My child's future mental health: Carer's engagement with risk identification in an intervention study for youth with at-risk mental states

AIM

Prevention and early intervention efforts of serious mental illnesses has yielded promising results. However, alongside benefits, several ethical concerns have been raised, including the effects of being identified as being at-risk. In these debates, the voice of parents or carers is conspicuously absent. This is especially concerning as several at-risk interventions are trialled in under-age youth where parents consent on behalf of young people. Therefore, this study aimed to understand carer's experiences of their teenager being identified as at risk for psychosis.

METHODS

Semi-structured interviews were conducted with seven carers who had provided consent for their teenager to participate in a stepped intervention study for youth at-risk for psychosis. Questions explored their experiences regarding having their teenager being identified as at-risk. Transcripts were analysed using thematic analysis.

RESULTS

We identified five main themes from seven female carers' experiences of risk identification including: (a) recall of risk information was limited, or variable, (b) goal of risk disclosure was perceived to be positive, (c) negative emotions were associated with knowledge of risk, (d) relief from uncertainty and helplessness and (e) effects of risk disclosure were mediated by individual circumstance.

CONCLUSION

Overall, the results demonstrate that carers' experience of risk disclosure varied with factors surrounding their individual circumstances, and the process of disclosure. Whilst participants acknowledged potential adverse effects associated with risk disclosure, many still adopted a positive outlook. Tailoring safe and effective disclosure of risk to suit the needs of youth and carers could outweigh the potential risks.

Location of renin-angiotensin system components in the hypoglossal nucleus of the rat

The renin-angiotensin system (RAS) in the hypoglossal nuclei of the rat was studied by immunohistochemistry. Antibodies to angiotensin AT(1) receptor (AT1), angiotensinogen (ANG), renin (REN), angiotensin converting enzyme (ACE) and angiotensin II (AII) were used. All the components of the RAS with the exception of renin were detected. Light and electron microscopy revealed the following results: ANG was predominantly found in astrocytes, with small amounts in neuronal dendrites; ACE was found in the cytoplasm of neurons, dendrites and astrocyte processes; AT1 was found in the cytoplasm of neurons and dendrites, but not on the membrane; and AII was found mainly in astrocytes with some located in the dendrites and cytoplasm. Right hypoglossal nerve lesion caused an increase in expression of AT1 in neurons as early as 2 days post-lesion. An increase in expression of ANG in astrocytes was also seen, but at a much later time of 3 weeks post-lesion. For AII, staining occurred in both the neurons and astrocytes in the undamaged hypoglossal nucleus. Nerve lesion caused a disappearance of neuronal stains and an increase in astrocyte stains. There were no changes in ACE staining after nerve lesion. We speculate that ANG and AII are made within the astrocytes, whereas ACE could either be uptaken from blood or de novo synthesized. AT1 may potentially be internal soluble receptors. As to the function of AII in the hypoglossal nucleus, the data do not support AII as a neurotransmitter in the hypoglossal nucleus. It may function as a neuromodulator and also be involved in basic cellular activities, e.g. regulation of transcription factors.

Linkage mapping of Lims1l, the murine homolog of the human LIM domain gene PINCH, to mouse chromosome 10

The human LIM domain gene LIMS1 was used to identify a mouse homolog. The resulting mouse sequence was used to identify a polymorphism by SSCP analysis. Linkage studies performed in the EUCIB backcross placed Lims1l on the proximal portion of mouse Chromosome 10. This localisation makes it an interesting candidate for the deafness mutant, waltzer (v).

Molecular cloning and characterization of a highly conserved human 67-kDa laminin receptor pseudogene mapping to Xq21.3

A highly conserved laminin receptor processed pseudogene (LAMRL5) that has been isolated from a fetal brain cDNA library is described. The pseudogene is a complete copy (97.9% identical) of the transcribed laminin receptor (LAMR1) with all the introns precisely removed. The sequence has direct repeats of 18 bp at either end. It has an 885 nucleotide open reading frame from the start methionine codon to the stop codon that contains no deletions, additions or premature stop codons relative to the expressed LAMR1 gene and has the coding potential for a protein of 295 amino acids. Although TATA and CAAT boxes exist in the region 5' to the open reading frame and a polyadenylation signal is present in the 3' region, no evidence could be obtained either by reverse transcriptase-polymerase chain reaction (RT-PCR) or in the expressed sequence tag (EST) database that LAMRL5 is expressed in vivo. If not expressed, it is estimated that this LAMRL5 pseudogene was incorporated into the human genome approximately 3.5-5 million years ago.