and found measures such as attraction, behaviour, and identity are not interchangeable. /
Conclusions: This analysis adds substantially to our understanding of health disparities by sexual minority status in the UK. This thesis identifies pathways by which social inequality “gets under the skin” for sexual minority people and areas of further research and intervention. In addition, the thesis offers a critique of the data landscape for sexual minority research in the UK
Understanding wellbeing and psychopathology in sexual minority adolescents in the UK: A multi-methods investigation
No full textAdolescent mental health has declined in recent decades and will likely be associated with poor adult mental health and related health comorbidities in future. Within the UK a tumultuous political and economic climate is seeing widening disparities between the minority and majority groups. One form of minoritized status that merits attention during adolescence and beyond, relates to sexuality. Research consistently shows that sexual minorities experience significantly worse mental health outcomes, with adolescence being a key point of vulnerability. However, research conducted with sexual minority adolescent populations has been limited in the UK. The aim of this PhD was to investigate the prevalence of adversities in sexual minority adolescents, to understand their experiences of mental-ill health and of wellbeing, as well as the social circumstances contributing to such outcomes. This body of work aimed to add to the existing theoretical literature and to provide focus for future interventions. To do so this PhD utilises a range of methodological approaches from literature synthesis, population-based analyses, experimental psychology approaches to critical qualitative inquiry.
This PhD consists of six chapters and four studies. Chapter 1 summarizes the extant literature, the political and social context in the UK and the methodological approaches adopted within this PhD. Chapter 2 identifies factors associated with subjective wellbeing in sexual minority adolescents utilising a systematic review methodology. A model of minority wellbeing was proposed, whereby factors associated with higher levels of wellbeing tended to have an external locus e.g., family/social support; whilst those factors associated with lower levels of wellbeing tended to have a more internals locus e.g., internalised homonegativity. In the absence of existing estimates, Chapter 3 uses data from The Millennium Cohort Study to provide contemporary population-based estimates of mental health, adversity, and health problems in sexual minority adolescents growing up today. Sexual minorities were more likely to experience greater mental ill-health, worse interpersonal difficulties, and poorer health related outcomes than their heterosexual counterparts. These adversities also cumulated at higher levels for sexual minorities. Chapter 4 tested the postulations of an existing sexual minority mental ill-health theoretical model (the Psychological Mediation Framework). Using an experimental approach, associations between sexual minority status, emotional dysregulation, minority specific mechanisms (i.e., internalised homonegativity), depression and wellbeing were tested via an Implicit Association Test (IAT). Support for the Psychological Mediation Framework was mixed, where conscious internalised homonegativity was linked to depression but not when it was subconscious. The relationship between minority specific mediators, depression and wellbeing varied based on whether internalised homonegativity was conscious or not and in some cases showed counterintuitive relationships (unconscious internalised homonegativity linked to higher levels of wellbeing).
To contextualise and further understand these findings, developing a new theoretical framework that would map the pathways associated with mental health outcomes in sexual minority adolescents in the UK was explored. Chapter 5 employed a constructivist grounded theory methodology. Sexual minorities across the UK were interviewed about their sexual identity navigation. Findings led to the development of the Dynamic Identity Formation of Sexual minority adolescent’s theory (DIFS). Sexual identity navigation was dynamic, seeing a movement between cultures such as heternormativity and gender binarism and queerness, the enactment of these cultures, to the experience of the individual. The culture of queerness ran parallel to heternormativity and was usually accessed later in one’s developmental journey. As pernicious as the enactment of heternormativity and gender binarism could be, so could the culture of queerness – in both cultural spaces young people experienced othering. Chapter 6 summarises the contribution this PhD has for the research field, the strength of this work and future directions.
Overall, it appears that sexual minorities experience significant disparities in their mental health in the UK today. Subtle messaging and social processes such as othering are having more detrimental impacts than are currently realised and can have a significant impact on an individual in the absence of discrete victimisation events. Younger sexual minorities seem particularly vulnerable as they navigate their minoritised identity.
All empirical chapters have been or are pending submission to peer reviewed journal and variation in the structure of chapters reflects the recommendations of each journal
Examining Mental Health and Well-being Provision in Schools in Europe: Methodological Approach
No full textSchools are considered an ideal setting for community-based mental health and well-being interventions for young people. However, in spite of extensive literature examining the effectiveness of such interventions, very few studies have investigated existing mental health and well-being provision in schools. The current study aims to extend such previous research by surveying primary and secondary schools to investigate the nature of available provision in nine European countries (Germany, Ireland, the Netherlands, Poland, Serbia, Spain, Sweden, the UK and Ukraine). Furthermore, the study aims to investigate potential barriers to mental health and well-being provision and compare provision within and between countries.</p
Socioeconomic inequalities in vocabulary and their implications for educational attainment and mental health in adolescence
No full textThis thesis examines the extent to which childhood vocabulary can be used to predict adolescent mental health and educational outcomes, and to which differences in early vocabulary are associated with socioeconomic circumstances (SEC). These questions arise out of an increased interest in the relation between SEC and vocabulary, and efforts to develop interventions to promote vocabulary prior to school entry, which have so far been met with mixed success. Since vocabulary is thought to predict later mental health and education outcomes, and there are social inequalities in language, education and mental health, this thesis sought to provide insight into whether early vocabulary interventions are likely to benefit children in the longer term, through secondary data analysis of two large, nationally representative UK datasets: 1) The 1970 British Cohort Study (BCS1970), and 2) The Millennium Cohort Study (MCS2001).
I first examined whether early child vocabulary is related to adolescent mental health, finding small effects, which importantly differed as a function of reporter: when adolescent self-report was considered, better childhood vocabulary skill predicted poorer adolescent mental health outcomes.
I next looked more closely at the relation between SEC and vocabulary, by investigating socioeconomic inequalities in vocabulary throughout childhood and into adolescence. I found multiple SEC indicators (most notably parent education, income and occupation) uniquely predicted child and adolescent vocabulary. Inequalities persist from ages 3 to 14 years, with effects being most pronounced at the start and end of formal schooling.
I finally investigated whether vocabulary at school entry predicted educational outcomes at the end of secondary school. Here, unlike for mental health, there was a clear relation: better childhood vocabulary predicted better educational outcomes on GCSE or equivalent examinations. This effect was substantially moderated by SEC. Thus, not all children benefit from strong early vocabulary skills in the same way.
Overall, the findings of this thesis suggest that good vocabulary skill, as measured by standardised tests, is important for educational attainment but not internalising mental health. Effective interventions are potentially well placed to improve educational outcomes. However, moderation effects suggest such early interventions alone may not suffice, since the educational benefits of good early vocabulary do not appear stable over SEC strata. In sum, although early language interventions are well placed to improve educational outcomes, in order to improve wider functioning in adolescence, we also need to directly target internalising mental health and structural inequalities
Supplemental materials for paper: Lifecourse Trajectories and Cross-generation Trends in Social Isolation: Findings from Five Successive British Birth Cohort Studies
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