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Tassie E, Langham J, Gurol-Urganci I, van der Meulen J, Howard LM, Pasupathy D, Sharp H, Davey A, O'Mahen H, Heslin M, Byford S. An exploration of service use pattern changes and cost analysis following implementation of community perinatal mental health teams in pregnant women with a history of specialist mental healthcare in England: a national population-based cohort study. BMC Health Serv Res 2024; 24:359. [PMID: 38561766 PMCID: PMC10983755 DOI: 10.1186/s12913-024-10553-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/03/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The National Health Service in England pledged >£365 million to improve access to mental healthcare services via Community Perinatal Mental Health Teams (CPMHTs) and reduce the rate of perinatal relapse in women with severe mental illness. This study aimed to explore changes in service use patterns following the implementation of CPMHTs in pregnant women with a history of specialist mental healthcare in England, and conduct a cost-analysis on these changes. METHODS This study used a longitudinal cohort design based on existing routine administrative data. The study population was all women residing in England with an onset of pregnancy on or after 1st April 2016 and who gave birth on or before 31st March 2018 with pre-existing mental illness (N = 70,323). Resource use and costs were compared before and after the implementation of CPMHTs. The economic perspective was limited to secondary mental health services, and the time horizon was the perinatal period (from the start of pregnancy to 1-year post-birth, ~ 21 months). RESULTS The percentage of women using community mental healthcare services over the perinatal period was higher for areas with CPMHTs (30.96%, n=9,653) compared to areas without CPMHTs (24.72%, n=9,615). The overall percentage of women using acute care services (inpatient and crisis resolution teams) over the perinatal period was lower for areas with CPMHTs (4.94%, n=1,540 vs. 5.58%, n=2,171), comprising reduced crisis resolution team contacts (4.41%, n=1,375 vs. 5.23%, n=2,035) but increased psychiatric admissions (1.43%, n=445 vs. 1.13%, n=441). Total mental healthcare costs over the perinatal period were significantly higher for areas with CPMHTs (fully adjusted incremental cost £111, 95% CI £29 to £192, p-value 0.008). CONCLUSIONS Following implementation of CPMHTs, the percentage of women using acute care decreased while the percentage of women using community care increased. However, the greater use of inpatient admissions alongside greater use of community care resulted in a significantly higher mean cost of secondary mental health service use for women in the CPMHT group compared with no CPMHT. Increased costs must be considered with caution as no data was available on relevant outcomes such as quality of life or satisfaction with services.
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Grants
- 17/49/38 National Institute for Health and Care Research, UK
- 17/49/38 National Institute for Health and Care Research, UK
- 17/49/38 National Institute for Health and Care Research, UK
- 17/49/38 National Institute for Health and Care Research, UK
- 17/49/38 National Institute for Health and Care Research, UK
- 17/49/38 National Institute for Health and Care Research, UK
- 17/49/38 National Institute for Health and Care Research, UK
- 17/49/38 National Institute for Health and Care Research, UK
- 17/49/38 National Institute for Health and Care Research, UK
- 17/49/38 National Institute for Health and Care Research, UK
- 17/49/38 National Institute for Health and Care Research, UK
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Affiliation(s)
- Emma Tassie
- King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Julia Langham
- Department of Health Services Research & Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Ipek Gurol-Urganci
- Department of Health Services Research & Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Jan van der Meulen
- Department of Health Services Research & Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Dharmintra Pasupathy
- Reproduction and Perinatal Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Helen Sharp
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Antoinette Davey
- Faculty of Life and Environmental Sciences, Department of Psychology, University of Exeter, Perry Road, Prince of Wales Road, Exeter, UK
| | - Heather O'Mahen
- Faculty of Life and Environmental Sciences, Department of Psychology, University of Exeter, Perry Road, Prince of Wales Road, Exeter, UK
| | - Margaret Heslin
- King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sarah Byford
- King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Bozicevic L, Lucas C, Magai DN, Ooi Y, Maliwichi L, Sharp H, Gladstone M. Evaluating caregiver-child interactions in low- and middle-income countries: a systematic review of tools and methods. J Reprod Infant Psychol 2024:1-36. [PMID: 38441002 DOI: 10.1080/02646838.2024.2321615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 02/16/2024] [Indexed: 03/06/2024]
Abstract
AIMS/BACKGROUND The United Nations Sustainable Development Goals (SDGs) has placed emphasis on improving early child development globally. This is supported through the Nurturing Care Framework which includes responsive caregiving. To evaluate responsive caregiving, tools to assess quality of caregiver-child interactions are used, however there is little information on how they are currently employed and/or adapted particularly in low- and middle-income countries (LMICs) where children have a greater risk of adverse outcomes. The aim of this review is to provide a comprehensive guide on methodologies used to evaluate caregiver-child interaction - including their feasibility and cultural adaptation. DESIGN/METHODS We conducted a systematic review of studies over 20years in LMICs which assessed caregiver-child interactions. Characteristics of each tool, their validity (assessed with COSMIN Risk of Bias checklist), and the quality of the study (Mixed Methods Appraisal Tool) are reported. RESULTS We identified 59 studies using 34 tools across 20 different LMICs. Most tools (86.5%) employed video-recorded observations of caregiver-child interactions at home (e.g. Ainsworth's Sensitivity Scale, OMI) or in the laboratory (e.g. PICCOLO) with a few conducting direct observations in the field (e.g. OMCI, HOME); 13.5% were self-reported. Tools varied in methodology with limited or no mention of validity and reliability. Most tools are developed in Western countries and have not been culturally validated for use in LMIC settings. CONCLUSION There are limited caregiver-child interaction measures used in LMIC settings, with only some locally validated locally. Future studies should aim to ensure better validity, applicability and feasibility of caregiver-child interaction tools for global settings.
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Affiliation(s)
- L Bozicevic
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - C Lucas
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - D N Magai
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Y Ooi
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - L Maliwichi
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Department of Psychology and Medical Humanities, School of Humanities and Social Sciences, University of Malawi, Blantyre, Malawi
| | - H Sharp
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - M Gladstone
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
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Gurol-Urganci I, Langham J, Tassie E, Heslin M, Byford S, Davey A, Sharp H, Pasupathy D, van der Meulen J, Howard LM, O'Mahen HA. Community perinatal mental health teams and associations with perinatal mental health and obstetric and neonatal outcomes in pregnant women with a history of secondary mental health care in England: a national population-based cohort study. Lancet Psychiatry 2024; 11:174-182. [PMID: 38278162 DOI: 10.1016/s2215-0366(23)00409-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/17/2023] [Accepted: 11/29/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Women with a pre-existing severe mental disorder have an increased risk of relapse after giving birth. We aimed to evaluate associations of the gradual regional implementation of community perinatal mental health teams in England from April, 2016, with access to mental health care and with mental health, obstetric, and neonatal outcomes. METHODS For this cohort study, we used the national dataset of secondary mental health care provided by National Health Service England, including mental health-care episodes from April 1, 2006, to March 31, 2019, linked at patient level to the Hospital Episode Statistics, and birth notifications from the Personal Demographic Service. We included women (aged ≥18 years) with an onset of pregnancy from April 1, 2016, who had given birth to a singleton baby up to March 31, 2018, and who had a pre-existing mental disorder, defined as contacts with secondary mental health care in the 10 years immediately before pregnancy. The primary outcome was acute relapse, defined as psychiatric hospital admission or crisis resolution team contact in the postnatal period (first year after birth). Secondary outcomes included any secondary mental health care in the perinatal period (pregnancy and postnatal period) and obstetric and neonatal outcomes. Outcomes were compared according to whether a community perinatal mental health team was available before pregnancy, with odds ratios (ORs) adjusted for time trends and maternal characteristics (adjORs). FINDINGS Of 807 798 maternity episodes in England, we identified 780 026 eligible women with a singleton birth, of whom 70 323 (9·0%) had a pre-existing mental disorder. A postnatal acute relapse was found in 1117 (3·6%) of 31 276 women where a community perinatal mental health team was available and in 1745 (4·5%) of 39 047 women where one was unavailable (adjOR 0·77, 95% CI 0·64-0·92; p=0·0038). Perinatal access to any secondary mental health care was found in 9888 (31·6%) of 31 276 women where a community perinatal mental health team was available and 10 033 (25·7%) of 39 047 women where one was not (adjOR 1·35, 95% CI 1·23-1·49; p<0·0001). Risk of stillbirth and neonatal death was higher where a community perinatal mental health team was available (165 [0·5%] of 30 980 women) than where it was not (151 [0·4%] of 38 693 women; adjOR 1·34, 95% CI 1·09-1·66; p=0·0063), as was the risk of a baby small for gestational age (2227 [7·2%] of 31 030 women vs 2542 [6·6%] of 38 762 women; adjOR 1·10, 1·02-1·20; p=0·016), whereas preterm birth risk was lower (3167 [10·1%] of 31 206 women vs 4341 [11·1%] of 38 961; adjOR 0·86, 0·74-0·99; p=0·032). INTERPRETATION The regional availability of community perinatal mental health teams reduced the postnatal risk of acute relapse and increased the overall use of secondary mental health care. Community perinatal mental health teams should have close links with maternity services to avoid intensive psychiatric support overshadowing obstetric and neonatal risks. FUNDING The National Institute for Health and Care Research.
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Affiliation(s)
- Ipek Gurol-Urganci
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Julia Langham
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Emma Tassie
- King's Health Economics, King's College London, London, UK
| | | | - Sarah Byford
- King's Health Economics, King's College London, London, UK
| | - Antoinette Davey
- Washington Singer Laboratories, University of Exeter, Exeter, UK
| | - Helen Sharp
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Dharmintra Pasupathy
- Institute of Psychiatry, Psychology and Neuroscience, and Department of Women and Children's Health, King's College London, London, UK; Reproduction and Perinatal Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Jan van der Meulen
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
| | - Louise M Howard
- Section of Women's Mental Health, King's College London, London, UK
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Bluett-Duncan M, Pickles A, Chandra PS, Hill J, Kishore MT, Satyanarayana V, Sharp H. Experience and Reporting of Postnatal Depression Across Cultures: A Comparison Using Anchoring Vignettes of Mothers in the United Kingdom and India. Am J Epidemiol 2024; 193:214-226. [PMID: 37667811 PMCID: PMC10773478 DOI: 10.1093/aje/kwad182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/06/2023] [Accepted: 08/30/2023] [Indexed: 09/06/2023] Open
Abstract
Postnatal mental health is often assessed using self-assessment questionnaires in epidemiologic research. Differences in response style, influenced by language, culture, and experience, may mean that the same response may not have the same meaning in different settings. These differences need to be identified and accounted for in cross-cultural comparisons. Here we describe the development and application of anchoring vignettes to investigate the cross-cultural functioning of the Edinburgh Postnatal Depression Scale (EPDS) in urban community samples in India (n = 549) and the United Kingdom (n = 828), alongside a UK calibration sample (n = 226). Participants completed the EPDS and anchoring vignettes when their children were 12-24 months old. In an unadjusted item-response theory model, UK mothers reported higher depressive symptoms than Indian mothers (d = 0.48, 95% confidence interval: 0.358, 0.599). Following adjustment for differences in response style, these positions were reversed (d = -0.25, 95% confidence interval: -0.391, -0.103). Response styles vary between India and the United Kingdom, indicating a need to take these differences into account when making cross-cultural comparisons. Anchoring vignettes offer a valid and feasible method for global data harmonization.
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Affiliation(s)
- Matthew Bluett-Duncan
- Correspondence to Dr. Matthew Bluett-Duncan, Division of Neuroscience, University of Manchester, Manchester M13 9NT, United Kingdom (e-mail: )
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Wright N, Hill J, Sharp H, Refberg-Brown M, Crook D, Kehl S, Pickles A. COVID-19 pandemic impact on adolescent mental health: a reassessment accounting for development. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-023-02337-y. [PMID: 38170282 DOI: 10.1007/s00787-023-02337-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024]
Abstract
Current prospective reports suggest a pandemic-related increase in adolescent mental health problems. We examine whether age-related change over 11-14 years accounts for this increase. Mothers and adolescents in a UK-based birth cohort (Wirral Child Health and Development Study; WCHADS; N = 737) reported on adolescent depression and behavioural problems pre-pandemic (December 2019-March 2020), mid-pandemic (June 2020-March 2021) and late pandemic (July 2021-March 2022). Analysis used repeated measures models for over-dispersed Poisson counts with an adolescent-specific intercept with age as a time-varying covariate. Maturational curves for girls, but not for boys, showed a significant increase in self-reported depression symptoms over ages 11-14 years. Behavioural problems decreased for both. After adjusting for age-related change, girls' depression increased by only 13% at mid-pandemic and returned to near pre-pandemic level at late pandemic (mid versus late - 12%), whereas boys' depression increased by 31% and remained elevated (mid versus late 1%). Age-adjusted behavioural problems increased for both (girls 40%, boys 41%) and worsened from mid- to late pandemic (girls 33%, boys 18%). Initial reports of a pandemic-related increase in depression in young adolescent girls could be explained by a natural maturational rise. In contrast, maturational decreases in boys' depression and both boys' and girls' behavioural problems may mask an effect of the pandemic.
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Affiliation(s)
- N Wright
- Department of Psychology, Manchester Metropolitan University, Manchester, UK.
| | - J Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - H Sharp
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - M Refberg-Brown
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - D Crook
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK
| | - S Kehl
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - A Pickles
- Department of Biostatics & Health Informatics, King's College London, London, UK
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Wright N, Courchesne V, Pickles A, Bedford R, Duku E, Kerns CM, Bennett T, Georgiades S, Hill J, Richard A, Sharp H, Smith IM, Vaillancourt T, Zaidman-Zait A, Zwaigenbaum L, Szatmari P, Elsabbagh M. A longitudinal comparison of emotional, behavioral and attention problems in autistic and typically developing children. Psychol Med 2023; 53:7707-7719. [PMID: 37381780 PMCID: PMC10755241 DOI: 10.1017/s0033291723001599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/03/2023] [Accepted: 05/12/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Mental health problems are elevated in autistic individuals but there is limited evidence on the developmental course of problems across childhood. We compare the level and growth of anxious-depressed, behavioral and attention problems in an autistic and typically developing (TD) cohort. METHODS Latent growth curve models were applied to repeated parent-report Child Behavior Checklist data from age 2-10 years in an inception cohort of autistic children (Pathways, N = 397; 84% boys) and a general population TD cohort (Wirral Child Health and Development Study; WCHADS; N = 884, 49% boys). Percentile plots were generated to quantify the differences between autistic and TD children. RESULTS Autistic children showed elevated levels of mental health problems, but this was substantially reduced by accounting for IQ and sex differences between the autistic and TD samples. There was small differences in growth patterns; anxious-depressed problems were particularly elevated at preschool and attention problems at late childhood. Higher family income predicted lower base-level on all three dimensions, but steeper increase of anxious-depressed problems. Higher IQ predicted lower level of attention problems and faster decline over childhood. Female sex predicted higher level of anxious-depressed and faster decline in behavioral problems. Social-affect autism symptom severity predicted elevated level of attention problems. Autistic girls' problems were particularly elevated relative to their same-sex non-autistic peers. CONCLUSIONS Autistic children, and especially girls, show elevated mental health problems compared to TD children and there are some differences in predictors. Assessment of mental health should be integrated into clinical practice for autistic children.
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Affiliation(s)
- N. Wright
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - V. Courchesne
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - A. Pickles
- Department of Biostatistics & Health Informatics, King's College London, London, UK
| | - R. Bedford
- Department of Psychology, University of Bath, Bath, UK
| | - E. Duku
- McMaster University, Hamilton, Canada
| | - C. M. Kerns
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | | | | | - J. Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - A. Richard
- IWK Health Centre, Autism Research Centre, Halifax, Canada
| | - H. Sharp
- Department of Primary Care and Mental Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - I. M. Smith
- Dalhousie University and IWK Health, Halifax, Canada
| | | | | | | | - P. Szatmari
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - M. Elsabbagh
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Pathways Team
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
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Langham J, Gurol-Urganci I, Muller P, Webster K, Tassie E, Heslin M, Byford S, Khalil A, Harris T, Sharp H, Pasupathy D, van der Meulen J, Howard LM, O'Mahen HA. Obstetric and neonatal outcomes in pregnant women with and without a history of specialist mental health care: a national population-based cohort study using linked routinely collected data in England. Lancet Psychiatry 2023; 10:748-759. [PMID: 37591294 DOI: 10.1016/s2215-0366(23)00200-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Pregnant women with pre-existing mental illnesses have increased risks of adverse obstetric and neonatal outcomes compared with pregnant women without pre-existing mental illnesses. We aimed to estimate these differences in risks according to the highest level of pre-pregnancy specialist mental health care, defined as psychiatric hospital admission, crisis resolution team (CRT) contact, or specialist community care only, and the timing of the most recent care episode in the 7 years before pregnancy. METHODS Hospital and birth registration records of women with singleton births between April 1, 2014, and March 31, 2018 in England were linked to records of babies and records from specialist mental health services provided by the England National Health Service, a publicly funded health-care system. We compared the risks of adverse pregnancy outcomes, including fetal and neonatal death, preterm birth, and babies being born small for gestational age (SGA; birthweight <10th percentile), and composite indicators for neonatal adverse outcomes and maternal morbidity, between women with and without a history of contact with specialist mental health care. We calculated odds ratios adjusted for maternal characteristics (aORs), using logistic regression. FINDINGS Of 2 081 043 included women (mean age 30·0 years; range 18-55 years; 77·7% White, 11·4% South Asian, 4·7% Black, and 6·2% mixed or other ethnic background), 151 770 (7·3%) had at least one pre-pregnancy specialist mental health-care contact. 7247 (0·3%) had been admitted to a psychiatric hospital, 29 770 (1·4%) had CRT contact, and 114 753 (5·5%) had community care only. With a pre-pregnancy mental health-care contact, risk of stillbirth or neonatal death within 7 days of birth was not significantly increased (0·45-0·49%; aOR 1·11, 95% CI 0·99-1·24): risk of preterm birth (<37 weeks) increased (6·5-9·8%; aOR 1·53, 1·35-1·73), as did risk of SGA (6·2- 7·5%; aOR 1·34, 1·30-1·37) and neonatal adverse outcomes (6·4-8·4%; aOR 1·37, 1·21-1·55). With a pre-pregnancy mental health-care contact, risk of maternal morbidity increased slightly from 0·9% to 1·0% (aOR 1·18, 1·12-1·25). Overall, risks were highest for women who had a psychiatric hospital admission any time or a mental health-care contact in the year before pregnancy. INTERPRETATION Information about the level and timing of pre-pregnancy specialist mental health-care contacts helps to identify women at increased risk of adverse obstetric and neonatal outcomes. These women are most likely to benefit from dedicated community perinatal mental health teams working closely with maternity services to provide integrated care. FUNDING National Institute for Health Research.
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Affiliation(s)
- Julia Langham
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK; Royal College of Obstetricians and Gynaecologists, London, UK
| | - Ipek Gurol-Urganci
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK; Royal College of Obstetricians and Gynaecologists, London, UK
| | - Patrick Muller
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK; Royal College of Obstetricians and Gynaecologists, London, UK
| | - Kirstin Webster
- Royal College of Obstetricians and Gynaecologists, London, UK
| | - Emma Tassie
- King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Margaret Heslin
- King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sarah Byford
- King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Asma Khalil
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George's University Hospitals, NHS Foundation Trust, London, UK; Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - Tina Harris
- Centre for Reproduction Research, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Helen Sharp
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Dharmintra Pasupathy
- Department of Women and Children's Health, King's College London, London, UK; Reproduction and Perinatal Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Jan van der Meulen
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK; Royal College of Obstetricians and Gynaecologists, London, UK.
| | - Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Zaina L, Choma J, Saad J, Barroca L, Sharp H, Machado L, de Souza CRB. What do software startups need from UX work? Empir Softw Eng 2023; 28:80. [PMID: 37200579 PMCID: PMC10182555 DOI: 10.1007/s10664-023-10322-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 05/20/2023]
Abstract
Empirical research on software development practices in startups is growing. However, little has been investigated about how User eXperience (UX) work has been carried out in software startups. The primary objective of this paper is to investigate what software startups need from UX work. To achieve this goal, we conducted open-ended interviews and retrospective meetings with 16 software professionals from two software startups in Brazil. We analysed the data qualitatively using different coding approaches: initial coding, focused coding, and theoretical coding. We found 14 UX work-related needs which emerged from the daily practices used for software development in the two startups studied. Based on our findings, we propose an initial theoretical framework that highlights two theoretical themes and four groups underlying the needs identified. Our study reveals several relationships between UX work-related needs which are helpful to understand in order to identify what startups need from UX work in practice and to focus startup teams' efforts on the most urgent needs. As future work, we plan to explore ways in which these needs may be addressed so that UX work may be put into practice in software startups.
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Affiliation(s)
- Luciana Zaina
- Federal University of São Carlos, Rdv. João L. Santos, Km 110, Sorocaba, SP Brazil
| | - Joelma Choma
- Federal University of São Carlos, Rdv. João L. Santos, Km 110, Sorocaba, SP Brazil
| | - Jullia Saad
- Federal University of São Carlos, Rdv. João L. Santos, Km 110, Sorocaba, SP Brazil
| | - Leonor Barroca
- Faculty of Science, Technology, Engineering and Mathematics, The Open University, Walton Hall, Milton Keynes, UK
| | - Helen Sharp
- Faculty of Science, Technology, Engineering and Mathematics, The Open University, Walton Hall, Milton Keynes, UK
| | - Leticia Machado
- Federal University of Jequitinhonha and Mucuri Valleys, R. da Glória, 187, Diamantina, MG Brazil
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Evershed RP, Davey Smith G, Roffet-Salque M, Timpson A, Diekmann Y, Lyon MS, Cramp LJE, Casanova E, Smyth J, Whelton HL, Dunne J, Brychova V, Šoberl L, Gerbault P, Gillis RE, Heyd V, Johnson E, Kendall I, Manning K, Marciniak A, Outram AK, Vigne JD, Shennan S, Bevan A, Colledge S, Allason-Jones L, Amkreutz L, Anders A, Arbogast RM, Bălăşescu A, Bánffy E, Barclay A, Behrens A, Bogucki P, Carrancho Alonso Á, Carretero JM, Cavanagh N, Claßen E, Collado Giraldo H, Conrad M, Csengeri P, Czerniak L, Dębiec M, Denaire A, Domboróczki L, Donald C, Ebert J, Evans C, Francés-Negro M, Gronenborn D, Haack F, Halle M, Hamon C, Hülshoff R, Ilett M, Iriarte E, Jakucs J, Jeunesse C, Johnson M, Jones AM, Karul N, Kiosak D, Kotova N, Krause R, Kretschmer S, Krüger M, Lefranc P, Lelong O, Lenneis E, Logvin A, Lüth F, Marton T, Marley J, Mortimer R, Oosterbeek L, Oross K, Pavúk J, Pechtl J, Pétrequin P, Pollard J, Pollard R, Powlesland D, Pyzel J, Raczky P, Richardson A, Rowe P, Rowland S, Rowlandson I, Saile T, Sebők K, Schier W, Schmalfuß G, Sharapova S, Sharp H, Sheridan A, Shevnina I, Sobkowiak-Tabaka I, Stadler P, Stäuble H, Stobbe A, Stojanovski D, Tasić N, van Wijk I, Vostrovská I, Vuković J, Wolfram S, Zeeb-Lanz A, Thomas MG. Dairying, diseases and the evolution of lactase persistence in Europe. Nature 2022; 608:336-345. [PMID: 35896751 PMCID: PMC7615474 DOI: 10.1038/s41586-022-05010-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/22/2022] [Indexed: 12/22/2022]
Abstract
In European and many African, Middle Eastern and southern Asian populations, lactase persistence (LP) is the most strongly selected monogenic trait to have evolved over the past 10,000 years1. Although the selection of LP and the consumption of prehistoric milk must be linked, considerable uncertainty remains concerning their spatiotemporal configuration and specific interactions2,3. Here we provide detailed distributions of milk exploitation across Europe over the past 9,000 years using around 7,000 pottery fat residues from more than 550 archaeological sites. European milk use was widespread from the Neolithic period onwards but varied spatially and temporally in intensity. Notably, LP selection varying with levels of prehistoric milk exploitation is no better at explaining LP allele frequency trajectories than uniform selection since the Neolithic period. In the UK Biobank4,5 cohort of 500,000 contemporary Europeans, LP genotype was only weakly associated with milk consumption and did not show consistent associations with improved fitness or health indicators. This suggests that other reasons for the beneficial effects of LP should be considered for its rapid frequency increase. We propose that lactase non-persistent individuals consumed milk when it became available but, under conditions of famine and/or increased pathogen exposure, this was disadvantageous, driving LP selection in prehistoric Europe. Comparison of model likelihoods indicates that population fluctuations, settlement density and wild animal exploitation-proxies for these drivers-provide better explanations of LP selection than the extent of milk exploitation. These findings offer new perspectives on prehistoric milk exploitation and LP evolution.
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Affiliation(s)
- Richard P Evershed
- Organic Geochemistry Unit, School of Chemistry, University of Bristol, Bristol, UK.
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
- NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK.
| | | | - Adrian Timpson
- Department of Genetics, Evolution and Environment, University College London, London, UK
- Max Planck Institute for the Science of Human History, Jena, Germany
| | - Yoan Diekmann
- Department of Genetics, Evolution and Environment, University College London, London, UK
- Palaeogenetics Group, Institute of Organismic and Molecular Evolution (iomE), Johannes Gutenberg University Mainz, Mainz, Germany
| | - Matthew S Lyon
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK
| | - Lucy J E Cramp
- Department of Anthropology and Archaeology, University of Bristol, Bristol, UK
| | - Emmanuelle Casanova
- Organic Geochemistry Unit, School of Chemistry, University of Bristol, Bristol, UK
| | - Jessica Smyth
- Organic Geochemistry Unit, School of Chemistry, University of Bristol, Bristol, UK
- School of Archaeology, University College Dublin, Dublin, Ireland
| | - Helen L Whelton
- Organic Geochemistry Unit, School of Chemistry, University of Bristol, Bristol, UK
| | - Julie Dunne
- Organic Geochemistry Unit, School of Chemistry, University of Bristol, Bristol, UK
| | - Veronika Brychova
- Department of Dairy, Fat and Cosmetics, University of Chemistry and Technology Prague, Prague, Czech Republic
- Nuclear Dosimetry Department, Institute of Nuclear Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - Lucija Šoberl
- Organic Geochemistry Unit, School of Chemistry, University of Bristol, Bristol, UK
| | - Pascale Gerbault
- Department of Genetics, Evolution and Environment, University College London, London, UK
- School of Life Sciences, University of Westminster, London, UK
| | - Rosalind E Gillis
- Archéozoologie, Archéobotanique: Sociétés, Pratiques et Environnement (UMR 7209), CNRS-Muséum National d'Histoire Naturelle-Sorbonne Universités, Paris, France
- ICArEHB, Faculdade de Ciências Humanas e Sociais, Universidade do Algarve, Faro, Portugal
| | - Volker Heyd
- Department of Anthropology and Archaeology, University of Bristol, Bristol, UK
- Department of Cultures, Section of Archaeology, University of Helsinki, Helsinki, Finland
| | - Emily Johnson
- Department of Archaeology, University of Exeter, Exeter, UK
- Archaeology South-East, UCL Institute of Archaeology, University College London, London, UK
| | - Iain Kendall
- Organic Geochemistry Unit, School of Chemistry, University of Bristol, Bristol, UK
| | - Katie Manning
- Department of Geography, King's College London, London, UK
| | | | - Alan K Outram
- Department of Archaeology, University of Exeter, Exeter, UK
| | - Jean-Denis Vigne
- Archéozoologie, Archéobotanique: Sociétés, Pratiques et Environnement (UMR 7209), CNRS-Muséum National d'Histoire Naturelle-Sorbonne Universités, Paris, France
| | - Stephen Shennan
- UCL Institute of Archaeology, University College London, London, UK
| | - Andrew Bevan
- UCL Institute of Archaeology, University College London, London, UK
| | - Sue Colledge
- UCL Institute of Archaeology, University College London, London, UK
| | | | - Luc Amkreutz
- National Museum of Antiquities, Leiden, the Netherlands
| | - Alexandra Anders
- Institute of Archaeological Sciences, Eötvös Loránd University, Budapest, Hungary
| | | | - Adrian Bălăşescu
- Department of Bioarchaeology, 'Vasile Pârvan' Institute of Archaeology, Romanian Academy, Bucharest, Romania
| | - Eszter Bánffy
- Institute of Archaeology, Research Centre for the Humanities, Eötvös Loránd Research Network, Centre of Excellence of the Hungarian Academy of Sciences, Budapest, Hungary
- Römisch-Germanische Kommission, Frankfurt, Germany
| | | | - Anja Behrens
- German Archaeological Institute, Berlin, Germany
| | - Peter Bogucki
- School of Engineering and Applied Science, Princeton University, Princeton, NJ, USA
| | - Ángel Carrancho Alonso
- Área de Prehistoria, Departamento de Historia, Geografía y Comunicación, University of Burgos, Burgos, Spain
| | - José Miguel Carretero
- Laboratorio Evolución Humana, University of Burgos, Burgos, Spain
- Centro Mixto UCM-ISCIII de Evolución y Comportamiento Humana, Madrid, Spain
| | | | - Erich Claßen
- LVR-State Service for Archaeological Heritage, Bonn, Germany
| | - Hipolito Collado Giraldo
- Patrimonio & Arte Research Group, Extremadura University, Badajoz and Cáceres, Badajoz, Spain
- Geosciences Centre, Coimbra University, Coimbra, Portugal
| | | | | | - Lech Czerniak
- Institute of Archaeology and Ethnology, University of Gdańsk, Gdańsk, Poland
| | - Maciej Dębiec
- Institute of Archaeology, University Rzeszów, Rzeszów, Poland
| | | | | | | | - Julia Ebert
- Institute of Prehistoric Archaeology, Free University of Berlin, Berlin, Germany
| | - Christopher Evans
- Cambridge Archaeological Unit, University of Cambridge, Cambridge, UK
| | | | - Detlef Gronenborn
- Römisch-Germanisches Zentralmuseum, Leibniz Research Institute for Archaeology, Mainz, Germany
| | - Fabian Haack
- Archaeological Department, Landesmuseum Württemberg, Stuttgart, Germany
| | | | - Caroline Hamon
- UMR 8215, Trajectoires, Université Paris 1 Panthéon-Sorbonne, Paris, France
| | - Roman Hülshoff
- State Office for Heritage Management and Archaeology, Saxony Anhalt/State Museum of Prehistory, Halle/Saale, Germany
| | - Michael Ilett
- UMR 8215, Trajectoires, Université Paris 1 Panthéon-Sorbonne, Paris, France
| | - Eneko Iriarte
- Laboratorio Evolución Humana, University of Burgos, Burgos, Spain
| | - János Jakucs
- Institute of Archaeology, Research Centre for the Humanities, Eötvös Loránd Research Network, Centre of Excellence of the Hungarian Academy of Sciences, Budapest, Hungary
| | | | | | - Andy M Jones
- Cornwall Archaeological Unit, Cornwall Council, Truro, UK
| | | | - Dmytro Kiosak
- 'I.I. Mechnikov', Odessa National University, Odessa, Ukraine
- Ca' Foscari, University of Venice, Venice, Italy
| | - Nadezhda Kotova
- Institute of Archaeology of Academy of Science of Ukraine, Kiev, Ukraine
| | - Rüdiger Krause
- Prehistory Department, Institut of Archaeology, Johann Wolfgang Goethe-Universität, Frankfurt, Germany
| | | | - Marta Krüger
- Department of Archaeology, Adam Mickiewicz University, Poznań, Poland
| | - Philippe Lefranc
- UMR 7044, INRAP Grand-Est Sud, University of Strasbourg, Strasbourg, France
| | - Olivia Lelong
- GUARD Glasgow, Glasgow, UK
- Eunomia Research & Consulting, Bristol, UK
| | - Eva Lenneis
- Department of Prehistoric and Historical Archaeology, University of Vienna, Vienna, Austria
| | | | | | - Tibor Marton
- Institute of Archaeology, Research Centre for the Humanities, Eötvös Loránd Research Network, Centre of Excellence of the Hungarian Academy of Sciences, Budapest, Hungary
| | | | | | - Luiz Oosterbeek
- Geosciences Centre, Coimbra University, Coimbra, Portugal
- Polytechnic Institute of Tomar, Tomar, Portugal
- Terra e Memória Institute, Mação, Portugal
| | - Krisztián Oross
- Institute of Archaeology, Research Centre for the Humanities, Eötvös Loránd Research Network, Centre of Excellence of the Hungarian Academy of Sciences, Budapest, Hungary
| | | | - Joachim Pechtl
- Kelten Römer Museum Manching, Manching, Germany
- Department of Archaeology, University of Innsbruck, Innsbruck, Austria
| | - Pierre Pétrequin
- MSHE C.N. Ledoux, CNRS & University of Franche-Comté, Besançon, France
| | - Joshua Pollard
- Department of Archaeology, University of Southampton, Southampton, UK
| | | | | | - Joanna Pyzel
- Institute of Archaeology and Ethnology, University of Gdańsk, Gdańsk, Poland
| | - Pál Raczky
- Institute of Archaeological Sciences, Eötvös Loránd University, Budapest, Hungary
| | | | - Peter Rowe
- Tees Archaeology, Hartlepool, UK
- North Yorkshire County Council HER, Northallerton, UK
| | | | | | - Thomas Saile
- Institute of History, University of Regensburg, Regensburg, Germany
| | - Katalin Sebők
- Institute of Archaeological Sciences, Eötvös Loránd University, Budapest, Hungary
| | - Wolfram Schier
- Institute of Prehistoric Archaeology, Free University of Berlin, Berlin, Germany
| | | | | | - Helen Sharp
- Leicestershire County Council Museums, Leicestershire, UK
| | | | | | - Iwona Sobkowiak-Tabaka
- Institute of Archaeology and Ethnology, Polish Academy of Sciences, Poznań, Poland
- Faculty of Archaeology, Adam Mickiewicz University, Poznań, Poland
| | - Peter Stadler
- Department of Prehistoric and Historical Archaeology, University of Vienna, Vienna, Austria
| | | | - Astrid Stobbe
- Prehistory Department, Institut of Archaeology, Johann Wolfgang Goethe-Universität, Frankfurt, Germany
| | - Darko Stojanovski
- Geology Department, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
- Department of Humanistic Studies, University of Ferrara, Ferrara, Italy
| | | | - Ivo van Wijk
- Faculty of Archaeology, Leiden University, Leiden, the Netherlands
| | - Ivana Vostrovská
- Institute of Archaeology and Museology, Masaryk University, Brno, Czech Republic
- Department of History, Palacký University, Olomouc, Czech Republic
| | | | | | - Andrea Zeeb-Lanz
- Generaldirektion Kulturelles Erbe Rheinland-Pfalz, Dir. Landesarchäologie, Speyer, Germany
| | - Mark G Thomas
- Department of Genetics, Evolution and Environment, University College London, London, UK.
- UCL Genetics Institute, University College London, London, UK.
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10
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Obando D, Hill J, Sharp H, Pickles A, Fisher L, Wright N. Synergy between callous-unemotional traits and aggression in preschool children: Cross-informant and cross-cultural replication in the UK Wirral Child Health and Development Study, and the Colombian La Sabana Parent-Child Study. Dev Psychopathol 2022; 34:1079-1087. [PMID: 33752771 DOI: 10.1017/s0954579420002114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Incremental prediction of aggression from callous-unemotional (CU) traits is well established, but cross-cultural replication and studies of young children are needed. Little is understood about the contribution of CU traits in children who are already aggressive. We addressed these issues in prospective studies in the United Kingdom and Colombia. In a UK epidemiological cohort, CU traits and aggression were assessed at age 3.5 years, and aggression at 5.0 years by mothers (N = 687) and partners (N = 397). In a Colombian general population sample, CU traits were assessed at age 3.5 years and aggression at 3.5 and 5.0 years by mother report (N = 220). Analyses consistently showed prediction of age-5.0 aggression by age-3.5 CU traits controlling for age-3.5 aggression. Associations between age-3.5 CU traits and age-5.0 aggression were moderated by aggression at 3.5 years, with UK interaction terms, same informant, β = .07 p = .014 cross-informant, β = .14 p = .002, and in Colombia, β = .09 p = .128. The interactions arose from stronger associations between CU traits and later aggression in those already aggressive. Our findings with preschoolers replicated across culturally diverse settings imply a major role for CU traits in the maintenance and amplification of already established aggression, and cast doubt on their contribution to its origins.
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Affiliation(s)
- D Obando
- Department of Psychology, Universidad de La Sabana, Chia, Colombia
| | - J Hill
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - H Sharp
- School of Psychology, Institute of Health & Life Sciences, University of Liverpool, Liverpool, UK
| | - A Pickles
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
| | - L Fisher
- School of Psychology, Institute of Health & Life Sciences, University of Liverpool, Liverpool, UK
| | - N Wright
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
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Sharp H, Berry C, Cuthbert S. Working in the Woodlands: A mixed methods evaluation of Green Care in First Episode Psychosis. Eur Psychiatry 2022. [PMCID: PMC9567196 DOI: 10.1192/j.eurpsy.2022.532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Recognition of the essential role of nature-based activities for general wellbeing is expanding. Currently, there is limited evidence of the benefits of green care for those with severe and enduring mental illness, including psychosis. Objectives We aim to establish benefits and difficulties encountered during a 10-session green care programme for 18-30 year olds who have experienced first episode of psychosis (FEP) using a mixed methods approach. Methods This was a service evaluation of a ’Woodland Group’ of 10 half-day sessions for participants with FEP. Sessions consisted of a welcome and agenda setting, ice-breaking activity, core nature-based activity. Quantitative data for this evaluation was collected through the 15-item Questionnaire on the Process of Recovery (QPR), and a semi-structured intervention experience questionnaire. Qualitative data was collected via a focus group. Thematic analysis was performed by the three co-authors. Results 4/8 patients showed reliable improvement on QPR outcome measures, 1 showed deterioration and 3 showed no change. Mean QPR scores showed modest increase from average 3.4 (week 1) to 3.8 (week 10). 100% of respondents would recommend this group to others. Thematic analysis identified themes of connection with nature and others, development of a sense of wellbeing and ‘peacefulness’ and new perspectives on psychotic experience. Conclusions This small, retrospective evaluation is the first to investigate green care interventions for young people experiencing FEP. Our results reflect the positive informal feedback from participants and supporting staff. Limitations include small sample size, incomplete data, and reliance on patient-reported outcomes. These findings show promise for nature-based activities within EIS. Disclosure No significant relationships.
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Hodsoll J, Pickles A, Bozicevic L, Supraja TA, Hill J, Chandra PS, Sharp H. A Comparison of Non-verbal Maternal Care of Male and Female Infants in India and the United Kingdom: The Parent-Infant Caregiving Touch Scale in Two Cultures. Front Psychol 2022; 13:852618. [PMID: 35401353 PMCID: PMC8984138 DOI: 10.3389/fpsyg.2022.852618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/21/2022] [Indexed: 12/04/2022] Open
Abstract
Differences in infant caregiving behavior between cultures have long been noted, although the quantified comparison of touch-based caregiving using uniform standardized methodology has been much more limited. The Parent-Infant Caregiving Touch scale (PICTS) was developed for this purpose and programming effects of early parental tactile stimulation (stroking) on infant hypothalamic-pituitary adrenal (HPA)-axis functioning (stress-response system), cardiovascular regulation and behavioral outcomes, similar to that reported in animals, have now been demonstrated. In order to inform future studies examining such programming effects in India, we first aimed to describe and examine, using parametric and non-parametric item-response methods, the item-response frequencies and characteristics of responses on the PICTS, and evidence for cross-cultural differential item functioning (DIF) in the United Kingdom (UK) and India. Second, in the context of a cultural favoring of male children in India, we also aimed to test the association between the sex of the infant and infant "stroking" in both cultural settings. The PICTS was administered at 8-12 weeks postpartum to mothers in two-cohort studies: The Wirral Child Health and Development Study, United Kingdom (n = 874) and the Bangalore Child Health and Development Study, India (n = 395). Mokken scale analysis, parametric item-response analysis, and structural equation modeling for categorical items were used. Items for two dimensions, one for stroking behavior and one for holding behavior, could be identified as meeting many of the criteria required for Mokken scales in the United Kingdom, only the stroking scale met these criteria in the sample from India. Thus, while a comparison between the two cultures was possible for the stroking construct, comparisons for the other non-verbal parenting constructs within PICTS were not. Analyses revealed higher rates of early stroking being reported for the United Kingdom than India, but no sex differences in rates in either country and no differential sex difference by culture. We conclude that PICTS items can be used reliably in both countries to conduct further research on the role of early tactile stimulation in shaping important child development outcomes.
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Affiliation(s)
- John Hodsoll
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Andrew Pickles
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Laura Bozicevic
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | | | - Jonathan Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Prabha S. Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Helen Sharp
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
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Braithwaite EC, Sharp H, Pickles A, Hill J, Wright N. Breast may not always be best: moderation of effects of postnatal depression by breastfeeding and infant sex. Biol Sex Differ 2021; 12:59. [PMID: 34743731 PMCID: PMC8573903 DOI: 10.1186/s13293-021-00403-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 10/25/2021] [Indexed: 11/28/2022] Open
Abstract
Background There is good evidence that female infants are particularly vulnerable to poor emotional outcomes following in utero glucocorticoid exposure. It is currently unclear whether such effects might persist into the postnatal period for breastfed infants, as maternal cortisol is expressed in breastmilk and is influenced by maternal psychological distress. We pre-registered hypotheses that maternal postnatal depression would be associated with infant negative emotionality, and that this effect would be moderated by breastfeeding status and infant sex. Methods We analysed data from the Wirral Child Health and Development Study (WCHADS), a prospective epidemiological study starting in pregnancy. Nine weeks after birth mothers self-reported depressive symptoms and breastfeeding status, and reported infant negative emotionality using the distress to limits subscale of the infant behaviour questionnaire (IBQ-R) when their infant was aged 9 weeks and 14 months. Maximum likelihood estimations made use of data from 857 mother-infant pairs. Results At 9 weeks of age, maternal postnatal depressive symptoms were positively associated with infant distress to limits; however, this effect was not moderated by infant sex or breastfeeding. At age 14 months, the association between postnatal depression symptoms and distress to limits was greatest in the breastfed females, whereas the association was smaller, but still significant, in the non-breastfed females. For males, the association was non-significant in both the breastfed and non-breastfed groups. A test of sex difference between breastfed males and females was significant. Conclusions We provide evidence that effects of maternal postnatal depression on child emotional outcomes are moderated by breastfeeding status and differ by infant sex. Female vulnerability to elevated maternal breastmilk glucocorticoids may, at least in part, explain these effects. Female infants breastfed by mothers with high depressive symptoms showed the highest levels of negative emotionality at age 14 months. Conversely, female infants breastfed by mothers with very low depressive symptoms showed the lowest negative emotionality. Negative emotionality of males was unrelated to maternal postnatal depression and breastfeeding at 14 months of age. We provide novel evidence that effects of maternal postnatal depression on infant emotional outcomes is moderated by breastfeeding status and differs by infant sex.
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Affiliation(s)
- Elizabeth C Braithwaite
- Department of Psychology, Faculty of Health and Education, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester, M15 6GX, UK.
| | - Helen Sharp
- Department of Primary Care and Mental Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Andrew Pickles
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Jonathan Hill
- School for Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Nicola Wright
- Department of Psychology, Faculty of Health and Education, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester, M15 6GX, UK
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14
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Bedford R, Carter Leno V, Wright N, Bluett-Duncan M, Smith TJ, Anzures G, Pickles A, Sharp H, Hill J. Emotion Recognition Performance in Children with Callous Unemotional Traits is Modulated by Co-occurring Autistic Traits. J Clin Child Adolesc Psychol 2021; 50:811-827. [PMID: 33252272 DOI: 10.1080/15374416.2020.1833338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Atypical emotion recognition (ER) is characteristic of children with high callous unemotional (CU) traits. The current study aims to 1) replicate studies showing ER difficulties for static faces in relation to high CU-traits; 2) test whether ER difficulties remain when more naturalistic dynamic stimuli are used; 3) test whether ER performance for dynamic stimuli is moderated by eye-gaze direction and 4) assess the impact of co-occurring autistic traits on the association between CU and ER. METHODS Participants were 292 (152 male) 7-year-olds from the Wirral Child Health and Development Study (WCHADS). Children completed a static and dynamic ER eye-tracking task, and accuracy, reaction time and attention to the eyes were recorded. RESULTS Higher parent-reported CU-traits were significantly associated with reduced ER for static expressions, with lower accuracy for angry and happy faces. No association was found for dynamic expressions. However, parent-reported autistic traits were associated with ER difficulties for both static and dynamic expressions, and after controlling for autistic traits, the association between CU-traits and ER for static expressions became non-significant. CU-traits and looking to the eyes were not associated in either paradigm. CONCLUSION The finding that CU-traits and ER are associated for static but not naturalistic dynamic expressions may be because motion cues in the dynamic stimuli draw attention to emotion-relevant features such as eyes and mouth. Further, results suggest that ER difficulties in CU-traits may be due, in part, to co-occurring autistic traits. Future developmental studies are required to tease apart pathways toward the apparently overlapping cognitive phenotype.
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Affiliation(s)
- Rachael Bedford
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London
- Department of Psychology, University of Bath
| | - Virginia Carter Leno
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London
| | - Nicola Wright
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London
- Department of Psychological Sciences, Institute of Life and Human Sciences, Liverpool University
| | - Matthew Bluett-Duncan
- Department of Psychological Sciences, Institute of Life and Human Sciences, Liverpool University
| | - Tim J Smith
- Department of Psychological Sciences, Birkbeck College, University of London
| | - Gizelle Anzures
- Department of Psychology, Florida Atlantic University
- Brain Institute, Florida Atlantic University
| | - Andrew Pickles
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London
| | - Helen Sharp
- Department of Psychological Sciences, Institute of Life and Human Sciences, Liverpool University
| | - Jonathan Hill
- School of Psychology and Clinical Language Sciences, University of Reading
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15
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Wright N, Hill J, Sharp H, Pickles A. Interplay between long-term vulnerability and new risk: Young adolescent and maternal mental health immediately before and during the COVID-19 pandemic. JCPP Adv 2021; 1:e12008. [PMID: 34485987 PMCID: PMC8206735 DOI: 10.1111/jcv2.12008] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/10/2021] [Accepted: 02/26/2021] [Indexed: 11/29/2022] Open
Abstract
Background We examine whether there has been an increase in young adolescent and maternal mental health problems from pre- to post-onset of the COVID-19 pandemic. Methods Children aged 11-12 years and their mothers participating in a UK population-based birth cohort (Wirral Child Health and Development Study) provided mental health data between December 2019 and March 2020, and again 3 months after lockdown, 89% (N = 202) of 226 assessed pre-COVID-19. Emotional and behavioural problems were assessed by self- and maternal reports, and long-term vulnerability by maternal report of prior child adjustment, and maternal prenatal depression. Results The young adolescents reported a 44% (95% confidence interval [CI: 23%-65%]) increase in symptoms of depression and 26% (95% CI [12%-40%]) for post-traumatic stress disorder, with corresponding maternal reports of child symptoms of 71% (95% CI [44%-99%]) and 43% (95% CI 29%-86%). Disruptive behaviour problem symptoms increased by 76% (95% CI [43%-109%]) particularly in children without previous externalising symptoms. Both female gender and having had high internalising symptoms earlier in childhood were associated with elevated rates of depression pre-pandemic, and with greater absolute increases during COVID-19. Mothers' own depression symptoms increased by 42% (95% CI [20%-65%]), and this change was greater among mothers who had prenatal depression. No change in anxiety was observed among children or mothers. None of these increases were moderated by COVID-19-related experiences such as frontline worker status of a parent. Prior to the pandemic, rates of maternal and child depression were greater in families experiencing higher deprivation, but changed only in less deprived families, raising their rates to those of the high deprivation group. Conclusions COVID-19 has led to a marked increase in mental health problems in young adolescents and their mothers with concomitant requirements for mental health services to have the resources to adapt to meet the level and nature of the needs.
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Affiliation(s)
- Nicola Wright
- Department of Biostatistics & Health Informatics Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
| | - Jonathan Hill
- School of Psychology and Clinical Language Sciences University of Reading Reading Berkshire UK
| | - Helen Sharp
- Department of Life and Human Sciences University of Liverpool Liverpool Merseyside UK
| | - Andrew Pickles
- Department of Biostatistics & Health Informatics Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
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Parsons IT, Stacey MJ, Faconti L, Hill N, O’Hara J, Walter E, Farukh B, McNally R, Sharp H, Patten A, Grimaldi R, Gall N, Chowienczyk P, Woods DR. Correction to: Histamine, mast cell tryptase and post-exercise hypotension in healthy and collapsed marathon runners. Eur J Appl Physiol 2021; 121:3257-3258. [PMID: 34410476 PMCID: PMC8505363 DOI: 10.1007/s00421-021-04782-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- I. T. Parsons
- Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, England
- School of Cardiovascular Medicine and Sciences, King’s College London, London, UK
| | - M. J. Stacey
- Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, England
- Imperial College Healthcare NHS Trust, London, UK
| | - L. Faconti
- School of Cardiovascular Medicine and Sciences, King’s College London, London, UK
| | - N. Hill
- Imperial College Healthcare NHS Trust, London, UK
| | - J. O’Hara
- Carnegie School of Sport, Leeds Beckett University, Leeds, England
| | - E. Walter
- Royal Surrey County Hospital NHS Foundation Trust, London, UK
| | - B. Farukh
- School of Cardiovascular Medicine and Sciences, King’s College London, London, UK
| | - R. McNally
- School of Cardiovascular Medicine and Sciences, King’s College London, London, UK
| | - H. Sharp
- Brighton and Sussex NHS Trust, London, UK
| | - A. Patten
- Brighton and Sussex NHS Trust, London, UK
| | | | - N. Gall
- King’s College Hospital, London, UK
| | - P. Chowienczyk
- School of Cardiovascular Medicine and Sciences, King’s College London, London, UK
| | - D. R. Woods
- Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, England
- Carnegie School of Sport, Leeds Beckett University, Leeds, England
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Holla C, Bozicevic L, Sharp H, Chandra PS. The feasibility of using videos to assess maternal sensitivity in low income urban settings in India - The researcher's perspective. Asian J Psychiatr 2021; 61:102672. [PMID: 34020321 DOI: 10.1016/j.ajp.2021.102672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/14/2021] [Accepted: 05/05/2021] [Indexed: 11/20/2022]
Abstract
Maternal sensitivity is one of the parenting dimensions associated with optimal child outcomes. Video-recording mother-child interactions is an objective and methodologically accurate way to assess maternal sensitivity. This research method is widely used in Western settings, but data is lacking in low-and-middle-income countries. We present findings drawn from the Bangalore Child Health and Development Study on the feasibility of video-recording interactions in low income home settings in India. Cultural, personal and practical advantages reported by researchers and strategies implemented to overcome barriers are described in the present letter to inform researchers who intend to use this method in non-Western populations.
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Affiliation(s)
- Chaithra Holla
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangalore, India.
| | - Laura Bozicevic
- Faculty of Health and Life Sciences, University of Liverpool, UK.
| | - Helen Sharp
- Faculty of Health and Life Sciences, University of Liverpool, UK.
| | - Prabha S Chandra
- National Institute of Mental Health and Neurosciences, Bangalore, India.
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Bluett-Duncan M, Kishore MT, Patil DM, Satyanarayana VA, Sharp H. A systematic review of the association between perinatal depression and cognitive development in infancy in low and middle-income countries. PLoS One 2021; 16:e0253790. [PMID: 34170948 PMCID: PMC8232443 DOI: 10.1371/journal.pone.0253790] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 06/14/2021] [Indexed: 11/18/2022] Open
Abstract
The association between perinatal depression and infant cognitive development has been well documented in research based in high-income contexts, but the literature regarding the same relationship in low and middle-income countries (LMICs) is less developed. The aim of this study is to systematically review what is known in this area in order to inform priorities for early intervention and future research in LMICs. The review protocol was pre-registered on Prospero (CRD42018108589) and relevant electronic databases were searched using a consistent set of keywords and 1473 articles were screened against the eligibility criteria. Sixteen articles were included in the review, seven focusing on the antenatal period, eight on the postnatal period, and one which included both. Five out of eight studies found a significant association between antenatal depression (d = .21-.93) and infant cognitive development, while four out of nine studies found a significant association with postnatal depression (d = .17-.47). Although the evidence suggests that LMICs should prioritise antenatal mental health care, many of the studies did not adequately isolate the effects of depression in each period. Furthermore, very few studies explored more complex interactions that may exist between perinatal depression and other relevant factors. More high-quality studies are needed in LMIC settings, driven by current theory, that test main effects and examine moderating or mediating pathways to cognitive development.
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Affiliation(s)
- Matthew Bluett-Duncan
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, United Kingdom
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - M. Thomas Kishore
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Divya M. Patil
- Department of Epidemiology, School of Public Health, University of Washington, Washington, DC, United States of America
| | - Veena A. Satyanarayana
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Helen Sharp
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, United Kingdom
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Sharp H, Themelis K, Amato M, Barritt A, Davies K, Harrison N, Critchley H, Garfinkel S, Eccles J. The role of interoception in the mechanism of pain and fatigue in fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Eur Psychiatry 2021. [PMCID: PMC9471464 DOI: 10.1192/j.eurpsy.2021.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionPain, fatigue and anxiety are common features of fibromyalgia and ME/CFS and significantly impact quality of life. Aetiology is poorly defined but dysfunctional inflammatory, autonomic and interoceptive (sensing of internal bodily signals) processes are implicated.ObjectivesTo investigate how altered interoception relates to baseline expression of pain, fatigue and anxiety symptoms in fibromyalgia and ME/CFS and in response to an inflammatory challenge.MethodsSixty-five patients with fibromyalgia and/or ME/CFS diagnosis and 26 matched controls underwent baseline assessment: pressure-pain thresholds and self-report questionnaires assessing pain, fatigue and anxiety severity. Participants received injections of typhoid (inflammatory challenge) or saline (placebo) in a randomised, double-blind, crossover design, before completing heartbeat tracking tasks. Three interoception dimensions were examined: subjective sensibility, objective accuracy and metacognitive awareness. Interoceptive trait prediction error was calculated as discrepancy between accuracy and sensibility.ResultsPatients with fibromyalgia and ME/CFS had significantly higher interoceptive sensibility and trait prediction error, despite no differences in interoceptive accuracy. Interoceptive sensibility and trait prediction error correlated with all self-report pain, fatigue and anxiety measures, and with lower pain thresholds. Anxiety mediated the positive-predictive relationships between pain (Visual Analogue Scale and Widespread Pain Index), fatigue impact and interoceptive sensibility. After inflammatory challenge, metacognitive awareness correlated with baseline self-reported symptom measures and lower pain thresholds.ConclusionsThis is the first study investigating interoceptive dimensions in patients with fibromyalgia and ME/CFS, which were found to be dysregulated and differentially influenced by inflammatory mechanisms. Interoceptive processes may represent a new potential target for diagnostic and therapeutic investigation in these poorly understood conditions.DisclosureNo significant relationships.
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Wright N, Hill J, Sharp H, Pickles A. Commentary response: Addressing the scientific as well as the social-inequalities questions - Response to the commentary of Newlove-Delgado (2021). JCPP Adv 2021; 1:e12015. [PMID: 37431504 PMCID: PMC10242957 DOI: 10.1111/jcv2.12015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Nicola Wright
- Department of Biostatistics & Health InformaticsInstitute of PsychiatryKing's College LondonLondonUK
| | - Jonathan Hill
- Department of Child and Adolescent PsychiatrySchool of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Helen Sharp
- Department of Perinatal and Child and Adolescent Clinical PsychologyInstitute of Life and Human SciencesUniversity of LiverpoolLiverpoolUK
| | - Andrew Pickles
- Department of Biostatistics & Health InformaticsInstitute of PsychiatryKing's College LondonLondonUK
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21
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Slade P, Sheen K, Weeks A, Wray S, De Pascalis L, Lunt K, Bedwell C, Thompson B, Hill J, Sharp H. Do stress and anxiety in early pregnancy affect the progress of labor: Evidence from the Wirral Child Health and Development Study. Acta Obstet Gynecol Scand 2021; 100:1288-1296. [PMID: 33543770 PMCID: PMC8359214 DOI: 10.1111/aogs.14063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/24/2020] [Accepted: 11/19/2020] [Indexed: 12/01/2022]
Abstract
Introduction Despite widespread belief that anxiety causes longer labor, evidence of association is inconsistent. Data gathered as part of a prospective epidemiological longitudinal study were used to investigate associations between antenatal anxiety and pregnancy‐specific stress, and labor progression was assessed by duration and use of augmentation. Material and methods Pregnant primiparous women completed measures for anxiety and pregnancy‐specific stress at 20 weeks’ gestation (n = 1145). Birth outcome data were extracted from medical records. Regression analyses and a path analysis assessed associations between antenatal anxiety and pregnancy‐specific stress, and indices of labor progression (labor duration and augmentation). Results Anxiety/pregnancy‐specific stress were not directly associated with duration of stage 1 labor (HIGH/LOW anxiety: mean difference = 13.94 minutes, SD = 20.66, 95% CI −26.60 to 54.49, P < .50)/(HIGH/LOW pregnancy‐specific stress: mean difference = 12.05 minutes, SD = 16.09, 95% CI −19.52 to 43.63, P < .45). However, anxiety/pregnancy‐specific stress were associated with epidural use (HIGH/LOW anxiety: 39% vs 31%, P < .042; HIGH/LOW pregnancy‐specific stress: 38% vs 29%, P < .001), which was itself associated with longer labor (mean difference: 158.79 minutes, SD = 16.76, 95% CI 125.89‐191.68, P < .001). Anxiety and pregnancy‐specific stress were associated with increased likelihood of augmentation but these associations were nonsignificant after accounting for epidural, which was itself highly associated with augmentation. However, path analysis indicated an indirect effect linking pregnancy‐specific stress, but not general anxiety, to labor duration and augmentation: elevated pregnancy‐specific stress led to greater use of epidural, which was linked to both increased rates of augmentation, and increased labor duration. Conclusions Contrary to general belief, general anxiety and specific pregnancy stress were not directly linked to longer duration of stage one labor. However specific pregnancy stress was associated with epidural use, which in turn was significantly associated with risk of augmentation, and longer stage one labor. Identification of pregnancy‐specific stress could help to identify women for whom psychological interventions could improve birth experience.
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Affiliation(s)
- Pauline Slade
- Department of Primary Care and Mental Health, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - Kayleigh Sheen
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Andrew Weeks
- Department of Women's and Children's Health, University of Liverpool, Liverpool Women's Hospital, Liverpool, UK
| | - Susan Wray
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - Leonardo De Pascalis
- Psychological Sciences, Institute of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Karen Lunt
- Department of Midwifery, Child and Reproductive Health, University of Chester, Chester, UK
| | - Carol Bedwell
- International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Johnathan Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Helen Sharp
- Department of Primary Care and Mental Health, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
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Kern F, Sharp H, Hachmann S. Governing the second deep transition towards a circular economy: How rules emerge, align and diffuse. Environ Innov Soc Transit 2020; 37:171-186. [PMID: 32959009 PMCID: PMC7493796 DOI: 10.1016/j.eist.2020.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 06/26/2020] [Accepted: 08/28/2020] [Indexed: 06/11/2023]
Abstract
The recently developed Deep Transitions framework has so far been mainly used to explore the first deep transition towards industrial modernity. This paper looks at a potential second deep transition towards a circular economy, which is hoped to lead to a more sustainable global economic system. Our focus is on exploring the role of the EU in developing and diffusing this emerging set of rules. We draw on ideas from the international relations literature to explain why and how the EU adopted the idea of a circular economy, helped formulate it into a set of rules and how it promoted its international diffusion. The paper concludes with lessons about the case and critical reflections about the Deep Transitions framework. In particular, we argue for taking a more actor-based approach when researching the unfolding second deep transition.
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Affiliation(s)
- Florian Kern
- Institute for Ecological Economy Research, Potsdamer Str. 105, 10785 Berlin, Germany
| | - Helen Sharp
- Institute for Ecological Economy Research, Potsdamer Str. 105, 10785 Berlin, Germany
| | - Samyra Hachmann
- Institute for Ecological Economy Research, Potsdamer Str. 105, 10785 Berlin, Germany
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23
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Braithwaite EC, Pickles A, Wright N, Sharp H, Hill J. Sex differences in foetal origins of child emotional symptoms: a test of evolutionary hypotheses in a large, general population cohort. J Child Psychol Psychiatry 2020; 61:1194-1202. [PMID: 32196666 PMCID: PMC8641379 DOI: 10.1111/jcpp.13229] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 01/07/2020] [Accepted: 01/24/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Based on previous findings from the Wirral Child Health and Development Study (WCHADS), and on evolutionary hypotheses, we preregistered analyses of data from a large epidemiological sample (https://osf.io/fn5g9/register/564d31db8c5e4a7c9694b2be), to test for sex-dependent moderation by prenatal maternal depressive symptoms of the association between postnatal maternal depressive symptoms and child emotional problems. METHODS A total of 8,354 mothers and children were followed from pregnancy to 3.5 years in the Avon Longitudinal Study of Parents and Children (ALSPAC). Self-report measures of prenatal and postnatal maternal depressive symptoms, and maternal report of child emotional symptoms were administered. RESULTS There was a three-way interaction between maternal prenatal and postnatal depression, and child sex (Coeff .042 95% CI 0.015 to 0.068, p = .002). This arose from moderation by prenatal depression, in opposite directions in boys and in girls. In boys, the association between postnatal depression and child emotional symptoms was weaker following lower prenatal depressive symptoms (interaction term coeff = .030, p = .001), and in girls, to a lesser extent, the association was stronger following lower prenatal depressive symptoms (interaction term coeff = -.012, p = .221). CONCLUSIONS We replicated the finding from the WCHADS that prenatal depression modifies the association between postnatal depression and children's emotional problems in a sex-dependent fashion. In ALSPAC, the sex difference was explained mainly by a protective effect of low prenatal depression in boys, while in WCHADS, it arose from greater vulnerability of girls to postnatal depression following low prenatal depression. In the light of these findings, in evaluating and implementing early interventions, there is need to consider that risks associated with postnatal depression may vary depending on maternal mood during pregnancy and may differ between boys and girls.
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Affiliation(s)
- Elizabeth C. Braithwaite
- Department of PsychologyFaculty of Health, Psychology and Social CareManchester Metropolitan UniversityManchesterUK
| | - Andrew Pickles
- Department of Biostatistics and Health InformaticsInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Nicola Wright
- Department of Biostatistics and Health InformaticsInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Helen Sharp
- Department of Psychological SciencesFaculty of Health and Life SciencesUniversity of LiverpoolLiverpoolUK
| | - Jonathan Hill
- School for Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
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24
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Wright N, Pickles A, Braithwaite EC, Sharp H, Hill J. Sex-dependent associations between maternal prenatal cortisol and child callous-unemotional traits: Findings from the Wirral Child Health and Development Study. Psychoneuroendocrinology 2019; 109:104409. [PMID: 31446327 PMCID: PMC6857434 DOI: 10.1016/j.psyneuen.2019.104409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 07/12/2019] [Accepted: 08/12/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Elevated maternal glucocorticoids during pregnancy may impact on fetal development in a sex-dependent way, leading to increased amygdala activation and increased risk for internalising disorders in females. Based on evidence implicating reduced amygdala activation in callous-unemotional (CU) traits, we predicted that elevated maternal cortisol in pregnancy would be associated with lower CU traits and elevated anxious-depressed symptoms, only in girls. METHODS Participants were 225 members of a stratified subsample within an epidemiological longitudinal cohort (WCHADS). Salivary cortisol was measured over two days at 32 weeks gestation (on waking, 30-min post-waking and during the evening) and the log of the area under the curve (LogAUC) was calculated as an index of diurnal cortisol. Mothers reported on child CU traits and anxious-depressed symptoms at 2.5, 3.5 and 5.0 years of age. RESULTS As predicted there was a sex of child by cortisol interaction (p < .001) whereby elevated maternal cortisol was associated with lower child CU traits, explaining 25% of the variance, in girls, but not in boys. This effect remained when controlling for relevant confounders and anxious-depressed symptoms. By contrast, elevated maternal cortisol did not predict higher anxious-depressed symptoms in girls. CONCLUSIONS The study adds to growing evidence for sex-dependent effects of elevated maternal cortisol during pregnancy on early child psychopathology, consistent with mediation by elevated amygdala activation. The conditions under which, in girls, this is associated with heightened responsiveness to others' distress characteristic of low CU traits, or with increased affective symptoms, require further study.
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Affiliation(s)
- Nicola Wright
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
| | - Andrew Pickles
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
| | | | - Helen Sharp
- Department of Psychological Sciences, Institute of Life and Human Sciences, Liverpool, UK.
| | - Jonathan Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
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25
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Manca M, Pessoa V, Myers P, Pickles A, Hill J, Sharp H, Murgatroyd C, Bubb VJ, Quinn JP. Distinct chromatin structures at the monoamine oxidase-A promoter correlate with allele-specific expression in SH-SY5Y cells. Genes Brain Behav 2019; 18:e12483. [PMID: 29667298 PMCID: PMC6617726 DOI: 10.1111/gbb.12483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/19/2018] [Accepted: 04/13/2018] [Indexed: 11/30/2022]
Abstract
Monoamine oxidase-A (MAOA) metabolises monoamines and is implicated in the pathophysiology of psychiatric disorders. A polymorphic repetitive DNA domain, termed the uVNTR (upstream variable number tandem repeat), located at the promoter of the MAOA gene is a risk factor for many of these disorders. MAOA is on the X chromosome suggesting gender could play a role in regulation. We analysed MAOA regulation in the human female cell line, SH-SY5Y, which is polymorphic for the uVNTR. This heterozygosity allowed us to correlate allele-specific gene expression with allele-specific transcription factor binding and epigenetic marks for MAOA. Gene regulation was analysed under basal conditions and in response to the mood stabiliser sodium valproate. Both alleles were transcriptionally active under basal growth conditions; however, the alleles showed distinct transcription factor binding and epigenetic marks at their respective promoters. Exposure of the cells to sodium valproate resulted in differential allelic expression which correlated with allele-specific changes in distinct transcription factor binding and epigenetic marks at the region encompassing the uVNTR. Biochemically our model for MAOA promoter function has implications for gender differences in gene × environment responses in which the uVNTR has been implicated as a genetic risk.
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Affiliation(s)
- M. Manca
- Department of Molecular and Clinical Pharmacology, Institute of Translational MedicineUniversity of LiverpoolLiverpoolUK
- Institute of Psychology, Health and SocietyUniversity of LiverpoolLiverpoolUK
| | - V. Pessoa
- Department of Molecular and Clinical Pharmacology, Institute of Translational MedicineUniversity of LiverpoolLiverpoolUK
- Institute of Psychology, Health and SocietyUniversity of LiverpoolLiverpoolUK
| | - P. Myers
- Department of Molecular and Clinical Pharmacology, Institute of Translational MedicineUniversity of LiverpoolLiverpoolUK
| | - A. Pickles
- King's College London, MRC Social Genetic and Developmental Psychiatry Research CentreInstitute of PsychiatryLondonUK
| | - J. Hill
- School for Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - H. Sharp
- Institute of Psychology, Health and SocietyUniversity of LiverpoolLiverpoolUK
| | - C. Murgatroyd
- School of Healthcare ScienceManchester Metropolitan UniversityManchesterUK
| | - V. J. Bubb
- Department of Molecular and Clinical Pharmacology, Institute of Translational MedicineUniversity of LiverpoolLiverpoolUK
| | - J. P. Quinn
- Department of Molecular and Clinical Pharmacology, Institute of Translational MedicineUniversity of LiverpoolLiverpoolUK
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Rutherford C, Sharp H, Hill J, Pickles A, Taylor-Robinson D. How does perinatal maternal mental health explain early social inequalities in child behavioural and emotional problems? Findings from the Wirral Child Health and Development Study. PLoS One 2019; 14:e0217342. [PMID: 31125387 PMCID: PMC6534344 DOI: 10.1371/journal.pone.0217342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 05/10/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This study aimed to assess how maternal mental health mediates the association between childhood socio-economic conditions at birth and subsequent child behavioural and emotional problem scores. METHODS Analysis of the Wirral Child Health and Development Study (WCHADS), a prospective epidemiological longitudinal study of the early origins of child mental health (n = 664). Household income at 20-weeks gestation, a measure of socio-economic conditions (SECs) in pregnancy, was the main exposure. The outcome measure was externalising and internalising problems, as measured by the Child Behaviour Checklist at 5 years. We assessed the association of household income with child behavioural outcomes in sequential linear models adjusting for maternal mental health in the pre- and post- natal period. RESULTS Children of mothers in more disadvantaged households had higher scores for externalising behaviour with a difference of 3.6 points comparing the most affluent to the most disadvantaged families (the socio-economic (SEC) gap). In our regression model adjusting for baseline confounders, comparing children of mothers in the most disadvantaged households to the least disadvantaged, we found that most disadvantaged children scored 45 percentage points (95% CI 9, 93) higher for externalising problems, and 42% of this difference was explained in the fully adjusted model. Adjusting for prenatal maternal depressive symptomology attenuated the SEC gap in externalising problems by about a third, rendering the association non-significant, whilst adjusting for pre- and post-natal maternal mental health attenuated the SEC gap by 42%. There was no significant relationship between household income and internalising problems. CONCLUSION Social disadvantage is associated with higher child externalising behaviour problems score at age 5, and about 40% of this was explained by maternal perinatal mental health. Policies supporting maternal mental health in pregnancy are important to address the early emergence of inequalities in child mental health.
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Affiliation(s)
- Callum Rutherford
- Department of Public Health and Policy, Farr Institute, University of Liverpool, Liverpool, United Kingdom
| | - Helen Sharp
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Jonathan Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Andrew Pickles
- Biostatistics Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - David Taylor-Robinson
- Department of Public Health and Policy, Farr Institute, University of Liverpool, Liverpool, United Kingdom
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Hill J, Pickles A, Wright N, Braithwaite E, Sharp H. Predictions of children's emotionality from evolutionary and epigenetic hypotheses. Sci Rep 2019; 9:2519. [PMID: 30792470 PMCID: PMC6384926 DOI: 10.1038/s41598-019-39513-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/21/2019] [Indexed: 01/21/2023] Open
Abstract
Sex-dependent effects of mismatched prenatal-postnatal maternal conditions are predicted by combining two evolutionary hypotheses: that foetal conditions provide a forecast of likely postnatal environments (Predictive Adaptive Response), and that the female foetus is better adapted than the male to maternal adversity (Trivers-Willard hypothesis). Animal studies have implicated glucocorticoid mechanisms modifiable by effects of postnatal tactile stimulation on glucocorticoid receptor gene expression. In this study we examined behavioural predictions in humans based on these evolutionary and epigenetic models. Mothers in a general population cohort provided self-reported anxiety scores at 20 weeks pregnancy, and at 9 weeks, 14 months and 3.5 years postpartum, and frequency of infant stroking at 9 weeks. Mothers and teachers reported child symptoms at 7 years. SEM models with maximum-likelihood estimates made use of data from 887 participants. There was a three-way interaction between prenatal and postnatal anxiety and maternal stroking in the prediction of irritability, seen only in girls. This arose because lower maternal stroking was associated with higher irritability, only in the mismatched, low-high and high-low maternal anxiety groups. We provide evidence that mechanisms likely to have evolved well before the emergence of humans, contribute to the development of children’s emotionality and risk for depression.
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Affiliation(s)
- Jonathan Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK.
| | - Andrew Pickles
- Institute of Psychiatry, Psychology and Neuroscience, King College London, London, SE5 8AF, UK
| | - Nicola Wright
- Institute of Psychiatry, Psychology and Neuroscience, King College London, London, SE5 8AF, UK
| | - Elizabeth Braithwaite
- Department of Psychology, Manchester Metropolitan University, Manchester, M15 6BH, UK
| | - Helen Sharp
- Department of Psychological Science, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, L69 3GB, UK
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Billingsley KJ, Manca M, Gianfrancesco O, Collier DA, Sharp H, Bubb VJ, Quinn JP. Regulatory characterisation of the schizophrenia-associated CACNA1C proximal promoter and the potential role for the transcription factor EZH2 in schizophrenia aetiology. Schizophr Res 2018; 199:168-175. [PMID: 29501388 PMCID: PMC6179964 DOI: 10.1016/j.schres.2018.02.036] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 12/05/2017] [Accepted: 02/19/2018] [Indexed: 12/13/2022]
Abstract
Genomic wide association studies identified the CACNA1C locus as genetically associated with both schizophrenia and bipolar affective disorder. CACNA1C encodes Cav1.2, one of four subunits of L-type voltage gated calcium channels. Variation resides in non-coding regions of CACNA1C which interact with the promoter and are validated expression quantitative trait loci. Using reporter gene constructs we demonstrate the CACNA1C promoter is a major mediator of inducible regulation of CACNA1C activity in the SH-SY5Y neuroblastoma cell line. Exposure of SH-SY5Y cells to lithium and cocaine modulated both the endogenous CACNA1C gene and the promoter in reporter gene constructs. Deletion analysis of the promoter demonstrated the actions of both lithium and cocaine were mediated by the proximal promoter. Initial interrogation of ENCODE ChIP-seq data over the CACNA1C promoter indicated binding of the transcription factor 'Enhancer of zeste homolog 2' (EZH2), which was consistent with our data that overexpression of EZH2 repressed CACNA1C promoter reporter gene expression. Array data from the Human Brain Transcriptome demonstrated that EZH2 was highly expressed across the developing brain, but subsequently maintained at low levels after birth and adulthood. RNA-seq data obtained from PD_NGSAtlas, a reference database for epigenomic and transcriptomic data for psychiatric disorders, demonstrated a 3-fold increase in EZH2 expression in the anterior cingulate cortex of individuals with schizophrenia compared to controls. We propose that EZH2 may contribute to schizophrenia risk at two distinct time points either through disruption in development leading to neurodevelopmental changes, or through anomalous reactivation of expression in the adult brain.
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Affiliation(s)
- Kimberley J Billingsley
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool L69 3BX, UK
| | - Maurizio Manca
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Olympia Gianfrancesco
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool L69 3BX, UK
| | | | - Helen Sharp
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Vivien J Bubb
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool L69 3BX, UK
| | - John P Quinn
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool L69 3BX, UK.
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Wright N, Hill J, Sharp H, Pickles A. Maternal sensitivity to distress, attachment and the development of callous-unemotional traits in young children. J Child Psychol Psychiatry 2018; 59:790-800. [PMID: 29380375 PMCID: PMC6033174 DOI: 10.1111/jcpp.12867] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND Callous-unemotional (CU) traits are characterized by a lack of responsiveness to the emotions of others, particularly negative emotions. A parenting environment where the child's own distress emotions are sensitively responded to may help foster the child's ability to respond to the emotions of others. We tested whether maternal sensitivity to distress, and other parenting characteristics, were associated with CU traits over the preschool period, and examined whether this was mediated via infant attachment status. METHOD In an epidemiological cohort, CU traits were assessed at age 2.5, 3.5, and 5.0 years by mother report. Dimensions of parenting were assessed in free play at age 29 weeks in a stratified subsample of 272, and attachment status at 14 months (n = 265). Structural equation modelling with maximum likelihood estimation was used to examine predictions from parenting dimensions and attachment status. RESULTS A parenting factor comprised of sensitivity to distress (n = 207), sensitivity to non-distress, positive regard toward the infant (or warmth), and intrusiveness, predicted child CU traits (p = .023). This effect was accounted for mainly by sensitivity to distress (p = .008) and positive regard (p = .023) which showed a synergistic effect as evidenced by a significant interaction (p = .01). This arose because the combination of low sensitivity to distress and low positive regard created the risk for elevated CU traits. Although sensitivity and positive regard predicted attachment security and disorganization, there were no associations between attachment status and CU traits. CONCLUSIONS The finding of contributions from both sensitivity to distress and positive regard to reduced CU traits suggests that children's responsiveness to others' emotions may be increased by their own mothers' responsiveness to them and their mothers' warmth. There was no evidence that this was mediated via attachment status. Implications for intervention and future directions are discussed.
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Affiliation(s)
- Nicola Wright
- Institute of Psychology, Health and SocietyUniversity of LiverpoolLiverpoolUK
| | - Jonathan Hill
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Helen Sharp
- Institute of Psychology, Health and SocietyUniversity of LiverpoolLiverpoolUK
| | - Andrew Pickles
- Biostatistics Department at the Institute of PsychiatryKing's College LondonLondonUK
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Huntley F, Wright N, Pickles A, Sharp H, Hill J. Maternal mental health and child problem behaviours: disentangling the role of depression and borderline personality dysfunction. BJPsych Open 2017; 3:300-305. [PMID: 29234522 PMCID: PMC5707443 DOI: 10.1192/bjpo.bp.117.005843] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 10/30/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND It is not known whether associations between child problem behaviours and maternal depression can be accounted for by comorbid borderline personality disorder (BPD) dysfunction. AIM To examine the contributions of maternal depression and BPD symptoms to child problem behaviours. METHOD Depression trajectories over the first-year postpartum were generated using repeated measurement from a general population sample of 997 mothers recruited in pregnancy. In a stratified subsample of 251, maternal depression and BPD symptoms were examined as predictors of child problem behaviours at 2.5 years. RESULTS Child problem behaviours were predicted by a high maternal depression trajectory prior to the inclusion of BPD symptoms. This association was no longer significant after the introduction of BPD symptoms. CONCLUSIONS Risks for child problem behaviours currently attributed to maternal depression may arise from more persistent and pervasive difficulties found in borderline personality dysfunction. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2017, this is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) license.
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Affiliation(s)
- Fay Huntley
- , ClinPsyD, PhD, Department of Psychological Sciences, Institute of Psychology, Health and Society, , University of Liverpool, UK
| | - Nicola Wright
- , BSc, MSc, Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, UK
| | - Andrew Pickles
- , FMedSci, Professor, Biostatistics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Helen Sharp
- , DClinPsy, PhD, Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Jonathan Hill
- , FRCPsych, Professor, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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Vidal‐Ribas P, Pickles A, Tibu F, Sharp H, Hill J. Sex differences in the associations between vagal reactivity and oppositional defiant disorder symptoms. J Child Psychol Psychiatry 2017; 58:988-997. [PMID: 28573761 PMCID: PMC5575540 DOI: 10.1111/jcpp.12750] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Vagal reactivity to stress in children has been associated with future psychiatric outcomes. However, results have been mixed possibly because these effects are in opposite direction in boys and girls. These sex differences are relevant in the context of development of psychopathology, whereby the rates of psychiatric disorders differ by sex. In this study, we aimed to examine the association between vagal reactivity, assessed as a reduction in respiratory sinus arrhythmia (RSA) in response to a challenge, and the development of future oppositional defiant disorder (ODD) symptoms in boys and girls. In addition, we examine the specific associations with ODD symptom dimensions, named irritability and headstrong. We hypothesized that increased vagal reactivity was associated with increased ODD symptoms in girls and a reduction in ODD symptoms in boys. METHODS Participants were members of the Wirral Child Health and Development Study, a prospective epidemiological longitudinal study of 1,233 first-time mothers recruited at 20 weeks' gestation. RSA during four nonstressful and one stressful (still-face) procedures was assessed when children were aged 29 weeks in a sample stratified by adversity (n = 270). Maternal reports of ODD symptoms were collected when children were 2.5 years old (n = 253), 3.5 years old (n = 826), and 5 years old (n = 770). Structural equation modeling (SEM) was employed to test our hypotheses. RESULTS There was a significant sex difference in the prediction of ODD symptoms due to the opposite directionality in which increasing vagal reactivity was associated with an increase in ODD symptoms in girls and a reduction of ODD symptoms in boys. This Sex by Vagal reactivity interaction was common for both ODD dimensions, with no sex by dimension-specific associations. CONCLUSIONS Physiological reactivity to a stressful situation predicts differently ODD symptoms in boys and girls very early in life, with no difference across irritability and headstrong components. Findings are discussed in the context of the several mechanisms involved on the later development of distinct psychiatric disorders in boys and girls.
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Affiliation(s)
- Pablo Vidal‐Ribas
- Department of Child and Adolescent PsychiatryInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Andrew Pickles
- Department of Biostatistics and Health InformaticsInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Florin Tibu
- Institute of Child DevelopmentBucharest Early Intervention Project LabBucharestRomania
| | - Helen Sharp
- Institute of Psychology, Health and SocietyUniversity of LiverpoolLiverpoolUK
| | - Jonathan Hill
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
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Braithwaite EC, Pickles A, Sharp H, Glover V, O'Donnell KJ, Tibu F, Hill J. Maternal prenatal cortisol predicts infant negative emotionality in a sex-dependent manner. Physiol Behav 2017; 175:31-36. [PMID: 28322912 PMCID: PMC5429387 DOI: 10.1016/j.physbeh.2017.03.017] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 01/16/2017] [Accepted: 03/14/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Prenatal stress influences fetal developmental trajectories, which may implicate glucocorticoid mechanisms. There is also emerging evidence that effects of prenatal stress on offspring development are sex-dependent. However, little is known about the prospective relationship between maternal prenatal cortisol levels and infant behaviour, and whether it may be different in male and female infants. We sought to address this question using data from a prospective longitudinal cohort, stratified by risk. METHOD The Wirral Child Health and Development Study (WCHADS) cohort (n=1233) included a stratified random sub-sample (n=216) who provided maternal saliva samples, assayed for cortisol, at home over two days at 32weeks of pregnancy (on waking, 30-min post-waking and during the evening) and a measure of infant negative emotionality from the Neonatal Behavioural Assessment Scale (NBAS) at five weeks-of-age. General population estimates of associations among measures were obtained using inverse probability weights. RESULTS Maternal prenatal cortisol sampled on waking predicted infant negative emotionality in a sex-dependent manner (interaction term, p=0.005); female infants exposed to high levels of prenatal cortisol were more negative (Beta=0.440, p=0.042), whereas male infants were less negative (Beta=-0.407, p=0.045). There was no effect of the 30-min post-waking measure or evening cortisol. DISCUSSION Our findings add to an emerging body of work that has highlighted sex differences in fetal programming, whereby females become more reactive following prenatal stress, and males less reactive. A more complete understanding of sex-specific developmental trajectories in the context of prenatal stress is essential for the development of targeted prevention strategies.
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Affiliation(s)
- Elizabeth C Braithwaite
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK; Department of Experimental Psychology, University of Oxford, Oxford, UK.
| | - Andrew Pickles
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
| | - Helen Sharp
- Department of Psychological Sciences, Institute of Psychology, Health and Society, Liverpool, UK.
| | - Vivette Glover
- Institute of Reproductive and Developmental Biology, Imperial College London, London, UK.
| | - Kieran J O'Donnell
- Douglas Hospital Research Centre, McGill University, Montreal, Canada; Canadian Institute For Advanced Research, Child and Brain Development Program, Ontario, Canada.
| | - Florin Tibu
- Institute of Child Development, Bucharest, Romania.
| | - Jonathan Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
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Koukounari A, Pickles A, Hill J, Sharp H. Psychometric Properties of the Parent-Infant Caregiving Touch Scale. Front Psychol 2015; 6:1887. [PMID: 26696945 PMCID: PMC4678235 DOI: 10.3389/fpsyg.2015.01887] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 11/22/2015] [Indexed: 12/05/2022] Open
Abstract
Recent work in animals suggests that the extent of early tactile stimulation by parents of offspring is an important element in early caregiving. We evaluate the psychometric properties of a new parent-report measure designed to assess frequency of tactile stimulation across multiple caregiving domains in infancy. We describe the full item set of the Parent-Infant Caregiving Touch Scale (PICTS) and, using data from a UK longitudinal Child Health and Development Study, the response frequencies and factor structure and whether it was invariant over two time points in early development (5 and 9 weeks). When their infant was 9 weeks old, 838 mothers responded on the PICTS while a stratified subsample of 268 mothers completed PICTS at an earlier 5 week old assessment (229 responded on both occasions). Three PICTS factors were identified reflecting stroking, holding and affective communication. These were moderately to strongly correlated at each of the two time points of interest and were unrelated to, and therefore distinct from, a traditional measure of maternal sensitivity at 7-months. A wholly stable psychometry over 5 and 9-week assessments was not identified which suggests that behavior profiles differ slightly for younger and older infants. Tests of measurement invariance demonstrated that all three factors are characterized by full configural and metric invariance, as well as a moderate degree of evidence of scalar invariance for the stroking factor. We propose the PICTS as a valuable new measure of important aspects of caregiving in infancy.
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Affiliation(s)
- Artemis Koukounari
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London London, UK
| | - Andrew Pickles
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London London, UK
| | - Jonathan Hill
- School of Psychology and Clinical Language Sciences, University of Reading Reading, UK
| | - Helen Sharp
- Department of Psychological Science, Institute of Psychology, Health and Society, University of Liverpool Liverpool, UK
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Wright N, Hill J, Pickles A, Sharp H. The Specific Role of Relationship Life Events in the Onset of Depression during Pregnancy and the Postpartum. PLoS One 2015; 10:e0144131. [PMID: 26645963 PMCID: PMC4672906 DOI: 10.1371/journal.pone.0144131] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 11/14/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The precipitating role of life events in the onset of depression is well-established. The present study sought to examine whether life events hypothesised to be personally salient would be more strongly associated with depression than other life events. In a sample of women making the first transition to parenthood, we hypothesised that negative events related to the partner relationship would be particularly salient and thus more strongly predictive of depression than other events. METHODS A community-based sample of 316 first-time mothers stratified by psychosocial risk completed interviews at 32 weeks gestation and 29 weeks postpartum to assess dated occurrence of life events and depression onsets from conception to 29 weeks postpartum. Complete data was available from 273 (86.4%). Cox proportional hazards regression was used to examine risk for onset of depression in the 6 months following a relationship event versus other events, after accounting for past history of depression and other potential confounders. RESULTS 52 women (19.0%) experienced an onset of depression between conception and 6 months postpartum. Both relationship events (Hazard Ratio = 2.1, p = .001) and other life events (Hazard Ratio = 1.3, p = .020) were associated with increased risk for depression onset; however, relationship events showed a significantly greater risk for depression than did other life events (p = .044). CONCLUSIONS The results are consistent with the hypothesis that personally salient events are more predictive of depression onset than other events. Further, they indicate the clinical significance of events related to the partner relationship during pregnancy and the postpartum.
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Affiliation(s)
- Nicola Wright
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
| | - Jonathan Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Andrew Pickles
- Biostatistics Department, Institute of Psychiatry, King’s College London, London, United Kingdom
| | - Helen Sharp
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
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Sharp H, Essiaf S, Coens C, Jagsi R, Hahn S. 1200 Training the clinical research investigators of tomorrow - first results from the Flims Impact Survey 2015. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(15)30018-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bedford R, Pickles A, Sharp H, Wright N, Hill J. Reduced Face Preference in Infancy: A Developmental Precursor to Callous-Unemotional Traits? Biol Psychiatry 2015; 78:144-50. [PMID: 25526972 PMCID: PMC4510143 DOI: 10.1016/j.biopsych.2014.09.022] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/04/2014] [Accepted: 09/27/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Children with callous-unemotional (CU) traits, a proposed precursor to adult psychopathy, are characterized by impaired emotion recognition, reduced responsiveness to others' distress, and a lack of guilt or empathy. Reduced attention to faces, and more specifically to the eye region, has been proposed to underlie these difficulties, although this has never been tested longitudinally from infancy. Attention to faces occurs within the context of dyadic caregiver interactions, and early environment including parenting characteristics has been associated with CU traits. The present study tested whether infants' preferential tracking of a face with direct gaze and levels of maternal sensitivity predict later CU traits. METHODS Data were analyzed from a stratified random sample of 213 participants drawn from a population-based sample of 1233 first-time mothers. Infants' preferential face tracking at 5 weeks and maternal sensitivity at 29 weeks were entered into a weighted linear regression as predictors of CU traits at 2.5 years. RESULTS Controlling for a range of confounders (e.g., deprivation), lower preferential face tracking predicted higher CU traits (p = .001). Higher maternal sensitivity predicted lower CU traits in girls (p = .009), but not boys. No significant interaction between face tracking and maternal sensitivity was found. CONCLUSIONS This is the first study to show that attention to social features during infancy as well as early sensitive parenting predict the subsequent development of CU traits. Identifying such early atypicalities offers the potential for developing parent-mediated interventions in children at risk for developing CU traits.
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Affiliation(s)
- Rachael Bedford
- Biostatistics Department, Institute of Psychiatry, King's College London, London.
| | - Andrew Pickles
- Biostatistics Department, Institute of Psychiatry, King’s College London, London
| | - Helen Sharp
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool
| | - Nicola Wright
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool
| | - Jonathan Hill
- Centre for Developmental Science and Disorders, University of Manchester, Manchester, United Kingdom
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Segal J, Petre M, Sharp H. The Future of E-infrastructures. Comput Sci Eng 2015. [DOI: 10.1109/mcse.2015.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Awan SN, Bressmann T, Poburka B, Roy N, Sharp H, Watts C. Dialectical effects on nasalance: a multicenter, cross-continental study. J Speech Lang Hear Res 2015; 58:69-77. [PMID: 25260176 DOI: 10.1044/2014_jslhr-s-14-0077] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 09/08/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE This study investigated nasalance in speakers from six different dialectal regions across North America using recent versions of the Nasometer. It was hypothesized that many of the sound changes observed in regional dialects of North American English would have a significant impact on measures of nasalance. METHOD Samples of the Zoo Passage, the Rainbow Passage, and the Nasal Sentences were collected from young adult male and female speakers (N=300) from six North American dialectical regions (Midland/Mid-Atlantic; Inland North Canada; Inland North; North Central; South; and Western dialects). RESULTS Across the three passage types, effect sizes for dialect were moderate in strength and accounted for approximately 7%-9% of the variation in nasalance. Increased differences in nasalance tended to occur between speakers from distinctly different geographical regions, with the highest nasalance across all passages observed for speakers from the Texas South dialect region. CONCLUSION Clinicians and researchers who use perceptual and instrumental measures of speech production should be aware that dialectical and socially acquired speech patterns may influence the acoustic characteristics of speech and may also influence the interpretation of normative expectations and typical versus disordered cutoff scores for instruments such as the Nasometer.
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Pawlik A, Segal J, Sharp H, Petre M. Crowdsourcing Scientific Software Documentation: A Case Study of the NumPy Documentation Project. Comput Sci Eng 2015. [DOI: 10.1109/mcse.2014.93] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Sharp H, Hill J, Hellier J, Pickles A. Maternal antenatal anxiety, postnatal stroking and emotional problems in children: outcomes predicted from pre- and postnatal programming hypotheses. Psychol Med 2015; 45:269-283. [PMID: 25068652 PMCID: PMC4301199 DOI: 10.1017/s0033291714001342] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 05/08/2014] [Accepted: 05/15/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Mothers' self-reported stroking of their infants over the first weeks of life modifies the association between prenatal depression and physiological and emotional reactivity at 7 months, consistent with animal studies of the effects of tactile stimulation. We now investigate whether the effects of maternal stroking persist to 2.5 years. Given animal and human evidence for sex differences in the effects of prenatal stress we compare associations in boys and girls. METHOD From a general population sample of 1233 first-time mothers recruited at 20 weeks gestation we drew a random sample of 316 for assessment at 32 weeks, stratified by reported inter-partner psychological abuse, a risk indicator for child development. Of these mothers, 243 reported at 5 and 9 weeks how often they stroked their infants, and completed the Child Behavior Checklist (CBCL) at 2.5 years post-delivery. RESULTS There was a significant interaction between prenatal anxiety and maternal stroking in the prediction of CBCL internalizing (p = 0.001) and anxious/depressed scores (p < 0.001). The effects were stronger in females than males, and the three-way interaction prenatal anxiety × maternal stroking × sex of infant was significant for internalizing symptoms (p = 0.003). The interactions arose from an association between prenatal anxiety and internalizing symptoms only in the presence of low maternal stroking. CONCLUSIONS The findings are consistent with stable epigenetic effects, many sex specific, reported in animal studies. While epigenetic mechanisms may be underlying the associations, it remains to be established whether stroking affects gene expression in humans.
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Affiliation(s)
- H. Sharp
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - J. Hill
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - J. Hellier
- Institute of Psychiatry, King's College London, London, UK
| | - A. Pickles
- Institute of Psychiatry, King's College London, London, UK
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McMillan LA, Rivett MO, Tellam JH, Dumble P, Sharp H. Influence of vertical flows in wells on groundwater sampling. J Contam Hydrol 2014; 169:50-61. [PMID: 24999176 DOI: 10.1016/j.jconhyd.2014.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 05/08/2014] [Accepted: 05/16/2014] [Indexed: 05/14/2023]
Abstract
Pumped groundwater sampling evaluations often assume that horizontal head gradients predominate and the sample comprises an average of water quality variation over the well screen interval weighted towards contributing zones of higher hydraulic conductivity (a permeability-weighted sample). However, the pumping rate used during sampling may not always be sufficient to overcome vertical flows in wells driven by ambient vertical head gradients. Such flows are reported in wells with screens between 3 and 10m in length where lower pumping rates are more likely to be used during sampling. Here, numerical flow and particle transport modeling is used to provide insight into the origin of samples under ambient vertical head gradients and under a range of pumping rates. When vertical gradients are present, sample provenance is sensitive to pump intake position, pumping rate and pumping duration. The sample may not be drawn from the whole screen interval even with extended pumping times. Sample bias is present even when the ambient vertical flow in the wellbore is less than the pumping rate. Knowledge of the maximum ambient vertical flow in the well does, however, allow estimation of the pumping rate that will yield a permeability-weighted sample. This rate may be much greater than that recommended for low-flow sampling. In practice at monitored sites, the sampling bias introduced by ambient vertical flows in wells may often be unrecognized or underestimated when drawing conclusions from sampling results. It follows that care should be taken in the interpretation of sampling data if supporting flow investigations have not been undertaken.
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Affiliation(s)
- Lindsay A McMillan
- Water Sciences Group, School of Geography, Earth & Environmental Sciences, University of Birmingham, Birmingham B15 2TT, UK.
| | - Michael O Rivett
- Water Sciences Group, School of Geography, Earth & Environmental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - John H Tellam
- Water Sciences Group, School of Geography, Earth & Environmental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Peter Dumble
- In-Situ Europe Ltd, Stratford Road Shirley, Solihull, West Midlands B90 3AU, UK
| | - Helen Sharp
- Environment Agency, The Lateral 8 City Walk, Leeds, West Yorkshire LS11 9AT, UK
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Jolles S, Borrell R, Zouwail S, Heaps A, Sharp H, Moody M, Selwood C, Williams P, Phillips C, Hood K, Holding S, El Shanawany T. Calculated globulin (CG) as a screening test for antibody deficiency. Clin Exp Immunol 2014; 177:671-8. [PMID: 24784320 PMCID: PMC4137851 DOI: 10.1111/cei.12369] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2014] [Indexed: 01/15/2023] Open
Abstract
Calculated globulin (total protein - albumin) is usually tested as part of a liver function test profile in both primary and secondary care and determines the serum globulin concentration, of which immunoglobulins are a major component. The main use hitherto of calculated globulin is to detect paraproteins when the level is high. This study investigated the potential to use low levels of calculated globulin to detect antibody deficiency. Serum samples with calculated globulin cut-off < 18 g/l based on results of a pilot study were collected from nine hospitals in Wales over a 12-month period. Anonymized request information was obtained and the samples tested for immunoglobulin levels, serum electrophoresis and, if appropriate, immunofixation. A method comparison for albumin measurement using bromocresol green and bromocresol purple was undertaken. Eighty-nine per cent (737 of 826) samples had an immunoglobulin (Ig)G level of < 6 g/l using the bromocresol green methodology with a cut-off of < 18 g/l, and 56% (459) had an IgG of < 4 g/l. Patients with both secondary and primary antibody deficiency were discovered and serum electrophoresis and immunofixation showed that 1·2% (10) had previously undetected small paraproteins associated with immune-paresis. Using bromocresol purple, 74% of samples had an IgG of < 6 g/l using a cut-off of < 23 g/l. Screening using calculated globulin with defined cut-off values detects both primary and secondary antibody deficiency and new paraproteins associated with immune-paresis. It is cheap, widely available and under-utilized. Antibody-deficient patients have been discovered using information from calculated globulin values, shortening diagnostic delay and time to treatment with immunoglobulin replacement therapy.
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Affiliation(s)
- S Jolles
- Department of Immunology, University Hospital of Wales, Cardiff, UK
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Sharp H, Pfau T, Hopkins S. The Effect of Hindlimb Studs on Movement Symmetry in Horses During Lungeing. Equine Vet J 2014. [DOI: 10.1111/evj.12323_45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- H. Sharp
- The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire UK
| | - T. Pfau
- The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire UK
| | - S. Hopkins
- The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire UK
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Pickles A, Hill J, Breen G, Quinn J, Abbott K, Jones H, Sharp H. Evidence for interplay between genes and parenting on infant temperament in the first year of life: monoamine oxidase A polymorphism moderates effects of maternal sensitivity on infant anger proneness. J Child Psychol Psychiatry 2013; 54:1308-17. [PMID: 23738520 DOI: 10.1111/jcpp.12081] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND The low expression polymorphism of the MAOA gene in interaction with adverse environments (G × E) is associated with antisocial behaviour disorders. These have their origins in early life, but it is not known whether MAOA G × E occurs in infants. We therefore examined whether MAOA G × E predicts infant anger proneness, a temperamental dimension associated with later antisocial behaviour disorders. In contrast to previous studies, we examined MAOA G × E prospectively using an observational measure of a key aspect of the infant environment, maternal sensitivity, at a specified developmental time point. METHODS In a stratified epidemiological cohort recruited during pregnancy, we ascertained MAOA status (low vs. high expression alleles) from the saliva of 193 infants, and examined specific predictions to maternal report of infant temperament at 14 months from maternal sensitivity assessed at 29 weeks of age. RESULTS Analyses, weighted to provide general population estimates, indicated a robust interaction between MAOA status and maternal sensitivity in the prediction of infant anger proneness (p = .003) which became stronger once possible confounders for maternal sensitivity were included in the model (p = .0001). The interaction terms were similar in males (p = .010) and females (p = .016), but the effects were different as a consequence of an additional sex of infant by maternal sensitivity interaction. CONCLUSIONS This prospective study provides the first evidence of moderation by the MAOA gene of effects of parenting on infant anger proneness, an important early risk for the development of disruptive and aggressive behaviour disorders.
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Affiliation(s)
- Andrew Pickles
- Institute of Psychiatry, King's College London, London, UK
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Hill J, Breen G, Quinn J, Tibu F, Sharp H, Pickles A. Evidence for interplay between genes and maternal stress in utero: monoamine oxidase A polymorphism moderates effects of life events during pregnancy on infant negative emotionality at 5 weeks. Genes Brain Behav 2013; 12:388-96. [PMID: 23480342 DOI: 10.1111/gbb.12033] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 02/22/2013] [Accepted: 02/25/2013] [Indexed: 02/01/2023]
Abstract
The low activity variant of the monoamine oxidase A (MAOA) functional promoter polymorphism, MAOA-LPR, in interaction with adverse environments (G × E) is associated with child and adult antisocial behaviour disorders. MAOA is expressed during foetal development so in utero G × E may influence early neurodevelopment. We tested the hypothesis that MAOA G × E during pregnancy predicts infant negative emotionality soon after birth. In an epidemiological longitudinal study starting in pregnancy, using a two stage stratified design, we ascertained MAOA-LPR status (low vs. high activity variants) from the saliva of 209 infants (104 boys and 105 girls), and examined predictions to observed infant negative emotionality at 5 weeks post-partum from life events during pregnancy. In analyses weighted to provide estimates for the general population, and including possible confounders for life events, there was an MAOA status by life events interaction (P = 0.017). There was also an interaction between MAOA status and neighbourhood deprivation (P = 0.028). Both interactions arose from a greater effect of increasing life events on negative emotionality in the MAOA-LPR low activity, compared with MAOA-LPR high activity infants. The study provides the first evidence of moderation by MAOA-LPR of the effect of the social environment in pregnancy on negative emotionality in infancy, an early risk for the development of child and adult antisocial behaviour disorders.
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Affiliation(s)
- J Hill
- Centre for Developmental Science and Disorders, University of Manchester, Room 3.305, Jean McFarlane Building, Oxford Road, Manchester M13 9PL, UK.
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Sharp H, Pickles A, Meaney M, Marshall K, Tibu F, Hill J. Frequency of infant stroking reported by mothers moderates the effect of prenatal depression on infant behavioural and physiological outcomes. PLoS One 2012; 7:e45446. [PMID: 23091594 PMCID: PMC3473033 DOI: 10.1371/journal.pone.0045446] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Accepted: 08/20/2012] [Indexed: 02/02/2023] Open
Abstract
Animal studies find that prenatal stress is associated with increased physiological and emotional reactivity later in life, mediated via fetal programming of the HPA axis through decreased glucocorticoid receptor (GR) gene expression. Post-natal behaviours, notably licking and grooming in rats, cause decreased behavioural indices of fear and reduced HPA axis reactivity mediated via increased GR gene expression. Post-natal maternal behaviours may therefore be expected to modify prenatal effects, but this has not previously been examined in humans. We examined whether, according to self-report, maternal stroking over the first weeks of life modified associations between prenatal depression and physiological and behavioral outcomes in infancy, hence mimicking effects of rodent licking and grooming. From a general population sample of 1233 first time mothers recruited at 20 weeks gestation we drew a stratified random sample of 316 for assessment at 32 weeks based on reported inter-partner psychological abuse, a risk to child development. Of these 271 provided data at 5, 9 and 29 weeks post delivery. Mothers reported how often they stroked their babies at 5 and 9 weeks. At 29 weeks vagal withdrawal to a stressor, a measure of physiological adaptability, and maternal reported negative emotionality were assessed. There was a significant interaction between prenatal depression and maternal stroking in the prediction of vagal reactivity to a stressor (p = .01), and maternal reports of infant anger proneness (p = .007) and fear (p = .043). Increasing maternal depression was associated with decreasing physiological adaptability, and with increasing negative emotionality, only in the presence of low maternal stroking. These initial findings in humans indicate that maternal stroking in infancy, as reported by mothers, has effects strongly resembling the effects of observed maternal behaviours in animals, pointing to future studies of the epigenetic, physiological and behavioral effects of maternal stroking.
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Affiliation(s)
- Helen Sharp
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.
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Hill J, Murray L, Leidecker V, Sharp H. The dynamics of threat, fear and intentionality in the conduct disorders: longitudinal findings in the children of women with post-natal depression. Philos Trans R Soc Lond B Biol Sci 2008; 363:2529-41. [PMID: 18450562 DOI: 10.1098/rstb.2008.0036] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
This paper considers how environmental threat may contribute to the child's use of avoidant strategies to regulate negative emotions, and how this may interact with high emotional reactivity to create vulnerability to conduct disorder symptoms. We report a study based on the hypothesis that interpreting others' behaviours in terms of their motives and emotions-using the intentional stance-promotes effective social action, but may lead to fear in threatful situations, and that inhibiting the intentional stance may reduce fear but promote conduct disorder symptoms. We assessed 5-year-olds' use of the intentional stance with an intentionality scale, contrasting high and low threat doll play scenarios. In a sample of 47 children of mothers with post-natal depression (PND) and 35 controls, children rated as securely attached with their mothers at the age of 18 months were better able to preserve the intentional stance than insecure children in high threat scenarios, but not in low threat scenarios. Girls had higher intentionality scores than boys across all scenarios. Only intentionality in the high threat scenario was associated with teacher-rated conduct disorder symptoms, and only in the children of women with PND. Intentionality mediated the associations between attachment security and gender and conduct disorder symptoms in the PND group.
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Affiliation(s)
- Jonathan Hill
- Child Psychiatry Research Group, Room 3.316, University Place, The University of Manchester, Oxford Road, Manchester M13 9PL, UK. jonathan.
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Abstract
AbstractBackground:Herbal remedies and other natural supplements have become popular alternative medical therapy. Patients using these products may present to ENT surgeons with epistaxis or with unexpected, excessive peri-operative bleeding.Objective:The purpose of this review was to consolidate the available data regarding herb–drug interactions and the direct effects of herbal medicines and nutritional supplements in isolation, regarding disturbance in haemostasis, so as to emphasise their individual importance.Method:A literature review was performed using the Medline (PubMed) and UKMi databases.Results:Searches of these databases revealed 24 herbal products with documented interactions with anticoagulants and 98 herbal products with theoretical interactions with the coagulation system. Herbal products with effects on coagulation when given alone were also documented.Conclusion:When encountering patients presenting with epistaxis, or in the elective surgical setting, a thorough enquiry about the use of herbal medicines is of great importance.
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Affiliation(s)
- F Javed
- Department of Otolaryngology and Head and Neck Surgery, William Harvey Hospital, Ashford, UK.
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