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Costantini I, López-López JA, Caldwell D, Campbell A, Hadjipanayi V, Cantrell SJ, Thomas T, Badmann N, Paul E, James DM, Cordero M, Jewell T, Evans J, Pearson RM. Early parenting interventions to prevent internalising problems in children and adolescents: a global systematic review and network meta-analysis. BMJ Ment Health 2023; 26:e300811. [PMID: 37907332 PMCID: PMC10619111 DOI: 10.1136/bmjment-2023-300811] [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] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/14/2023] [Indexed: 11/02/2023]
Abstract
QUESTION We compared the effectiveness of different types of parenting interventions based on an a priori taxonomy, and the impact of waitlists versus treatment as usual (TAU), in reducing child internalising problems. STUDY SELECTION AND ANALYSIS We conducted a systematic review and network meta-analysis of published and unpublished randomised controlled trials (RCTs) until 1 October 2022 that investigated parenting interventions with children younger than 4 years. EXCLUSION CRITERIA studies with children born preterm, with intellectual disabilities, or families receiving support for current abuse, neglect, and substance misuse. We assessed the certainty of evidence using the Confidence in Network Meta-Analysis framework. We used random-effects network meta-analysis to estimate standardised mean differences (SMDs) with 95% credible intervals (CrIs). FINDINGS Of 20 520 citations identified, 59 RCTs (18 349 participants) were eligible for the network meta-analysis. Parenting interventions focusing on the dyadic relationship (SMD: -0.26, 95% CrI: -0.43 to -0.08) and those with mixed focus (-0.09, -0.17 to -0.02) were more effective in reducing internalising problems than TAU at the first time point available. All interventions were more effective than waitlist, which increased the risk of internalising problems compared with TAU (0.36, 0.19 to 0.52). All effects attenuated at later follow-ups. Most studies were rated as with 'high risk' or 'some concerns' using the Risk of Bias Assessment Tool V.2. There was no strong evidence of effect modification by theoretically informed components or modifiers. CONCLUSIONS We found preliminary evidence that relationship-focused and mixed parenting interventions were effective in reducing child internalising problems, and the waitlist comparator increased internalising problems with implications for waiting times between referral and support. Considering the high risk of bias of most studies included, the findings from this meta-analysis should be interpreted with caution. PROSPERO registration number CRD42020172251.
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Affiliation(s)
- Ilaria Costantini
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
- Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
- Division of Psychiatry, University College London, London, UK
| | - José A López-López
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
- Department of Basic Psychology and Methodology, University of Murcia, Murcia, Spain
| | - Deborah Caldwell
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
- NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Amy Campbell
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | | | - Sarah J Cantrell
- Department of Paediatrics, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa
| | | | | | - Elise Paul
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Deborah M James
- Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
| | - Miguel Cordero
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
- Centro de Epidemiología y Políticas de Salud, Universidad del Desarrollo Facultad de Medicina Clínica Alemana, Las Condes, Chile
| | - Tom Jewell
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Jonathan Evans
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Rebecca M Pearson
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
- Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
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Bornstein MH, Putnick DL, Esposito G, Pearson RM. The nature and structure of maternal parenting practices and infant behaviors in U.S. national and international samples. Front Child Adolesc Psychiatry 2023; 2:1124037. [PMID: 37346387 PMCID: PMC10281019 DOI: 10.3389/frcha.2023.1124037] [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] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
Methods Twenty maternal parenting practices and 15 behaviors of their 5½- month-old infants in a U.S. national sample (N = 360) and 9 international samples (N = 653) were microcoded from videorecords of naturalistic interactions at home and aggregated into domains. Altogether, the samples were recruited from Argentina, Belgium, Brazil, France, Israel, Italy, Japan, Kenya, as well as the United States. Background and Rationale A previous test of three competing models of the nature and structure of the maternal parenting practices supported a hybrid 2 factor/6 domain model as superior to a 1-factor dimensional model and a multi-factor style model: Maternal parenting practices are structured into nurture, physical, social, didactic, material, and language domains undergirded by dyadic and extradyadic factors. Infant behaviors were organized into physical, social, exploration, nondistress vocalization, and distress communication domains. The current study sought to examine links connecting these previously identified maternal domains and factors with infant behavior domains using structural equation models. Results Mothers' dyadic factor is associated with infant social behaviors with mother; and mothers' extradyadic factor and encouragement of infant physical development are associated with infant exploration of their immediate physical environment and physical development. Infant distress communication (and less nondistress vocalization) is associated with more maternal nurturing. Discussion Mothers' parenting practices in the middle of the first year of infant life are commonly structured and adapted to specific needs and developmental tasks of infants. Evaluations of mother-infant interactions with national and international samples permit a wide yet judicious analysis of common vs. specific models of mother-infant relationships.
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Affiliation(s)
- Marc H Bornstein
- Intramural Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
- UNICEF, New York City, NY, United States
- Institute for Fiscal Studies, London, United Kingdom
| | - Diane L Putnick
- Intramural Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
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Culpin I, Hammerton G, Stein A, Bornstein MH, Tiemeier H, Cadman T, Fredriksen E, Evans J, Miller T, Dermott E, Heron J, Sallis HM, Pearson RM. Maternal postnatal depressive symptoms and offspring emotional and behavioral development at age 7 years in a U.K. birth cohort: The role of paternal involvement. Dev Psychol 2023; 59:770-785. [PMID: 36395049 PMCID: PMC7615033 DOI: 10.1037/dev0001482] [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] [Indexed: 11/19/2022]
Abstract
There is considerable variability in developmental outcomes of children whose mothers experience depression. Few longitudinal studies have examined contributions of paternal involvement in the association between maternal postnatal depression (PND) and offspring development. We examined pathways from maternal PND at 8 weeks (Edinburgh Postnatal Depression Scale; total score) to offspring emotional and behavioral development at 7 years (Strengths and Difficulties Questionnaire; total score) through behavioral, affective, and cognitive dimensions of paternal involvement in a U.K.-based birth cohort (Avon Longitudinal Study of Parents and Children; n = 3,434). Analyses were adjusted for baseline confounders and paternal PND (Edinburgh Postnatal Depression Scale; total score) as an intermediate confounder. Maternal PND was strongly associated with offspring development, but this association was not mediated by the combination of all indirect pathways through various dimensions of paternal involvement. Only father-child conflict emerged as a risk factor for adverse offspring development and as a mediator in the association between maternal PND and offspring development (albeit the effect size was small). If found causal, interventions that reduce father-child conflict may reduce the risk of adverse development in offspring of mothers with PND. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Iryna Culpin
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol
| | - Gemma Hammerton
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol
| | - Alan Stein
- Department of Psychiatry, University of Oxford
| | - Marc H Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center
| | - Tim Cadman
- MRC Integrative Epidemiology Unit, University of Bristol
| | | | - Jonathan Evans
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol
| | - Tina Miller
- School of Social Sciences, Oxford Brookes University
| | | | - Jon Heron
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol
| | - Hannah M Sallis
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol
| | - Rebecca M Pearson
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol
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Costantini I, Sallis H, Tilling K, Major‐Smith D, Pearson RM, Kounali D. Childhood trajectories of internalising and externalising problems associated with a polygenic risk score for neuroticism in a UK birth cohort study. JCPP Adv 2023; 3:e12141. [PMID: 37431323 PMCID: PMC10241477 DOI: 10.1002/jcv2.12141] [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] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/14/2022] [Indexed: 02/25/2023] Open
Abstract
Background Neuroticism represents a personality disposition towards experiencing negative emotions more frequently and intensely. Longitudinal studies suggest that neuroticism increases risk of several psychological problems. Improved understanding of how this trait manifests in early life could help inform preventative strategies in those liable to neuroticism. Methods This study explored how a polygenic risk score for neuroticism (NEU PRS) is expressed from infancy to late childhood across various psychological outcomes using multivariable linear and ordinal regression models. In addition, we employed a three-level mixed-effect model to characterise child internalising and externalising trajectories and estimate how a child PRS associated with both their overall levels and rates of change in 5279 children aged 3-11 in the Avon Longitudinal Study of Parents and Children cohort. Results We found evidence that the NEU PRS was associated with a more emotionally sensitive temperament in early infancy in addition to higher emotional and behavioural problems and a higher risk of meeting diagnostic criteria for a variety of clinical disorders, particularly anxiety disorders, in childhood. The NEU PRS was associated with overall levels of internalising and externalising trajectories, with a larger magnitude of association on the internalising trajectory. The PRS was also associated with slower rates of reduction of internalising problems across childhood. Conclusions Our findings using a large, well-characterised birth cohort study suggest that phenotypic manifestations of a PRS for adult neuroticism can be detected as early as in infancy and that this PRS associates with several mental health problems and differences in emotional trajectories across childhood.
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Affiliation(s)
- Ilaria Costantini
- Centre for Academic Mental HealthUniversity of BristolBristolUK
- Department of Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Hannah Sallis
- Centre for Academic Mental HealthUniversity of BristolBristolUK
- Department of Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- Medical Research Council (MRC) Integrative Epidemiology UnitUniversity of BristolBristolUK
- School of Psychological ScienceUniversity of BristolBristolUK
| | - Kate Tilling
- Department of Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- Medical Research Council (MRC) Integrative Epidemiology UnitUniversity of BristolBristolUK
| | - Daniel Major‐Smith
- Department of Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- Medical Research Council (MRC) Integrative Epidemiology UnitUniversity of BristolBristolUK
- Centre for Academic Child HealthBristol Medical SchoolUniversity of BristolBristolUK
| | - Rebecca M. Pearson
- Centre for Academic Mental HealthUniversity of BristolBristolUK
- Department of Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- Medical Research Council (MRC) Integrative Epidemiology UnitUniversity of BristolBristolUK
- Department of PsychologyManchester Metropolitan UniversityManchesterUK
| | - Daphne‐Zacharenia Kounali
- Centre for Academic Mental HealthUniversity of BristolBristolUK
- Department of Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
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Burgess R, Costantini I, Bornstein MH, Campbell A, Cordero Vega MA, Culpin I, Dingsdale H, John RM, Kennedy MR, Tyson HR, Pearson RM, Nabney I. A Quantitative Evaluation of Thin Slice Sampling for Parent-Infant Interactions. J Nonverbal Behav 2023; 47:117-210. [PMID: 37162792 PMCID: PMC10163135 DOI: 10.1007/s10919-022-00420-7] [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] [Subscribe] [Scholar Register] [Accepted: 11/25/2022] [Indexed: 01/20/2023]
Abstract
Behavioural coding is time-intensive and laborious. Thin slice sampling provides an alternative approach, aiming to alleviate the coding burden. However, little is understood about whether different behaviours coded over thin slices are comparable to those same behaviours over entire interactions. To provide quantitative evidence for the value of thin slice sampling for a variety of behaviours. We used data from three populations of parent-infant interactions: mother-infant dyads from the Grown in Wales (GiW) cohort (n = 31), mother-infant dyads from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort (n = 14), and father-infant dyads from the ALSPAC cohort (n = 11). Mean infant ages were 13.8, 6.8, and 7.1 months, respectively. Interactions were coded using a comprehensive coding scheme comprised of 11-14 behavioural groups, with each group comprised of 3-13 mutually exclusive behaviours. We calculated frequencies of verbal and non-verbal behaviours, transition matrices (probability of transitioning between behaviours, e.g., from looking at the infant to looking at a distraction) and stationary distributions (long-term proportion of time spent within behavioural states) for 15 thin slices of full, 5-min interactions. Measures drawn from the full sessions were compared to those from 1-, 2-, 3- and 4-min slices. We identified many instances where thin slice sampling (i.e., < 5 min) was an appropriate coding method, although we observed significant variation across different behaviours. We thereby used this information to provide detailed guidance to researchers regarding how long to code for each behaviour depending on their objectives.
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Affiliation(s)
- Romana Burgess
- Digital Health Engineering Group, Faculty of Engineering, Merchant Venturers Building, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, UK
| | - Ilaria Costantini
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, UK
| | - Marc H. Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD USA
| | - Amy Campbell
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, UK
| | - Miguel A. Cordero Vega
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, UK
| | - Iryna Culpin
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, UK
| | - Hayley Dingsdale
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, UK
| | - Rosalind M. John
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, UK
| | - Mari-Rose Kennedy
- Centre for Ethics in Medicine, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hannah R. Tyson
- Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, UK
| | - Rebecca M. Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, UK
- Bristol NIHR Biomedical Research Centre, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
| | - Ian Nabney
- Digital Health Engineering Group, Faculty of Engineering, Merchant Venturers Building, University of Bristol, Bristol, UK
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Culpin I, Hammerton G, Bornstein MH, Heron J, Evans J, Cadman T, Sallis HM, Tilling K, Stein A, Kwong AS, Pearson RM. Maternal postnatal depression and offspring depression at age 24 years in a UK-birth cohort: the mediating role of maternal nurturing behaviours concerning feeding, crying and sleeping. Wellcome Open Res 2022; 6:187. [PMID: 36312455 PMCID: PMC9585356 DOI: 10.12688/wellcomeopenres.17006.2] [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] [Accepted: 10/12/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Maternal postnatal depression (PND) is a risk factor for offspring depression in adulthood. However, few longitudinal studies have examined the role of maternal nurturing parenting behaviours in the association between maternal PND and offspring depression in adulthood. Methods: We examined pathways from maternal PND measured using self-reported Edinburgh Postnatal Depression Scale at 8 weeks to offspring ICD-10 depression diagnosed using the Clinical Interview Schedule-Revised computerised assessment at 24 years through maternal-reported nurturing behaviours concerning feeding, sleeping and crying measured from pregnancy to age 3 years 6 months in 5,881 members of the UK-based birth cohort study, the Avon Longitudinal Study of Parents and Children. Results: The fully adjusted model revealed an indirect effect from PND to adult offspring depression through the combination of all parenting factors (probit regression coefficient [ B]=0.038, 95% confidence interval [CI] 0.005, 0.071); however, there was no evidence of a direct effect from early maternal PND to offspring depression once the indirect effect via parenting factors was accounted for ( B=0.009, 95%CI -0.075, 0.093). Specificity analyses revealed indirect effects through maternal worries about feeding ( B=0.019, 95%CI 0.003, 0.035, p=0.010) and maternal perceptions and responses to crying ( B=0.018, 95%CI 0.004, 0.032, p=0.012). Conclusions: The adverse impact of maternal PND on offspring depression in early adulthood was explained by maternal nurturing behaviours concerning feeding, crying and sleeping in early childhood. Residual confounding and measurement error likely limit reliable conclusions. If found causal, interventions providing support to reduce worries around maternal nurturing behaviours and treating depression could reduce adverse outcomes in adult offspring of depressed mothers.
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Affiliation(s)
- Iryna Culpin
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
| | - Gemma Hammerton
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS82BN, UK
| | - Marc H. Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Child Health and Human Development, Bethesda, MD, USA
- Institute for Fiscal Studies, Institute for Fiscal Studies, London, UK
| | - Jon Heron
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS82BN, UK
- NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
| | - Jonathan Evans
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
- NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
| | - Tim Cadman
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS82BN, UK
| | - Hannah M. Sallis
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS82BN, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS82BN, UK
- NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
| | - Alan Stein
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alex S.F. Kwong
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Rebecca M. Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
- NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Culpin I, Heuvelman H, Rai D, Pearson RM, Joinson C, Heron J, Evans J, Kwong ASF. Father absence and trajectories of offspring mental health across adolescence and young adulthood: Findings from a UK-birth cohort. J Affect Disord 2022; 314:150-159. [PMID: 35842065 PMCID: PMC10666570 DOI: 10.1016/j.jad.2022.07.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 01/17/2022] [Revised: 06/30/2022] [Accepted: 07/09/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND High prevalence of parental separation and resulting biological father absence raises important questions regarding its impact on offspring mental health across the life course. We specifically examined whether these relationships vary by sex and the timing of exposure to father absence (early or middle childhood). METHODS This study is based on up to 8409 children from the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants provided self-reports of depression (Clinical Interview Schedule-Revised) at age 24 years and depressive symptoms (Short Mood and Feelings Questionnaire) between the ages of 10 and 24 years. Biological father absence in childhood was assessed through maternal questionnaires at regular intervals from birth to 10 years. We estimated the association between biological father absence and trajectories of depressive symptoms using multilevel growth-curve modelling. RESULTS Early but not middle childhood father absence was strongly associated with increased odds of offspring depression and greater depressive symptoms at age 24 years. Early childhood father absence was associated with higher trajectories of depressive symptoms during adolescence and early adulthood compared with father presence. Differences in the level of depressive symptoms between middle childhood father absent and father present groups narrowed into adulthood. LIMITATIONS This study could be biased by attrition and residual confounding. CONCLUSIONS We found evidence that father absence in childhood is persistently associated with offspring depression in adolescence and early adulthood. This relationship varies by sex and timing of father's departure, with early childhood father absence emerging as the strongest risk factor for adverse offspring mental health trajectories Further research is needed to identify mechanisms that could inform preventative interventions to reduce the risk of depression in children who experience father absence.
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Affiliation(s)
- Iryna Culpin
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.
| | - Hein Heuvelman
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, United Kingdom
| | - Dheeraj Rai
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; NIHR Biomedical Research Centre, University of Bristol, Bristol, United Kingdom; Avon and Wiltshire Partnership National Health Service (NHS) Trust, Bristol, UK
| | - Rebecca M Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; NIHR Biomedical Research Centre, University of Bristol, Bristol, United Kingdom
| | - Carol Joinson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jon Heron
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Jonathan Evans
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; NIHR Biomedical Research Centre, University of Bristol, Bristol, United Kingdom; Avon and Wiltshire Partnership National Health Service (NHS) Trust, Bristol, UK
| | - Alex S F Kwong
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
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Lewis G, Button KS, Pearson RM, Munafò MR, Lewis G. Inhibitory control of positive and negative information and adolescent depressive symptoms: a population-based cohort study. Psychol Med 2022; 52:853-863. [PMID: 32677595 DOI: 10.1017/s0033291720002469] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Indexed: 11/06/2022]
Abstract
BACKGROUND Large population-based cohort studies of neuropsychological factors that characterise or precede depressive symptoms are rare. Most studies use small case-control or cross-sectional designs, which may cause selection bias and cannot test temporality. In a large UK population-based cohort, we investigated cross-sectional and longitudinal associations between inhibitory control of positive and negative information and adolescent depressive symptoms. METHODS Cohort study of 2328 UK adolescents who completed an affective go/no-go task at age 18. Depressive symptoms were assessed with the Clinical Interview Schedule Revised (CIS-R) and short Mood and Feeling Questionnaire (sMFQ) at age 18, and with the sMFQ 1 year later (age 19). Analyses were multilevel and traditional linear regressions, before and after adjusting for confounders. RESULTS Cross-sectionally, we found little evidence that adolescents with more depressive symptoms made more inhibitory control errors [after adjustments, errors increased by 0.04% per 1 s.d. increase in sMFQ score (95% confidence interval 0.02-0.06)], but this association was not observed for the CIS-R. There was no evidence for an influence of valence. Longitudinally, there was no evidence that reduced inhibitory control was associated with future depressive symptoms. CONCLUSIONS Inhibitory control of positive and negative information does not appear to be a marker of current or future depressive symptoms in adolescents and would not be a useful target in interventions to prevent adolescent depression. Our lack of convincing evidence for associations with depressive symptoms suggests that the affective go/no-go task is not a promising candidate for future neuroimaging studies of adolescent depression.
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Affiliation(s)
- Gemma Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | | | | | - Marcus R Munafò
- School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
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Kwong ASF, Morris TT, Pearson RM, Timpson NJ, Rice F, Stergiakouli E, Tilling K. Polygenic risk for depression, anxiety and neuroticism are associated with the severity and rate of change in depressive symptoms across adolescence. J Child Psychol Psychiatry 2021; 62:1462-1474. [PMID: 33778956 DOI: 10.1111/jcpp.13422] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 07/03/2020] [Revised: 01/21/2021] [Accepted: 02/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Adolescence marks a period where depression will commonly onset. Twin studies show that genetic influences play a role in how depression develops and changes across adolescence. Recent genome-wide association studies highlight that common genetic variants - which can be combined into polygenic risk scores (PRS) - are also implicated in depression. However, the role of PRS in adolescent depression and changes in adolescent depression is not yet understood. We aimed to examine associations between PRS for five psychiatric traits and depressive symptoms measured across adolescence using cross-sectional and growth-curve models. The five PRS were as follows: depression (DEP), major depressive disorder (MDD), anxiety (ANX), neuroticism (NEU) and schizophrenia (SCZ). METHODS We used data from over 6,000 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC) to examine associations between the five PRS and self-reported depressive symptoms (Short Mood and Feelings Questionnaire) over 9 occasions from 10 to 24 years. The PRS were created from well-powered genome-wide association studies conducted in adult populations. We examined cross-sectional associations between the PRS at each age and then again with longitudinal trajectories of depressive symptoms in a repeated measures framework using multilevel growth-curve analysis to examine the severity and the rate of change. RESULTS There was strong evidence that higher PRS for DEP, MDD and NEU were associated with worse depressive symptoms throughout adolescence and into young adulthood in our cross-sectional analysis, with consistent associations observed across all nine occasions. Growth-curve analyses provided stronger associations (as measured by effect sizes) and additional insights, demonstrating that individuals with higher PRS for DEP, MDD and NEU had steeper trajectories of depressive symptoms across development, all with a greater increasing rate of change during adolescence. Evidence was less consistent for the ANX and SCZ PRS in the cross-sectional analysis, yet there was some evidence for an increasing rate of change in adolescence in the growth-curve analyses with the ANX PRS. CONCLUSIONS These results show that common genetic variants as indexed by varying psychiatric PRS show patterns of specificity that influence both the severity and rate of change in depressive symptoms throughout adolescence and then into young adulthood. Longitudinal data that make use of repeated measures designs have the potential to provide greater insights how genetic factors influence the onset and persistence of adolescent depression.
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Affiliation(s)
- Alex S F Kwong
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Tim T Morris
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rebecca M Pearson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Frances Rice
- Division of Psychological Medicine & Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics & Genomics, Cardiff University, Cardiff, UK
| | - Evie Stergiakouli
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Paul E, Kwong A, Moran P, Pawlby S, Howard LM, Pearson RM. Maternal thoughts of self-harm and their association with future offspring mental health problems. J Affect Disord 2021; 293:422-428. [PMID: 34246951 PMCID: PMC8370273 DOI: 10.1016/j.jad.2021.06.058] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/21/2021] [Accepted: 06/27/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Depression and self-harm are leading causes of disability in young people, but prospective data on how maternal depression and self-harm thoughts contribute to these outcomes, and how they may interact is lacking. METHODS The study sample consisted of 8,425 mothers and offspring from the Avon Longitudinal Study of Parents and Children, an ongoing birth cohort study. Exposures were maternal self-harm ideation and depression measured using the Edinburgh Postnatal Depression Scale, collected at eleven time points over the period 18 weeks' gestation to 18 years post-partum. Outcomes were offspring past-year major depressive disorder and lifetime self-harm assessed at age 24. RESULTS Nearly one-fifth (16.7%) of mothers reported thoughts of self-harm on at least one of the eleven assessment points. The frequency of maternal self-harm ideation was related to both outcomes in a dose-response manner. Young adults whose mothers had self-harm ideation on 5-11 occasions were over three times more likely (Odds ratio (OR), 3.32; 95% CI, 1.63-6.76) to be depressed and over 1.5 times as likely (OR, 1.55; 95% CI, 0.73, 3.29) to have self-harmed than their peers whose mothers had never reported self-harm thoughts. Maternal self-harm thoughts remained associated with both offspring outcomes independent of maternal depression, and no evidence was found for an interaction between the two exposures. DISCUSSION Clinicians collecting data on maternal depression may consider paying attention to questions about self-harm ideation in assessments. Examining accumulated maternal self-harm ideation over time may provide insights into which children are most at risk for later self-harm and depression.
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Affiliation(s)
- Elise Paul
- Department of Behavioural Science and Health at University College, London, United Kingdom.
| | - Alex Kwong
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, United Kingdom
| | - Paul Moran
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, United Kingdom.
| | - Susan Pawlby
- Faculty of Life Sciences & Medicine, School of Life Course Sciences, King's College London, London, United Kingdom.
| | - Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Rebecca M Pearson
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Cadman T, Kwong ASF, Moran P, O’Mahen H, Culpin I, Lawlor DA, Pearson RM. Joint associations of parental personality traits and socio-economic position with trajectories of offspring depression: Findings from up to 6925 families in a UK birth cohort. JCPP Adv 2021; 1:e12028. [PMID: 37431442 PMCID: PMC10242948 DOI: 10.1002/jcv2.12028] [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] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/28/2021] [Indexed: 11/08/2022] Open
Abstract
Background Parental personality may influence the course of offspring depression but epidemiological evidence for associations is lacking. It is also unknown whether associations between parental personality and offspring depression differ by socio-economic position (SEP). Our aims were to describe the trajectories of depressive symptoms across adolescence of offspring of parents with and without maladaptive personality traits and to test for effect modification by SEP. Methods A longitudinal study in the Avon Longitudinal Study of Parents and Children birth cohort (ns = 3054-7046). Exposures were binary measures of maladaptive maternal and paternal personality traits. The outcome was depressive symptoms measured over nine occasions (ages 11-24) using the short mood and feelings questionnaire (SMFQ; range: 0-26). Effect modifiers were parental education and self-reported material hardship. Multilevel growth curve models were used to estimate trajectories. Results offspring of mothers with high (vs. low) maladaptive traits showed higher levels of depressive symptoms at multiple ages of adolescence, the greatest of which was observed at age 22 (predicted SMFQ difference age 10 = 0.66, 95% confidence intervals [CIs]: 0.25 to 1.28; age 22 = 1.00, CI: 0.51 to 1.50). There was weaker and inconsistent evidence of an association between paternal maladaptive personality and offspring depressive symptoms (SMFQ difference age 10 = 0.21, CI: -0.58 to 0.99; age 22 = 0.02, CI: -0.94 to 0.90). Lower SEP was also associated with higher offspring depressive symptoms (SMFQ difference material hardship vs. no hardship age 10 = 0.79, 95% CI: 0.46 to 1.13; age 22 = 0.96, CI: 0.56 to 1.36). There was minimal statistical evidence for effect modification. Conclusions The offspring of mothers with high levels of maladaptive personality traits show evidence of greater depressive symptoms throughout adolescence although the absolute increase in symptoms is small. Evidence for the associations with fathers' personality was weaker. Socio-economic position and maladaptive personality traits appear to be independent risk factors for offspring depressive symptoms.
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Affiliation(s)
- Tim Cadman
- Integrative Epidemiology Unit (IEU)University of BristolBristolUK
- Population Health ScienceBristol Medical SchoolUniversity of BristolBristolUK
| | - Alex S. F. Kwong
- Integrative Epidemiology Unit (IEU)University of BristolBristolUK
- Population Health ScienceBristol Medical SchoolUniversity of BristolBristolUK
- Division of PsychiatryUniversity of EdinburghEdinburghUK
- Centre for Multilevel ModellingSchool of EducationUniversity of BristolBristolUK
| | - Paul Moran
- Population Health ScienceBristol Medical SchoolUniversity of BristolBristolUK
- Population Health ScienceCentre for Academic Mental HealthBristol Medical SchoolUniversity of BristolBristolUK
- Bristol NIHR Biomedical Research CentreBristolUK
| | - Heather O’Mahen
- Department of PsychologyCollege of Life and Environmental SciencesUniversity of ExeterExeterUK
| | - Iryna Culpin
- Population Health ScienceBristol Medical SchoolUniversity of BristolBristolUK
- Population Health ScienceCentre for Academic Mental HealthBristol Medical SchoolUniversity of BristolBristolUK
| | - Deborah A. Lawlor
- Integrative Epidemiology Unit (IEU)University of BristolBristolUK
- Population Health ScienceBristol Medical SchoolUniversity of BristolBristolUK
- Bristol NIHR Biomedical Research CentreBristolUK
| | - Rebecca M. Pearson
- Integrative Epidemiology Unit (IEU)University of BristolBristolUK
- Population Health ScienceBristol Medical SchoolUniversity of BristolBristolUK
- Population Health ScienceCentre for Academic Mental HealthBristol Medical SchoolUniversity of BristolBristolUK
- Bristol NIHR Biomedical Research CentreBristolUK
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Rajyaguru P, Kwong ASF, Braithwaite E, Pearson RM. Maternal and paternal depression and child mental health trajectories: evidence from the Avon Longitudinal Study of Parents and Children. BJPsych Open 2021; 7:e166. [PMID: 34556196 PMCID: PMC8485341 DOI: 10.1192/bjo.2021.959] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The relationships between offspring depression profiles across adolescence and different timings of parental depression during the perinatal period remain unknown. AIMS To explore different timings of maternal and paternal perinatal depression in relation to patterns of change in offspring depressive mood over a 14 year period. METHOD Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC). Parental antenatal depression (ANTD) was assessed at 18 weeks gestation, and postnatal depression (PNTD) at 8 weeks postpartum. Population-averaged trajectories of offspring depressive symptoms were estimated using the Short Mood and Feelings Questionnaire (SMFQ) on nine occasions between 10 and 24 years of age. RESULTS Full data were available for 5029 individuals. Offspring exposed to both timings of maternal depression had higher depressive symptoms across adolescence compared with offspring not exposed to ANTD or PNTD, characterised by higher depressive symptoms at age 16 (7.07 SMFQ points (95% CI = 6.19, 7.95; P < 0.001)) and a greater rate of linear change (0.698 SMFQ points (95% CI = 0.47, 0.93; P = 0.002)). Isolated maternal ANTD and to a lesser extent PNTD were also both associated with higher depressive symptoms at age 16, yet isolated maternal PNTD showed greater evidence for an increased rate of linear change across adolescence. A similar pattern was observed for paternal ANTD and PNTD, although effect sizes were attenuated. CONCLUSIONS This study adds to the literature demonstrating that exposure to two timings of maternal depression (ANTD and PNTD) is strongly associated with greater offspring trajectories of depressive symptoms.
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Affiliation(s)
- Priya Rajyaguru
- Centre for Academic Mental Health, University of Bristol, Bristol, and Oxford Health NHS Foundation Trust, UK
| | - Alex S F Kwong
- Population Health Sciences, Bristol Medical School, and Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Elizabeth Braithwaite
- Department of Psychology, School of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Rebecca M Pearson
- Population Health Sciences, Bristol Medical School, and Medical Research Council Integrative Epidemiology Unit, University of Bristol, and National Institute for Health Research Bristol Biomedical Research Centre, Bristol, UK
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13
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Culpin I, Hammerton G, Bornstein MH, Heron J, Evans J, Cadman T, Sallis HM, Tilling K, Stein A, Kwong AS, Pearson RM. Maternal postnatal depression and offspring depression at age 24 years in a UK-birth cohort: the mediating role of maternal nurturing behaviours concerning feeding, crying and sleeping. Wellcome Open Res 2021; 6:187. [PMID: 36312455 PMCID: PMC9585356 DOI: 10.12688/wellcomeopenres.17006.1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Maternal postnatal depression (PND) is a risk factor for offspring depression in adulthood. However, few longitudinal studies have examined the role of maternal nurturing parenting behaviours in the association between maternal PND and offspring depression in adulthood. Methods: We examined pathways from maternal PND measured using self-reported Edinburgh Postnatal Depression Scale at 8 weeks to offspring ICD-10 depression diagnosed using the Clinical Interview Schedule-Revised computerised assessment at 24 years through maternal-reported nurturing behaviours concerning feeding, sleeping and crying measured from pregnancy to age 3 years 6 months in 5,881 members of the UK-based birth cohort study, the Avon Longitudinal Study of Parents and Children. Results: The fully adjusted model revealed an indirect effect from PND to adult offspring depression through the combination of all parenting factors (probit regression coefficient [ B]=0.038, 95% confidence interval [CI] 0.005, 0.071); however, there was no evidence of a direct effect from early maternal PND to offspring depression once the indirect effect via parenting factors was accounted for ( B=0.009, 95%CI -0.075, 0.093). Specificity analyses revealed indirect effects through maternal worries about feeding ( B=0.019, 95%CI 0.003, 0.035, p=0.010) and maternal perceptions and responses to crying ( B=0.018, 95%CI 0.004, 0.032, p=0.012). Conclusions: The adverse impact of maternal PND on offspring depression in early adulthood was explained by maternal nurturing behaviours concerning feeding, crying and sleeping in early childhood. Residual confounding and measurement error likely limit reliable conclusions. If found causal, interventions providing support to reduce worries around maternal nurturing behaviours and treating depression could reduce adverse outcomes in adult offspring of depressed mothers.
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Affiliation(s)
- Iryna Culpin
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
| | - Gemma Hammerton
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS82BN, UK
| | - Marc H. Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Child Health and Human Development, Bethesda, MD, USA
- Institute for Fiscal Studies, Institute for Fiscal Studies, London, UK
| | - Jon Heron
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS82BN, UK
- NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
| | - Jonathan Evans
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
- NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
| | - Tim Cadman
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS82BN, UK
| | - Hannah M. Sallis
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS82BN, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS82BN, UK
- NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
| | - Alan Stein
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alex S.F. Kwong
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Rebecca M. Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS82BN, UK
- NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Redinger S, Pearson RM, Houle B, Norris SA, Rochat TJ. Thoughts of self-harm in early and late pregnancy in urban South Africa: Investigating prevalence, predictors and screening options. S Afr Med J 2021; 111:627-634. [PMID: 34382545 DOI: 10.7196/samj.2021.v111i7.15058] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Thoughts of self-harm (TSH) are an important marker of mental health risk, and risk for attempted and completed suicide. While there is increasing attention being paid to mental health problems in pregnancy in South Africa (SA), TSH have received less attention despite some cross-sectional studies suggesting that prevalence may be high (12 - 39%). There is a dearth of longitudinal research to inform prevention and treatment. OBJECTIVES To examine the rates of TSH across pregnancy in a longitudinal SA cohort and to investigate factors associated with the onset and persistence of TSH, as well as the relationship between TSH, depression and/or anxiety. METHODS Women were enrolled in a prospective pregnancy cohort (S1000) in Soweto, SA between 2014 and 2016, and assessed using validated screening measures (Edinburgh Postnatal Depression Scale (EPDS) and State Trait Anxiety Index short form) in early and later pregnancy. Data were available for 649 women. TSH were determined using EPDS item 10. Logistic regression and bifactor models were used to determine factors associated with TSH across pregnancy. RESULTS Of the 649 women, 18% reported TSH at some stage during their pregnancy. Prevalence of TSH was slightly higher in early pregnancy (12.5%) than later in pregnancy (11.6%). TSH were associated with a history of mental illness (adjusted odds ratio (aOR) 4.17; 95% confidence interval (CI) 1.3 - 13.7; p=0.020), concurrent depression (aOR 4.8; 95%CI 2.7 - 8.6; p<0.001); marital stress (aOR 1.74; 95% CI 1.0 - 3.0; p=0.040); and practical support (aOR 0.43; 95% CI 0.2 - 1.0; p=0.040) using a multivariate logistic regression. Bifactor analysis examining depression and anxiety scales showed that TSH contributed the highest variance to a shared depression and anxiety factor in early pregnancy. Logistic regressions showed that early depression was a strong predictor of later reports of TSH. CONCLUSIONS The present study shows that the risk of TSH during pregnancy is relatively common, and starts early during pregnancy. Screening approaches could be simplified to encourage healthcare practitioners working in busy and over-burdened public healthcare settings to engage in identifying at-risk women. Efforts in improving early identification of mental health risk in pregnancy should be matched with strengthening of current treatment and referral options. Since practical support and a good marital relationship reduce the risk of TSH, these may be important avenues of focus for designing interventions.
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Affiliation(s)
- S Redinger
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; DSI-NRF Centre of Excellence in Human Development, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Kwong ASF, Pearson RM, Adams MJ, Northstone K, Tilling K, Smith D, Fawns-Ritchie C, Bould H, Warne N, Zammit S, Gunnell DJ, Moran PA, Micali N, Reichenberg A, Hickman M, Rai D, Haworth S, Campbell A, Altschul D, Flaig R, McIntosh AM, Lawlor DA, Porteous D, Timpson NJ. Mental health before and during the COVID-19 pandemic in two longitudinal UK population cohorts. Br J Psychiatry 2021; 218:334-343. [PMID: 33228822 PMCID: PMC7844173 DOI: 10.1192/bjp.2020.242] [Citation(s) in RCA: 265] [Impact Index Per Article: 88.3] [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: 07/15/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The COVID-19 pandemic and mitigation measures are likely to have a marked effect on mental health. It is important to use longitudinal data to improve inferences. AIMS To quantify the prevalence of depression, anxiety and mental well-being before and during the COVID-19 pandemic. Also, to identify groups at risk of depression and/or anxiety during the pandemic. METHOD Data were from the Avon Longitudinal Study of Parents and Children (ALSPAC) index generation (n = 2850, mean age 28 years) and parent generation (n = 3720, mean age 59 years), and Generation Scotland (n = 4233, mean age 59 years). Depression was measured with the Short Mood and Feelings Questionnaire in ALSPAC and the Patient Health Questionnaire-9 in Generation Scotland. Anxiety and mental well-being were measured with the Generalised Anxiety Disorder Assessment-7 and the Short Warwick Edinburgh Mental Wellbeing Scale. RESULTS Depression during the pandemic was similar to pre-pandemic levels in the ALSPAC index generation, but those experiencing anxiety had almost doubled, at 24% (95% CI 23-26%) compared with a pre-pandemic level of 13% (95% CI 12-14%). In both studies, anxiety and depression during the pandemic was greater in younger members, women, those with pre-existing mental/physical health conditions and individuals in socioeconomic adversity, even when controlling for pre-pandemic anxiety and depression. CONCLUSIONS These results provide evidence for increased anxiety in young people that is coincident with the pandemic. Specific groups are at elevated risk of depression and anxiety during the COVID-19 pandemic. This is important for planning current mental health provisions and for long-term impact beyond this pandemic.
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Affiliation(s)
- Alex S. F. Kwong
- MRC Integrative Epidemiology Unit, University of Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, UK; and Division of Psychiatry, University of Edinburgh, UK
| | - Rebecca M. Pearson
- MRC Integrative Epidemiology Unit, University of Bristol, UK; and Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | | | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit, University of Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, UK; and Division of Psychiatry, University of Edinburgh, UK
| | - Daniel Smith
- MRC Integrative Epidemiology Unit, University of Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, UK; and Division of Psychiatry, University of Edinburgh, UK
| | | | - Helen Bould
- Population Health Sciences, Bristol Medical School, University of Bristol, UK; and Gloucestershire Health and Care NHS Foundation Trust, UK
| | - Naomi Warne
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Stanley Zammit
- Population Health Sciences, Bristol Medical School, University of Bristol, UK; and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - David J. Gunnell
- Population Health Sciences, Bristol Medical School, University of Bristol, UK; and National Institute of Health Research Biomedical Research Centre, University of Bristol, UK
| | - Paul A. Moran
- Population Health Sciences, Bristol Medical School, University of Bristol, UK; National Institute of Health Research Biomedical Research Centre, University of Bristol, UK; and Avon and Wiltshire Mental Health Partnership NHS Trust, UK
| | - Nadia Micali
- Great Ormond Street Institute of Child Health, University College London, UK; Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland; and Department of Paediatrics Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Switzerland
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Dheeraj Rai
- Population Health Sciences, Bristol Medical School, University of Bristol, UK; National Institute of Health Research Biomedical Research Centre, University of Bristol, UK; and Avon and Wiltshire Mental Health Partnership NHS Trust, UK
| | - Simon Haworth
- 1MRC Integrative Epidemiology Unit, University of Bristol, UK; and Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics & Molecular Medicine, University of Edinburgh, UK; and Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, UK
| | - Drew Altschul
- Centre for Genomic and Experimental Medicine, Institute of Genetics & Molecular Medicine, University of Edinburgh, UK
| | - Robin Flaig
- Centre for Genomic and Experimental Medicine, Institute of Genetics & Molecular Medicine, University of Edinburgh, UK; and Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, UK
| | | | - Deborah A. Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, UK; and National Institute of Health Research Biomedical Research Centre, University of Bristol, UK
| | - David Porteous
- Centre for Genomic and Experimental Medicine, Institute of Genetics & Molecular Medicine, University of Edinburgh, UK
| | - Nicholas J. Timpson
- MRC Integrative Epidemiology Unit at the University of Bristol, UK; and Population Health Sciences, Bristol Medical School, University of Bristol, UK
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Smith D, Northstone K, Bowring C, Wells N, Crawford M, Pearson RM, Thomas A, Brooks-Pollock E, Lawlor DA, Timpson NJ. The Avon Longitudinal Study of Parents and Children - A resource for COVID-19 research: Generation 2 questionnaire data capture May-July 2020. Wellcome Open Res 2021; 5:278. [PMID: 33791441 PMCID: PMC7968471 DOI: 10.12688/wellcomeopenres.16414.2] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 12/01/2022] Open
Abstract
The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective population-based cohort study which recruited pregnant women in 1990-1992 from the Bristol area (UK). ALSPAC has followed these women, their partners (Generation 0; G0) and their offspring (Generation 1; G1) ever since. From 2012, ALSPAC has identified G1 participants who were pregnant (or their partner was) or had become parents, and enrolled them, their partners, and children in the ALSPAC-Generation 2 (ALSPAC-G2) study, providing a unique multi-generational cohort. At present, approximately 1,100 G2 children (excluding those in utero) from 810 G1 participants have been enrolled. In response to the COVID-19 pandemic, ALSPAC rapidly deployed two online questionnaires; one during the initial lockdown phase in 2020 (9 th April-15 th May), and another when national lockdown restrictions were eased (26 th May-5 th July). As part of this second questionnaire, G1 parents completed a questionnaire about each of their G2 children. This covered: parental reports of children's feelings and behaviour since lockdown, school attendance, contact patterns, and health. A total of 289 G1 participants completed this questionnaire on behalf of 411 G2 children. This COVID-19 G2 questionnaire data can be combined with pre-pandemic ALSPAC-G2 data, plus ALSPAC-G1 and -G0 data, to understand how children's health and behaviour has been affected by the pandemic and its management. Data from this questionnaire will be complemented with linkage to health records and results of biological testing as they become available. Prospective studies are necessary to understand the impact of this pandemic on children's health and development, yet few relevant studies exist; this resource will aid these efforts. Data has been released as: 1) a freely-available dataset containing participant responses with key sociodemographic variables; and 2) an ALSPAC-held dataset which can be combined with existing ALSPAC data, enabling bespoke research across all areas supported by the study.
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Affiliation(s)
- Daniel Smith
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Kate Northstone
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Claire Bowring
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Nicholas Wells
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Michael Crawford
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Rebecca M. Pearson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Amy Thomas
- Bristol Veterinary School, University of Bristol, Bristol, BS40 5DU, UK
| | - Ellen Brooks-Pollock
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- Bristol Veterinary School, University of Bristol, Bristol, BS40 5DU, UK
| | - Deborah A. Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Nicholas John Timpson
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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17
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López-López JA, Kwong AS, Washbrook L, Tilling K, Fazel MS, Pearson RM. Depressive symptoms and academic achievement in UK adolescents: a cross-lagged analysis with genetic covariates. J Affect Disord 2021; 284:104-113. [PMID: 33592428 PMCID: PMC8105173 DOI: 10.1016/j.jad.2021.01.091] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 06/15/2020] [Revised: 01/12/2021] [Accepted: 01/31/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND The relationship between adolescent depressive symptoms and academic achievement remains poorly understood. The aim of this study was to help clarify the nature and directionality of this association. METHODS We used a sample of 13,599 British adolescents (main sample of N=3,809 participants). We fitted cross-lagged panel models using four repeated measures of self-reported depressive symptoms and four measures of academic achievement based on British national records between 11-18 years, separately for male and female adolescents and considering polygenic risk scores (PRS) for educational attainment and depression, alongside other child and parental covariates. RESULTS We found evidence of an overall negative association that was stronger in boys (R=-0.21, 95% CI -0.31 to -0.11) than in girls (-0.13, -0.31 to 0.05). Higher depressive symptoms were associated with lower academic achievement at a later stage up to the end of compulsory education (16 years), when the direction of the association reversed, although girls with lower achievement also appeared vulnerable to depressive symptoms at previous stages. The genetic variables derived for this study showed stronger associations for academic achievement, but the PRS for depression also showed a negative association with academic achievement in girls. Child intelligence quotient and peer victimization also showed relevant associations. LIMITATIONS Observational design, variation around measurement times, missing data. CONCLUSIONS Depressive symptoms and academic achievement should be considered jointly when designing school-based programmes for children and adolescents, alongside gender, child ability and school experience. Including genetic information in research can help to disentangle average from time-varying effects.
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Affiliation(s)
- José A. López-López
- Department of Population Health Sciences, Bristol Medical School, University of Bristol (UK),Centre for Academic Mental Health, University of Bristol (UK),Department of Basic Psychology & Methodology, Faculty of Psychology, University of Murcia (Spain),Corresponding author. Department of Basic Psychology & Methodology, Faculty of Psychology, University of Murcia, Espinardo Campus, 30100 Murcia (Spain). Tel.: +34 86888 4574.
| | - Alex S.F. Kwong
- Department of Population Health Sciences, Bristol Medical School, University of Bristol (UK),Centre for Academic Mental Health, University of Bristol (UK),MRC Integrative Epidemiology Unit, University of Bristol (UK)
| | - Liz Washbrook
- School of Education, University of Bristol (UK),Centre for Multilevel Modelling, University of Bristol (UK)
| | - Kate Tilling
- Department of Population Health Sciences, Bristol Medical School, University of Bristol (UK),MRC Integrative Epidemiology Unit, University of Bristol (UK),Centre for Multilevel Modelling, University of Bristol (UK)
| | | | - Rebecca M. Pearson
- Department of Population Health Sciences, Bristol Medical School, University of Bristol (UK),Centre for Academic Mental Health, University of Bristol (UK),MRC Integrative Epidemiology Unit, University of Bristol (UK)
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18
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Costantini I, Kwong ASF, Smith D, Lewcock M, Lawlor DA, Moran P, Tilling K, Golding J, Pearson RM. Locus of Control and Negative Cognitive Styles in Adolescence as Risk Factors for Depression Onset in Young Adulthood: Findings From a Prospective Birth Cohort Study. Front Psychol 2021; 12:599240. [PMID: 33935856 PMCID: PMC8080877 DOI: 10.3389/fpsyg.2021.599240] [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] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 03/02/2021] [Indexed: 12/24/2022] Open
Abstract
Whilst previous observational studies have linked negative thought processes such as an external locus of control and holding negative cognitive styles with depression, the directionality of these associations and the potential role that these factors play in the transition to adulthood and parenthood has not yet been investigated. This study examined the association between locus of control and negative cognitive styles in adolescence and probable depression in young adulthood and whether parenthood moderated these associations. Using a UK prospective population-based birth cohort study: the Avon Longitudinal Study of Parents and Children (ALSPAC), we examined the association between external locus of control and negative cognitive styles in adolescence with odds of depression in 4,301 young adults using logistic regression models unadjusted and adjusted for potential confounding factors. Interaction terms were employed to examine whether parenthood (i.e., having become a parent or not) moderated these associations. Over 20% of young adults in our sample were at or above the clinical threshold indicating probable depression. For each standard deviation (SD) increase in external locus of control in adolescence, there was a 19% (95% CI: 8-32%) higher odds of having probable depression in young adulthood, after adjusting for various confounding factors including baseline mood and different demographic and life events variables. Similarly, for each SD increase in negative cognitive styles in adolescence, there was a 29% (95% CI: 16-44%) higher odds of having probable depression in the adjusted model. We found little evidence that parenthood status moderated the relationship between external locus of control or negative cognitive styles in adolescence and probable depression following adjustment for confounding factors. Effect estimates were comparable when performed in the complete case dataset. These findings suggest that having an external locus of control and holding negative cognitive styles in mid- to late adolescence is associated with an increased likelihood of probable depression in young adulthood.
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Affiliation(s)
- Ilaria Costantini
- Centre for Academic Mental Health at the University of Bristol, Oakfield House, Bristol, United Kingdom
- Department of Experimental Psychology, School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Alex S. F. Kwong
- Department of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Daniel Smith
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Melanie Lewcock
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Deborah A. Lawlor
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research, Biomedical Research Centre, University Hospitals Bristol National Health Service Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Paul Moran
- Centre for Academic Mental Health at the University of Bristol, Oakfield House, Bristol, United Kingdom
- National Institute for Health Research, Biomedical Research Centre, University Hospitals Bristol National Health Service Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Kate Tilling
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jean Golding
- National Institute for Health Research, Biomedical Research Centre, University Hospitals Bristol National Health Service Foundation Trust and University of Bristol, Bristol, United Kingdom
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Rebecca M. Pearson
- Centre for Academic Mental Health at the University of Bristol, Oakfield House, Bristol, United Kingdom
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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19
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Szekely E, Neumann A, Sallis H, Jolicoeur-Martineau A, Verhulst FC, Meaney MJ, Pearson RM, Levitan RD, Kennedy JL, Lydon JE, Steiner M, Greenwood CMT, Tiemeier H, Evans J, Wazana A. Maternal Prenatal Mood, Pregnancy-Specific Worries, and Early Child Psychopathology: Findings From the DREAM BIG Consortium. J Am Acad Child Adolesc Psychiatry 2021; 60:186-197. [PMID: 32278003 DOI: 10.1016/j.jaac.2020.02.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 02/06/2020] [Accepted: 03/11/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Few studies have attempted to identify how distinct dimensions of maternal prenatal affective symptoms relate to offspring psychopathology. We defined latent dimensions of women's prenatal affective symptoms and pregnancy-specific worries to examine their association with early offspring psychopathology in three prenatal cohorts. METHOD Data were used from three cohorts of the DREAM-BIG consortium: Avon Longitudinal Study of Parents and Children (ALSPAC [N = 12,515]), Generation R (N = 6,803), and the Canadian prenatal cohort Maternal Adversity, Vulnerability, and Neurodevelopment (MAVAN [N = 578]). Maternal prenatal affective symptoms and pregnancy-specific worries were assessed using different measures in each cohort. Through confirmatory factor analyses, we determined whether comparable latent dimensions of prenatal maternal affective symptoms existed across the cohorts. We used structural equation models to examine cohort-specific associations between these dimensions and offspring psychopathology at 4 to 8 years of age (general psychopathology, specific internalizing and externalizing previously derived using confirmatory factor analyses). Cohort-based estimates were meta-analyzed using inverse variance-weighing. RESULTS Four prenatal maternal factors were similar in all cohorts: a general affective symptoms factor and three specific factors-an anxiety/depression factor, a somatic factor, and a pregnancy-specific worries factor. In meta-analyses, both the general affective symptoms factor and pregnancy-specific worries factor were independently associated with offspring general psychopathology. The general affective symptoms factor was further associated with offspring specific internalizing problems. There were no associations with specific externalizing problems. CONCLUSION These replicated findings of independent and adverse effects for prenatal general affective symptoms and pregnancy-specific worries on child mental health support the need for specific interventions in pregnancy.
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Affiliation(s)
- Eszter Szekely
- McGill University Faculty of Medicine, Montreal, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Alexander Neumann
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Hannah Sallis
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | | | - Frank C Verhulst
- Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands; Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark, and the Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Michael J Meaney
- McGill University Faculty of Medicine, Montreal, Quebec, Canada; Douglas Mental Health Institute, Montreal, Quebec, Canada, and Singapore Institute for Clinical Sciences, Singapore City, Singapore
| | - Rebecca M Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Robert D Levitan
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada
| | - James L Kennedy
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - John E Lydon
- McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | | | - Celia M T Greenwood
- McGill University Faculty of Medicine, Montreal, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Henning Tiemeier
- Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands; Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Jonathan Evans
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Ashley Wazana
- McGill University Faculty of Medicine, Montreal, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Centre for Child Development and Mental Health, Jewish General Hospital, Montreal, Quebec, Canada.
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20
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Redinger S, Pearson RM, Houle B, Norris SA, Rochat TJ. Antenatal depression and anxiety across pregnancy in urban South Africa. J Affect Disord 2020; 277:296-305. [PMID: 32858310 DOI: 10.1016/j.jad.2020.08.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/02/2020] [Accepted: 08/08/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Depression and anxiety in pregnancy have negative consequences for women and their offspring. High adversity places pregnant women at increased mental health risk, yet there is a dearth of longitudinal research in these settings. Little is known about the pathways by which these problems emerge or persist in pregnancy. METHODS Women were enrolled in a prospective pregnancy cohort in Soweto, South Africa (2014-2016) and assessed using validated measures (Edinburgh Postnatal Depression Scale EPDS ≥13; State Trait Anxiety Index STAI ≥12) in early (T1) and later pregnancy (T2). Data was available for n = 649 women. Multinominal regression modelling was used to determine factors associated with transient versus persistent depression and anxiety across pregnancy. Cross-lagged panel modelling explored direction of effect between depression and anxiety, and stressors. RESULTS We found high rates of depression (T1: 27%; T2: 25%) and anxiety (T1: 15%; T2: 17%). Perceiving a partner made one's life harder increased risk of persistent depression (RR 5.92 95% CI [3.0-11.8] p<0.001); family stress increased risk for persistent anxiety (RR 1.71 95% CI [1.1-2.7] p = 0.027). We find evidence of a direct effect of early depression (T1) on later family stress (T2); and early family stress (T1) on later anxiety (T2). LIMITATIONS We used screening measures of depression and anxiety rather than clinical interviews. CONCLUSIONS Studies which focus only on late pregnancy may underestimate risk. Early identification, in the first trimester, is critical for prevention and treatment. Partner and family stressors are a key intervention target.
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Affiliation(s)
- Stephanie Redinger
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, 29 Princess of Wales Terrace, Johannesburg, 2193, South Africa; DSI-NRF Centre of Excellence in Human Development, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa.
| | - Rebecca M Pearson
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, 29 Princess of Wales Terrace, Johannesburg, 2193, South Africa; Centre for Academic Mental Health, University of Bristol, Bristol, United Kingdom
| | - Brian Houle
- School of Demography, The Australian National University, Canberra, Australia
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, 29 Princess of Wales Terrace, Johannesburg, 2193, South Africa; Global Health Research Institute, School of Health and Human Development, University of Southampton, United Kingdom
| | - Tamsen Jean Rochat
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, 29 Princess of Wales Terrace, Johannesburg, 2193, South Africa; DSI-NRF Centre of Excellence in Human Development, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa; Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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21
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Smith D, Northstone K, Bowring C, Wells N, Crawford M, Pearson RM, Thomas A, Brooks-Pollock E, Lawlor DA, Timpson NJ. The Avon Longitudinal Study of Parents and Children - A resource for COVID-19 research: Generation 2 questionnaire data capture May-July 2020. Wellcome Open Res 2020; 5:278. [PMID: 33791441 PMCID: PMC7968471 DOI: 10.12688/wellcomeopenres.16414.1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 11/20/2022] Open
Abstract
The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective population-based cohort study which recruited pregnant women in 1990-1992 from the Bristol area (UK). ALSPAC has followed these women, their partners (Generation 0; G0) and their offspring (Generation 1; G1) ever since. From 2012, ALSPAC has identified G1 participants who were pregnant (or their partner was) or had become parents, and enrolled them, their partners, and children in the ALSPAC-Generation 2 (ALSPAC-G2) study, providing a unique multi-generational cohort. At present, approximately 1,100 G2 children (excluding those in utero) from 810 G1 participants have been enrolled. In response to the COVID-19 pandemic, ALSPAC rapidly deployed two online questionnaires; one during the initial lockdown phase in 2020 (9 th April-15 th May), and another when national lockdown restrictions were eased (26 th May-5 th July). As part of this second questionnaire, G1 parents completed a questionnaire about each of their G2 children. This covered: parental reports of children's feelings and behaviour since lockdown, school attendance, contact patterns, and health. A total of 289 G1 participants completed this questionnaire on behalf of 411 G2 children. This COVID-19 G2 questionnaire data can be combined with pre-pandemic ALSPAC-G2 data, plus ALSPAC-G1 and -G0 data, to understand how children's health and behaviour has been affected by the pandemic and its management. Data from this questionnaire will be complemented with linkage to health records and results of biological testing as they become available. Prospective studies are necessary to understand the impact of this pandemic on children's health and development, yet few relevant studies exist; this resource will aid these efforts. Data has been released as: 1) a freely-available dataset containing participant responses with key sociodemographic variables; and 2) an ALSPAC-held dataset which can be combined with existing ALSPAC data, enabling bespoke research across all areas supported by the study.
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Affiliation(s)
- Daniel Smith
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Kate Northstone
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Claire Bowring
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Nicholas Wells
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Michael Crawford
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Rebecca M. Pearson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Amy Thomas
- Bristol Veterinary School, University of Bristol, Bristol, BS40 5DU, UK
| | - Ellen Brooks-Pollock
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- Bristol Veterinary School, University of Bristol, Bristol, BS40 5DU, UK
| | - Deborah A. Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Nicholas John Timpson
- ALSPAC, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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22
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Costantini I, Paul E, Caldwell DM, López-López JA, Pearson RM. Protocol for a systematic review and network meta-analysis of randomised controlled trials examining the effectiveness of early parenting interventions in preventing internalising problems in children and adolescents. Syst Rev 2020; 9:244. [PMID: 33076982 PMCID: PMC7574314 DOI: 10.1186/s13643-020-01500-9] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 10/07/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Internalising problems, such as depression and anxiety, are common and represent an important economical and societal burden. The effectiveness of parenting interventions in reducing the risk of internalising problems in children and adolescents has not yet been summarised. The aims of this review are to assess the effectiveness of parenting interventions in the primary, secondary and tertiary prevention of internalising problems in children and adolescents and to determine which intervention components and which intervention aspects are most effective for reducing the risk of internalising problems in children and adolescents. METHODS Electronic searches in OVID SP versions of MEDLINE, EMBASE and PsycINFO; Cochrane Central Register of Controlled Trials; EBSCO version of ERIC and ClinicalTrials.gov have been performed to identify randomised controlled trials or quasi-randomised controlled trials of parenting interventions. At least two independent researchers will assess studies for inclusion and extract data from each paper. The risk of bias assessment will be conducted independently by two reviewers using the Cochrane Collaboration's Risk of Bias Assessment Tool. Statistical heterogeneity is anticipated given potential variation in participant characteristics, intervention type and mode of delivery, and outcome measures. Random effects models, assuming a common between-study variability, will be used to account for statistical heterogeneity. Results will be analysed using a network meta-analysis (NMA). If appropriate, we will also conduct a component-level NMA, where the 'active ingredients' of interventions are modelled using a network meta-regression approach. DISCUSSION Preventing and reducing internalising problems could have major beneficial effects at the economic and societal level. Informing policy makers on the effectiveness of parenting interventions and on which intervention's component is driving the effect is important for the development of treatment strategies. SYSTEMATIC REVIEW REGISTRATION International Prospective Register for Systematic Reviews (PROSPERO) number CRD42020172251.
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Affiliation(s)
- Ilaria Costantini
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BP UK
| | - Elise Paul
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BP UK
| | - Deborah M. Caldwell
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BP UK
| | - José A. López-López
- Department of Basic Psychology & Methodology, University of Murcia, Murcia, Spain
| | - Rebecca M. Pearson
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BP UK
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23
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Culpin I, Bornstein MH, Putnick DL, Sallis H, Lee R, Cordero M, Rajyaguru P, Kordas K, Cadman T, Pearson RM. Specific domains of early parenting, their heritability and differential association with adolescent behavioural and emotional disorders and academic achievement. Eur Child Adolesc Psychiatry 2020; 29:1401-1409. [PMID: 31786662 PMCID: PMC7501134 DOI: 10.1007/s00787-019-01449-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/23/2019] [Accepted: 11/22/2019] [Indexed: 11/28/2022]
Abstract
Variations in parenting across large populations have rarely been described. It also remains unclear which specific domains of parenting are important for which specific offspring developmental outcomes. This study describes different domains of early parenting behaviours and their genetic heritability, then determines the extent to which specific domains of parenting are associated with later offspring outcomes. Parenting behaviours (birth to 3 years) were extracted from self-reported questionnaires administered to 12,358 mothers from the UK-based birth cohort study, the Avon Longitudinal Study of Parents and Children and modelled as a latent factor using Confirmatory Factor Analysis. Genetic heritability and correlations between parenting factors were estimated using genome-wide complex trait analysis. Three parenting factors were derived: parental enjoyment, conflictual relationships and stimulation; all showed low genetic heritability. There was no evidence of association between parental enjoyment and offspring behavioural disorders and depressed mood. Stimulation was associated with better English grades (standardised β = 0.195, p < 0.001) and enjoyment was negatively associated with English grades (β = - 0.244, p = < 0.001). Conflictual relationships were associated with higher risk of offspring behavioural disorders (β = 0.228, p = 0.010) and depressed mood (β = 0.077, p = 0.005). Higher enjoyment reduced the association between conflict and behavioural problems (interaction term β = 0.113, p < 0.001). We found evidence for predictive specificity of early parenting domains for offspring outcomes in adolescence. Early stimulation, unlike enjoyment, promoted later educational achievement. Conflictual relationships were associated with greater risk of behavioural problems, buffered by increased enjoyment. These findings hold implications for parenting interventions, guiding their focus according to the specificity of parenting domains and their long-term outcomes in children.
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Affiliation(s)
- Iryna Culpin
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, BS8 2BN UK
| | - Marc H. Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, USA
- Institute for Fiscal Studies, London, UK
| | - Diane L. Putnick
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, USA
| | - Hannah Sallis
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, BS8 2BN UK
- MRC Integrative Epidemiology Unit, The University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
| | - Ruby Lee
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, BS8 2BN UK
| | - Miguel Cordero
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, BS8 2BN UK
| | - Priya Rajyaguru
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, BS8 2BN UK
| | - Katarzyna Kordas
- Avon Longitudinal Study of Parents and Children (ALSPAC), Bristol Medical School, University of Bristol, Bristol, UK
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University At Buffalo, Buffalo, USA
| | - Tim Cadman
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, BS8 2BN UK
- MRC Integrative Epidemiology Unit, The University of Bristol, Bristol, UK
| | - Rebecca M. Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, BS8 2BN UK
- NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
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24
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Paul E, Pearson RM. Depressive symptoms measured using the Edinburgh Postnatal Depression Scale in mothers and partners in the ALSPAC Study: A data note. Wellcome Open Res 2020; 5:108. [PMID: 32766456 PMCID: PMC7385546 DOI: 10.12688/wellcomeopenres.15925.2] [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] [Subscribe] [Scholar Register] [Accepted: 08/18/2020] [Indexed: 01/21/2023] Open
Abstract
Depression is a leading cause of disability and is associated with a number of adverse offspring outcomes when it occurs in parents. Depression is present in men and women at different rates, and recent research suggests that symptom profiles between the sexes may differ. Longitudinal data are needed to answer remaining questions about the long-term course, gender differences, antecedents and outcomes of depression. The Avon Longitudinal Study of Parents and Children (ALSPAC) is a large birth cohort study in England which administered one of the most commonly used depression instruments, the Edinburgh Postnatal Depression Scale (EPDS) at 11 timepoints in mothers and at 10 timepoints in their partners. In addition to repeated measurements of the EPDS, ALSPAC has a wealth of participant data on biological, social, demographic, and lifestyle factors. The purpose of this data note is to introduce potential users of the data to the characteristics of the EPDS in ALSPAC, as well as some key considerations when using the data.
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Affiliation(s)
- Elise Paul
- Medical School, University of Bristol, Bristol, UK
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Matijasevich A, Pearson RM, Loret de Mola C, Maruyama JM, La Maison C, Munhoz TN, Barros FC, Santos IS, D Barros AJ. Early child stimulation and attention-related executive functions at 11 years: 2004 Pelotas birth cohort study. Eur Child Adolesc Psychiatry 2020; 29:1265-1276. [PMID: 31748986 DOI: 10.1007/s00787-019-01440-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022]
Abstract
The study aimed to explore associations between socioeconomic position (SEP) indicators, early child stimulation (ECS) and attention-related executive functions (EF) at age 11. Children born in Pelotas, Brazil, in 2004, were recruited to a birth cohort (n = 4231, non-response rate at recruitment < 1%) and followed from birth to age 11. SEP variables were family income and maternal schooling. At the 24 and 48-month follow-ups, five markers of cognitive stimulation and social interaction were recorded and positive answers were summed to a score ranging from 0 to 5. At age 11, attentional-switching and control, and selective-attention were assessed using the adapted Test-of-Everyday-Attention-for-Children (TEA-Ch). We used multivariable logistic regression models and mediation analysis to investigate potential mediator role of ECS in the association between SEP and EF. 3106 children were included in the analyses. Less than 7% of the more stimulated individuals showed low performance in attention-related EFs at age 11 compared with almost 20% in the bottom groups of stimulation. Higher child stimulation scores were associated with fewer impairments in attentional-control (OR adj 0.84; CI 95% 0.72-0.98) and attentional-switching (OR adj 0.85; CI 95% 0.73-0.99). Mediation analysis suggested that for attentional-switching, ECS mediated almost 20% of the total protective effect of maternal schooling for impaired EF. Assuming causal relationships, if maximum stimulation was provided to all children, the advantageous effect of maternal schooling on EF would be reduced by 47%. ECS may represent a protective factor for cognitive impairments in childhood and can be easily implemented at relatively low cost.
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Affiliation(s)
- Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo 455, 2º andar sala 2166, São Paulo, SP, CEP 01246-903, Brazil.,Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Rebecca M Pearson
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK.,Section of Child and Adolescent Psychiatry, Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Jessica Mayumi Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo 455, 2º andar sala 2166, São Paulo, SP, CEP 01246-903, Brazil.
| | - Carolina La Maison
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo 455, 2º andar sala 2166, São Paulo, SP, CEP 01246-903, Brazil
| | - Tiago N Munhoz
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Fernando C Barros
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Post-Graduate Program in Health and Behaviour, Catholic University of Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Aluísio J D Barros
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Kwong ASF, Pearson RM, Smith D, Northstone K, Lawlor DA, Timpson NJ. Longitudinal evidence for persistent anxiety in young adults through COVID-19 restrictions. Wellcome Open Res 2020. [DOI: 10.12688/wellcomeopenres.16206.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic and related mitigation measures are associated with poorer mental health in cross-sectional and longitudinal surveys. However, it’s unclear if this represents an adaptive response to an unprecedented event that is short lived, or the beginning of longer mental health problems that persist beyond the initial outbreak of the pandemic. We used data from the index generation of the Avon Longitudinal Study of Parents and Children (young people aged 26-29) to examine anxiety at the beginning of the COVID-19 pandemic (April 2020) and again once restrictions were eased (June 2020). We compared these to two pre-pandemic assessments of anxiety measured 2013/2014 and 2015/17. We found that the percentage of individuals with anxiety was almost double during the COVID-19 assessments compared to pre-pandemic levels, with 15% of individuals having anxiety at both occasions (persistent anxiety). Being female, those with per-existing mental health conditions, a history of financial problems and those who had reported difficulties accessing mental health information were at greater risk of persistent anxiety. Our findings suggest that anxiety in response to COVID-19 is not just an initial reaction but potentially the start of a persistent problem that extends beyond the pandemic. Efforts must be made to address risk groups who could be disproportionally affected as a result of the COVID-19 pandemic and related mitigation measures.
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Paul E, Pearson RM. Depressive symptoms measured using the Edinburgh Postnatal Depression Scale in mothers and partners in the ALSPAC Study: A data note. Wellcome Open Res 2020; 5:108. [DOI: 10.12688/wellcomeopenres.15925.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2020] [Indexed: 11/20/2022] Open
Abstract
Depression is a leading cause of disability and is associated with a number of adverse offspring outcomes with it occurs in parents. Depression is present in men and women at different rates, and recent research suggests that symptom profiles between the sexes may differ. Longitudinal data are needed to answer remaining questions about the long-term course, gender differences, antecedents and outcomes of depression. The Avon Longitudinal Study of Parents and Children (ALSPAC) is a large birth cohort study in England which administered one of the most commonly used depression instruments, the Edinburgh Postnatal Depression Scale (EPDS) at 11 timepoints in mothers and at 10 timepoints in their partners. In addition to repeated measurements of the EPDS, ALSPAC has a wealth of participant data on biological, social, demographic, and lifestyle factors. The purpose of this data note is to introduce potential users of the data to the characteristics of the EPDS in ALSPAC, as well as some key considerations when using the data.
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Goin DE, Pearson RM, Craske MG, Stein A, Pettifor A, Lippman SA, Kahn K, Neilands TB, Hamilton EL, Selin A, MacPhail C, Wagner RG, Gomez-Olive FX, Twine R, Hughes JP, Agyei Y, Laeyendecker O, Tollman S, Ahern J. Depression and Incident HIV in Adolescent Girls and Young Women in HIV Prevention Trials Network 068: Targets for Prevention and Mediating Factors. Am J Epidemiol 2020; 189:422-432. [PMID: 31667490 PMCID: PMC7306677 DOI: 10.1093/aje/kwz238] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 02/07/2019] [Revised: 10/03/2019] [Accepted: 10/07/2019] [Indexed: 12/31/2022] Open
Abstract
The human immunodeficiency virus (HIV) epidemic among adolescent girls and young women (AGYW) in sub-Saharan Africa is a critical public health problem. We assessed whether depressive symptoms in AGYW were longitudinally associated with incident HIV, and identified potential social and behavioral mediators. Data came from a randomized trial of a cash transfer conditional on school attendance among AGYW (ages 13-21 years) in rural Mpumalanga Province, South Africa, during 2011-2017. We estimated the relationship between depressive symptoms and cumulative HIV incidence using a linear probability model, and we assessed mediation using inverse odds ratio weighting. Inference was calculated using the nonparametric bootstrap. AGYW with depressive symptoms had higher cumulative incidence of HIV compared with those without (risk difference = 3.5, 95% confidence interval (CI): 0.1, 7.0). The strongest individual mediators of this association were parental monitoring and involvement (indirect effect = 1.6, 95% CI: 0.0, 3.3) and reporting a partner would hit her if she asked him to wear a condom (indirect effect = 1.5, 95% CI: -0.3, 3.3). All mediators jointly explained two-thirds (indirect effect = 2.4, 95% CI: 0.2, 4.5) of the association between depressive symptoms and HIV incidence. Interventions addressing mental health might reduce risk of acquiring HIV among AGYW.
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Affiliation(s)
- Dana E Goin
- Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Rebecca M Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, Bristol University, Bristol, United Kingdom
- Bristol Biomedical Research Centre, National Institute for Health Research, Bristol, United Kingdom
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Alan Stein
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Audrey Pettifor
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Sheri A Lippman
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Kathleen Kahn
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
| | - Torsten B Neilands
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Erica L Hamilton
- HIV Prevention Trials Network Leadership and Operations Center, Science Facilitation Department, FHI 360, Durham, North Carolina
| | - Amanda Selin
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
- Carolina Population Center, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
| | - Catherine MacPhail
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Ryan G Wagner
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
| | - F Xavier Gomez-Olive
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
| | - Rhian Twine
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
| | - James P Hughes
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington
| | - Yaw Agyei
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Oliver Laeyendecker
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
- Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology, School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Stephen Tollman
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
| | - Jennifer Ahern
- Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California
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Nath S, Pearson RM, Moran P, Pawlby S, Molyneaux E, Howard LM. Maternal personality traits, antenatal depressive symptoms and the postpartum mother-infant relationship: a prospective observational study. Soc Psychiatry Psychiatr Epidemiol 2020; 55:621-634. [PMID: 31642966 DOI: 10.1007/s00127-019-01790-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 10/09/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Maternal depression has been associated with bonding difficulties and lower maternal sensitivity in observed mother-infant interactions. However, little research has examined the impact of disordered personality traits in mothers on these outcomes. We investigated the association between disordered personality traits in mothers measured during pregnancy and postnatal (a) self-reported bonding with infant; (b) observational mother-infant interactions. METHODS Five hundred fifty-six women were recruited during early pregnancy and subsequently followed up at mid-pregnancy (approximately 28 weeks' gestation) and when infants were aged approximately 3 months (n = 459). During early pregnancy, data were collected on disordered personality traits (using the Standardised Assessment of Personality Abbreviated Scale) and depressive symptoms (using the Edinburgh Postnatal Depression Scale). At 3 months postpartum, self-reported perceived bonding (using the Postpartum Bonding Questionnaire) were collected. A sub-sample of women additionally provided observational mother-infant interaction data (n = 206) (coded using the Child-Adult Relationship Experimental Index). RESULTS Higher disordered personality traits was not associated with maternal perceptions of bonding impairment, but was associated with reduced maternal sensitivity during observational mother-infant interactions [adjusted for age, education, having older children, substance misuse prior to pregnancy, infant sex and gestational age: coefficient = - 0.28, 95% CI = - 0.56 to - 0.00, p < 0.05]. After adjusting for depressive symptoms, the association was attenuated [coefficient = - 0.19, 95% CI = - 0.48 to 0.11, p = 0.217]. CONCLUSIONS Mothers with disordered personality traits did not perceive themselves as having bonding impairments with their infants but were less sensitive during observed interactions, though depressive symptoms attenuated this relationship. Both depression and disordered personality traits need to be addressed to optimize mother-infant interactions.
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Affiliation(s)
- Selina Nath
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - Rebecca M Pearson
- Centre for Academic Mental Health, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Paul Moran
- Centre for Academic Mental Health, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Susan Pawlby
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Emma Molyneaux
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Louise M Howard
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
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Srinivasan R, Pearson RM, Johnson S, Lewis G, Lewis G. Maternal perinatal depressive symptoms and offspring psychotic experiences at 18 years of age: a longitudinal study. Lancet Psychiatry 2020; 7:431-440. [PMID: 32353278 PMCID: PMC7606907 DOI: 10.1016/s2215-0366(20)30132-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/06/2020] [Accepted: 03/16/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Evidence exists that maternal depression in the perinatal period has an adverse effect on a range of early childhood outcomes and increases the risk of offspring depression during adolescence. However, the association between maternal depression during the perinatal period and offspring psychotic experiences has not been investigated. We aimed to investigate whether there is an association between maternal antenatal or postnatal depression and offspring psychotic experiences at 18 years of age. METHODS This longitudinal study used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective birth cohort, which recruited 14 541 pregnant women with an estimated delivery date between April 1, 1991, and Dec 31, 1992. Perinatal depression was measured using the Edinburgh Postnatal Depression Scale (EPDS); offspring psychotic experiences at 18 years of age were measured using the Psychosis-Like Symptom Interview. Offspring of mothers with complete data on maternal perinatal depression measures, and complete data on outcome (psychotic experiences) and confounding variables were included in the main analysis. For the main analysis, we used logistic regression to examine the associations between maternal depression (antenatal and postnatal) and offspring psychotic experiences at the age of 18 years. We used biprobit regression to model the association between maternal antenatal depression and the two offspring outcomes (psychotic experiences and depression) at 18 years of age jointly. FINDINGS 3067 offspring for whom data were available on maternal perinatal depression and offspring psychotic experiences aged 18 years were included in analyses. Maternal antenatal depressive symptoms were associated with offspring psychotic experiences at 18 years of age, with an unadjusted odds ratio (OR) of 1·38 (95% CI 1·18-1·61, p=0·0001) and after adjustment for confounders, an OR of 1·26 (1·06-1·49, p=0·0074). Maternal antenatal depressive symptoms were associated with both offspring psychotic experiences at the age of 18 years (n=2830, OR for a 5-point increase in EPDS score: 1·32 [95% CI 1·16-1·51], p<0·0001) and offspring depression at 18 years (OR for a 5-point increase in EPDS score: 1·18 [1·03-1·34], p=0·016). From joint modelling, there was no evidence that the association between maternal antenatal depression and offspring psychotic experiences differed in strength compared with offspring depression (p=0·19). INTERPRETATION The offspring of mothers who experience depression in the perinatal period are more likely to report psychotic experiences at 18 years of age. If the association is found to be causal, it would strengthen the case for identifying and treating maternal depression during and after pregnancy. FUNDING UK Medical Research Council and the Wellcome Trust.
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Affiliation(s)
- Ramya Srinivasan
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK.
| | | | - Sonia Johnson
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Gemma Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
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López-López JA, Kwong ASF, Washbrook E, Pearson RM, Tilling K, Fazel MS, Kidger J, Hammerton G. Trajectories of depressive symptoms and adult educational and employment outcomes. BJPsych Open 2019; 6:e6. [PMID: 31829293 PMCID: PMC7001468 DOI: 10.1192/bjo.2019.90] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 11/10/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Depressive symptoms show different trajectories throughout childhood and adolescence that may have different consequences for adult outcomes. AIMS To examine trajectories of childhood depressive symptoms and their association with education and employment outcomes in early adulthood. METHOD We estimated latent trajectory classes from participants with repeated measures of self-reported depressive symptoms between 11 and 24 years of age and examined their association with two distal outcomes: university degree and those not in employment, education or training at age 24. RESULTS Our main analyses (n = 9399) yielded five heterogenous trajectories of depressive symptoms. The largest group found (70.5% of participants) had a stable trajectory of low depressive symptoms (stable-low). The other four groups had symptom profiles that reached full-threshold levels at different developmental stages and for different durations. We identified the following groups: childhood-limited (5.1% of participants) with full-threshold symptoms at ages 11-13; childhood-persistent (3.5%) with full-threshold symptoms at ages 13-24; adolescent onset (9.4%) with full-threshold symptoms at ages 17-19; and early-adult onset (11.6%) with full-threshold symptoms at ages 22-24. Relative to the majority 'stable-low' group, the other four groups all exhibited higher risks of one or both adult outcomes. CONCLUSIONS Accurate identification of depressive symptom trajectories requires data spanning the period from early adolescence to early adulthood. Consideration of changes in, as well as levels of, depressive symptoms could improve the targeting of preventative interventions in early-to-mid adolescence.
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Affiliation(s)
- José A. López-López
- Assistant Professor, Department of Basic Psychology and Methodology, University of Murcia, Spain; Honorary Research Fellow, Department of Population Health Sciences, Bristol Medical School; and Centre for Academic Mental Health, University of Bristol, UK
| | - Alex S. F. Kwong
- Student, School of Geographical Sciences, Centre for Multilevel Modelling and MRC Integrative Epidemiology Unit, University of Bristol, UK
| | - Elizabeth Washbrook
- Associate Professor in Quantitative Methods, Centre for Multilevel Modelling and School of Education, University of Bristol, UK
| | - Rebecca M. Pearson
- Lecturer in Psychiatric Epidemiology, Department of Population Health Sciences, Bristol Medical School; and Centre for Academic Mental Health, University of Bristol, UK
| | - Kate Tilling
- Professor of Medical Statistics, Department of Population Health Sciences, Bristol Medical School; and MRC Integrative Epidemiology Unit, University of Bristol, UK
| | - Mina S. Fazel
- Associate Professor, Department of Psychiatry, University of Oxford, UK
| | - Judi Kidger
- Lecturer in Public Health, Department of Population Health Sciences, Bristol Medical School; and Centre for Academic Mental Health, University of Bristol, UK
| | - Gemma Hammerton
- Senior Research Associate, Department of Population Health Sciences, Bristol Medical School; and Centre for Academic Mental Health, University of Bristol, UK
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Sallis H, Szekely E, Neumann A, Jolicoeur‐Martineau A, van IJzendoorn M, Hillegers M, Greenwood CM, Meaney MJ, Steiner M, Tiemeier H, Wazana A, Pearson RM, Evans J. General psychopathology, internalising and externalising in children and functional outcomes in late adolescence. J Child Psychol Psychiatry 2019; 60:1183-1190. [PMID: 31049953 PMCID: PMC6849715 DOI: 10.1111/jcpp.13067] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Internalising and externalising problems commonly co-occur in childhood. Yet, few developmental models describing the structure of child psychopathology appropriately account for this comorbidity. We evaluate a model of childhood psychopathology that separates the unique and shared contribution of individual psychological symptoms into specific internalising, externalising and general psychopathology factors and assess how these general and specific factors predict long-term outcomes concerning criminal behaviour, academic achievement and affective symptoms in three independent cohorts. METHODS Data were drawn from independent birth cohorts (Avon Longitudinal Study of Parents and Children (ALSPAC), N = 11,612; Generation R, N = 7,946; Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN), N = 408). Child psychopathology was assessed between 4 and 8 years using a range of diagnostic and questionnaire-based measures, and multiple informants. First, structural equation models were used to assess the fit of hypothesised models of shared and unique components of psychopathology in all cohorts. Once the model was chosen, linear/logistic regressions were used to investigate whether these factors were associated with important outcomes such as criminal behaviour, academic achievement and well-being from late adolescence/early adulthood. RESULTS The model that included specific factors for internalising/externalising and a general psychopathology factor capturing variance shared between symptoms regardless of their classification fits well for all of the cohorts. As hypothesised, general psychopathology factor scores were predictive of all outcomes of later functioning, while specific internalising factor scores predicted later internalising outcomes. Specific externalising factor scores, capturing variance not shared by any other psychological symptoms, were not predictive of later outcomes. CONCLUSIONS Early symptoms of psychopathology carry information that is syndrome-specific as well as indicative of general vulnerability and the informant reporting on the child. The 'general psychopathology factor' might be more relevant for long-term outcomes than specific symptoms. These findings emphasise the importance of considering the co-occurrence of common internalising and externalising problems in childhood when considering long-term impact.
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Affiliation(s)
- Hannah Sallis
- Centre for Academic Mental Health, Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
- UK Centre for Tobacco and Alcohol StudiesSchool of Psychological ScienceUniversity of BristolBristolUK
| | - Eszter Szekely
- Department of PsychiatryFaculty of MedicineMcGill UniversityMontréalQCCanada
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQCCanada
| | - Alexander Neumann
- Department of Child and Adolescent Psychiatry/PsychologyErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
| | | | - Marinus van IJzendoorn
- Department of Psychology, Education and Child StudiesErasmus University RotterdamRotterdamThe Netherlands
- Primary Care UnitSchool of Clinical MedicineUniversity of CambridgeCambridgeUK
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry/PsychologyErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
| | - Celia M.T. Greenwood
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQCCanada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréalQCCanada
- Departments of Oncology and Human GeneticsMcGill UniversityMontréalQCCanada
| | - Michael J Meaney
- Department of PsychiatryFaculty of MedicineMcGill UniversityMontréalQCCanada
- Douglas Mental Health University InstituteMontréalQCCanada
- Sackler Program for Epigenetics & PsychobiologyMcGill UniversityMontréalQCCanada
- Singapore Institute for Clinical SciencesSingapore CitySingapore
| | - Meir Steiner
- Women's Health Concerns ClinicSt. Joseph's HealthcareHamiltonONCanada
- Departments of Psychiatry & Behavioural Neurosciences and Obstetrics & GynecologyMcMaster UniversityHamiltonONCanada
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/PsychologyErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
- Department of Social and Behavioral SciencesHarvard T. H. Chan School of Public HealthBostonMAUSA
| | - Ashley Wazana
- Department of PsychiatryFaculty of MedicineMcGill UniversityMontréalQCCanada
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQCCanada
- Centre for Child Development and Mental HealthJewish General HospitalMontréalQCCanada
| | - Rebecca M. Pearson
- Centre for Academic Mental Health, Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Jonathan Evans
- Centre for Academic Mental Health, Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
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Irish M, Solmi F, Mars B, King M, Lewis G, Pearson RM, Pitman A, Rowe S, Srinivasan R, Lewis G. Depression and self-harm from adolescence to young adulthood in sexual minorities compared with heterosexuals in the UK: a population-based cohort study. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
There are few population-based cohort studies of the emergence, development, and persistence of mental health problems in sexual minorities compared with heterosexuals. We compared trajectories of depressive symptoms in sexual-minority adolescents and heterosexual adolescents from when they were aged 10 to 21 years, and examined self-harm at ages 16 and 21 years.
Methods
The study included 4828 adolescents born between April 1, 1991, and Dec 31, 1992, from the Avon Longitudinal Study of Parents and Children birth cohort (Bristol, UK) who reported their sexual orientation when aged 16 years. Depressive symptoms were assessed with the short Mood and Feelings Questionnaire at seven timepoints between ages 10 and 21 years. A self-harm questionnaire was completed at ages 16 and 21 years. Analyses were linear multilevel models with growth curves (depressive symptoms), logistic multilevel models (self-harm in the previous year at ages 16 and 21 years), and multinomial regression (lifetime self-harm with and without suicidal intent at age 21 years).
Findings
At age 10, depressive symptoms were higher in sexual minorities than in heterosexuals and increased with age to a larger extent. Depressive symptoms increased at each timepoint by 0·31 points in hetereosexuals, and by 0·49 points in sexual minorities. Sexual-minority adolescents were more likely than heterosexual adolescents to report self-harm in the previous year at ages 16 and 21 years, with no evidence that this estimate decreased with age. At aged 21, sexual minorities were more likely to report lifetime self-harm (ie, on at least one previous occasion) with suicidal intent than heterosexuals.
Interpretation
Mental health disparities between heterosexuals and sexual minorities are present early in adolescence and increase throughout the school years, persisting to young adulthood. Prevention of these mental health problems and early intervention must be a priority.
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Affiliation(s)
- M Irish
- Department of Psychological Medicine, King’s College London, London, UK
| | - F Solmi
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - B Mars
- Population Health Sciences, University of Bristol, Bristol, UK
| | - M King
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - G Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - R M Pearson
- Population Health Sciences, University of Bristol, Bristol, UK
| | - A Pitman
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - S Rowe
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - R Srinivasan
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - G Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
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Abstract
Our objective was to examine the differential effects of antenatal breastfeeding intention (BI) and breastfeeding practice (BP) on maternal postnatal responsiveness. We conducted a secondary analysis of longitudinal data from a subsample of 962 mother-infant dyads from a U.K.-based birth cohort study the Avon Longitudinal Study of Parents and Children. Exposures were BI and BPs measured at 32 weeks of gestation and 18 months' postpartum. The outcome was maternal responsiveness assessed at 12 months' postpartum. We used logistic regression analyses unadjusted and adjusted for confounders. Intention to breastfeed was associated with increased odds of postnatal maternal responsiveness independent of BP, adjusted odds ratio (OR) = 2.34, 95% CI [1.42, 3.86]. There was no evidence that BP was an independent predictor of maternal responsiveness, OR = 0.93, 95% CI [0.55, 1.57]. Life-course epidemiology analyses demonstrated that maternal responsiveness is most positive when both BI and BP are present. This is the first population-based study to provide evidence that BI during pregnancy is more strongly associated with maternal postnatal responsiveness than is BP. Further research is needed to understand the determinants of BI in pregnancy and its relationships with maternal responsiveness.
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Affiliation(s)
- Catherine L Jones
- Department of Psychology, School of Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Iryna Culpin
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jonathan Evans
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Rebecca M Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Kwong ASF, López-López JA, Hammerton G, Manley D, Timpson NJ, Leckie G, Pearson RM. Genetic and Environmental Risk Factors Associated With Trajectories of Depression Symptoms From Adolescence to Young Adulthood. JAMA Netw Open 2019; 2:e196587. [PMID: 31251383 PMCID: PMC6604106 DOI: 10.1001/jamanetworkopen.2019.6587] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/14/2019] [Indexed: 12/17/2022] Open
Abstract
Importance Less favorable trajectories of depressive mood from adolescence to early adulthood are associated with current and later psychopathology, impaired educational attainment, and social dysfunction, yet the genetic and environmental risk factors associated with these trajectories are not fully established. Examining what risk factors are associated with different trajectories of depressive mood could help identify the nature of depression symptoms and improve preventive interventions for those at most risk. Objective To examine the differential associations of genetic and environmental risk factors with trajectories of depression symptoms among individuals observed from ages 10 to 24 years. Design, Setting, and Participants In a longitudinal cohort study established in 1990 and currently ongoing (the Avon Longitudinal Study of Parents and Children [ALSPAC]), growth mixture modeling was used to identify trajectories of depression symptoms in 9394 individuals in the United Kingdom. Associations of different risk factors with these trajectories were then examined. Analysis was conducted between August 2018 and January 2019. Main Outcomes and Measures Trajectories were composed from depression symptoms measured using the Short Mood and Feelings Questionnaire at 9 occasions from ages 10 to 24 years. Risk factors included sex, a polygenic risk score taken from a recent genome-wide association study of depression symptoms, maternal postnatal depression, partner cruelty to the offspring's mother when the child was aged 2 to 4 years, childhood anxiety at age 8 years, and being bullied at age 10 years. Results Data on all risk factors, confounders, and the outcome were available for 3525 individuals, including 1771 (50.2%) who were female. Trajectories were assessed between the mean (SD) age of 10.7 (0.3) years and mean (SD) age of 23.8 (0.5) years. Overall, 5 distinct trajectories of depression symptoms were identified: (1) stable low (2506 individuals [71.1%]), (2) adolescent limited (325 individuals [9.2%]), (3) childhood limited (203 individuals [5.8%]), (4) early-adult onset (393 individuals [11.1%]), and (5) childhood persistent (98 individuals [2.8%]). Of all the associations of risk factors with trajectories, sex (odds ratio [OR], 6.45; 95% CI, 2.89-14.38), the polygenic risk score for depression symptoms (OR, 1.47; 95% CI, 1.10-1.96), and childhood anxiety (OR, 1.30; 95% CI, 1.16-1.45) showed the strongest association with the childhood-persistent trajectory of depression symptoms compared with the stable-low trajectory. Maternal postnatal depression (OR, 2.39; 95% CI, 1.41-4.07) had the strongest association with the early-adult-onset trajectory, while partner cruelty to mother (OR, 2.30; 95% CI, 1.36-3.90) had the strongest association with the adolescent-limited trajectory. Bullying (OR, 8.08; 95% CI, 4.92-13.26) showed the strongest association with the childhood-limited trajectory. Conclusions and Relevance The least favorable trajectories of depression symptoms (childhood persistent and early-adult onset) were associated with both genetic and environmental risk factors, but the 2 trajectories of limited duration that had resolved by early adulthood (childhood limited and adolescent limited) were not associated with the polygenic risk score or maternal postnatal depression. Bullying was strongly associated with both the childhood-persistent and childhood-limited trajectories, suggesting that this risk factor may have a time-specific effect. These findings suggest that examining genetic and multiple time-specific environmental antecedents could help identify trajectories of varying onset and chronicity.
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Affiliation(s)
- Alex S. F. Kwong
- Medical Research Center Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- School of Geographical Sciences, University of Bristol, Bristol, United Kingdom
- Centre for Multilevel Modelling, University of Bristol, Bristol, United Kingdom
| | - José A. López-López
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Gemma Hammerton
- Medical Research Center Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Centre for Academic Mental Health, University of Bristol, Bristol, United Kingdom
| | - David Manley
- School of Geographical Sciences, University of Bristol, Bristol, United Kingdom
- Centre for Multilevel Modelling, University of Bristol, Bristol, United Kingdom
| | - Nicholas J. Timpson
- Medical Research Center Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - George Leckie
- Centre for Multilevel Modelling, University of Bristol, Bristol, United Kingdom
- School of Education, University of Bristol, Bristol, United Kingdom
| | - Rebecca M. Pearson
- Medical Research Center Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Centre for Academic Mental Health, University of Bristol, Bristol, United Kingdom
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De Carli P, Costantini I, Sessa P, Visentin S, Pearson RM, Simonelli A. The expectant social mind: A systematic review of face processing during pregnancy and the effect of depression and anxiety. Neurosci Biobehav Rev 2019; 102:153-171. [PMID: 31055013 DOI: 10.1016/j.neubiorev.2019.04.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 11/28/2018] [Revised: 03/20/2019] [Accepted: 04/22/2019] [Indexed: 10/26/2022]
Abstract
Pregnancy carries enormous changes in the psychological and neurophysiological domains. It has been suggested that pregnant women undergo a cognitive reorganization aimed at increasing the salience of social stimuli (i.e., the tendency of social cues to capture observer's attention, so that their processing results prioritized). The goal of the present work was to systematically review the empirical evidence of a change in face processing during pregnancy. Moreover, we explored whether face processing is associated with antenatal depression and anxiety and the extent to which this is part of a potential mechanism to explain detrimental effects of maternal psychopathology on infant outcomes. We identified 19 relevant studies and discussed them based on their methodological qualities. The results of the review suggest that even though it is not possible to draw firm conclusions, pregnancy is likely to be a plasticity window for face processing at the behavioral and neural levels. Evidence confirms the detrimental effect of depression and anxiety on face processing during pregnancy. Clinical implications for parenting interventions are discussed.
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Affiliation(s)
- Pietro De Carli
- Department of Developmental and Social Psychology, University of Padua, Via Venezia, 8, 35131 Padova (PD), Italy.
| | - Ilaria Costantini
- Department of Developmental and Social Psychology, University of Padua, Via Venezia, 8, 35131 Padova (PD), Italy; Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS14 8TF, United Kingdom.
| | - Paola Sessa
- Department of Developmental and Social Psychology, University of Padua, Via Venezia, 8, 35131 Padova (PD), Italy; Padova Neuroscience Center, University of Padua, Via Venezia, 8, 35131 Padova (PD), Italy.
| | - Silvia Visentin
- Department of Woman and Child's Health, University of Padua, Via Giustiniani, 3, 35128 Padova (PD), Italy.
| | - Rebecca M Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS14 8TF, United Kingdom.
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padua, Via Venezia, 8, 35131 Padova (PD), Italy.
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Kwong ASF, Manley D, Timpson NJ, Pearson RM, Heron J, Sallis H, Stergiakouli E, Davis OSP, Leckie G. Identifying Critical Points of Trajectories of Depressive Symptoms from Childhood to Young Adulthood. J Youth Adolesc 2019; 48:815-827. [PMID: 30671716 PMCID: PMC6441403 DOI: 10.1007/s10964-018-0976-5] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 12/08/2018] [Indexed: 02/07/2023]
Abstract
Depression is a common mental illness and research has focused on late childhood and adolescence in an attempt to prevent or reduce later psychopathology and/or social impairments. It is important to establish and study population-averaged trajectories of depressive symptoms across adolescence as this could characterise specific changes in populations and help identify critical points to intervene with treatment. Multilevel growth-curve models were used to explore adolescent trajectories of depressive symptoms in 9301 individuals (57% female) from the Avon Longitudinal Study of Parents and Children, a UK based pregnancy cohort. Trajectories of depressive symptoms were constructed for males and females using the short mood and feelings questionnaire over 8 occasions, between 10 and 22 years old. Critical points of development such as age of peak velocity for depressive symptoms (the age at which depressive symptoms increase most rapidly) and the age of maximum depressive symptoms were also derived. The results suggested that from similar initial levels of depressive symptoms at age 11, females on average experienced steeper increases in depressive symptoms than males over their teenage and adolescent years until around the age of 20 when levels of depressive symptoms plateaued and started to decrease for both sexes. Females on average also had an earlier age of peak velocity of depressive symptoms that occurred at 13.5 years, compared to males who on average had an age of peak velocity at 16 years old. Evidence was less clear for a difference between the ages of maximum depressive symptoms which were on average 19.6 years for females and 20.4 for males. Identifying critical periods for different population subgroups may provide useful knowledge for treating and preventing depression and could be tailored to be time specific for certain groups. Possible explanations and recommendations are discussed.
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Affiliation(s)
- Alex S F Kwong
- School of Geographical Sciences, University of Bristol, University Road, Bristol, BS8 1SS, UK.
- Centre for Multilevel Modelling, University of Bristol, Bristol, UK.
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
| | - David Manley
- School of Geographical Sciences, University of Bristol, University Road, Bristol, BS8 1SS, UK
- Centre for Multilevel Modelling, University of Bristol, Bristol, UK
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rebecca M Pearson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health at the University of Bristol, Bristol, UK
| | - Jon Heron
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health at the University of Bristol, Bristol, UK
| | - Hannah Sallis
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health at the University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK
| | - Evie Stergiakouli
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Oral and Dental Sciences, University of Bristol, Bristol, UK
| | - Oliver S P Davis
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - George Leckie
- Centre for Multilevel Modelling, University of Bristol, Bristol, UK
- School of Education, University of Bristol, Bristol, UK
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Lawlor DA, Lewcock M, Rena-Jones L, Rollings C, Yip V, Smith D, Pearson RM, Johnson L, Millard LAC, Patel N, Skinner A, Tilling K. The second generation of The Avon Longitudinal Study of Parents and Children (ALSPAC-G2): a cohort profile. Wellcome Open Res 2019; 4:36. [PMID: 31984238 PMCID: PMC6971848 DOI: 10.12688/wellcomeopenres.15087.2] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [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] [Accepted: 02/08/2019] [Indexed: 01/19/2023] Open
Abstract
Background: The Avon Longitudinal Study of Parents and Children-Generation 2 (ALSPAC-G2) was set up to provide a unique multi-generational cohort. It builds on the existing ALSPAC resource, which recruited 14,541 pregnancies to women resident in the South West of England who were expected to deliver between 01/04/1991 and 31/12/1992. Those women and their partners (Generation 0; ALSPAC-G0) and their offspring (ALSPAC-G1) have been followed for the last 26 years. This profile describes recruitment and data collection on the next generation (ALSPAC-G2)-the grandchildren of ALSPAC-G0 and children of ALSPAC-G1. Recruitment: Recruitment began on the 6 th of June 2012 and we present details of recruitment and participants up to 30 th June 2018 (~6 years). We knew at the start of recruitment that some ALSPAC-G1 participants had already become parents and ALSPAC-G2 is an open cohort; we recruit at any age. We hope to continue recruiting until all ALSPAC-G1 participants have completed their families. Up to 30 th June 2018 we recruited 810 ALSPAC-G2 participants from 548 families. Of these 810, 389 (48%) were recruited during their mother's pregnancy, 287 (35%) before age 3 years, 104 (13%) between 3-6 years and 30 (4%) after 6 years. Over 70% of those invited to early pregnancy, late pregnancy, second week of life, 6-, 12- and 24-month assessments (whether for their recruitment, or a follow-up, visit) have attended, with attendance being over 60% for subsequent visits up to 7 years (to few are eligible for the 9- and 11-year assessments to analyse). Data collection: We collect a wide-range of social, lifestyle, clinical, anthropometric and biological data on all family members repeatedly. Biological samples include blood (including cord-blood), urine, meconium and faeces, and placental tissue. In subgroups detailed data collection, such as continuous glucose monitoring and videos of parent-child interactions, are being collected.
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Affiliation(s)
- Deborah A. Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Melanie Lewcock
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- ALSPAC, University of Bristol, Bristol, UK
| | - Louise Rena-Jones
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- ALSPAC, University of Bristol, Bristol, UK
| | - Claire Rollings
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- ALSPAC, University of Bristol, Bristol, UK
| | - Vikki Yip
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- ALSPAC, University of Bristol, Bristol, UK
| | - Daniel Smith
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- ALSPAC, University of Bristol, Bristol, UK
| | - Rebecca M. Pearson
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
- Centre for Academic Mental Health, University of Bristol, Bristol, UK
| | - Laura Johnson
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, BS8 2BN, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
- Centre for Exercise, Nutrition and Health Science, School for Policy Studies, University of Bristol, Bristol, UK
| | - Louise A. C. Millard
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- Intelligent Systems Laboratory, University of Bristol, Bristol, UK
| | - Nashita Patel
- Department of Women and Children’s Health, School of Life Course Sciences, Kings College London, London, UK
| | - Andy Skinner
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - ALSPAC Executive
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, BS8 2BN, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
- ALSPAC, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, University of Bristol, Bristol, UK
- Centre for Exercise, Nutrition and Health Science, School for Policy Studies, University of Bristol, Bristol, UK
- Intelligent Systems Laboratory, University of Bristol, Bristol, UK
- Department of Women and Children’s Health, School of Life Course Sciences, Kings College London, London, UK
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39
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Lawlor DA, Lewcock M, Rena-Jones L, Rollings C, Yip V, Smith D, Pearson RM, Johnson L, Millard LAC, Patel N, Skinner A, Tilling K. The second generation of The Avon Longitudinal Study of Parents and Children (ALSPAC-G2): a cohort profile. Wellcome Open Res 2019. [PMID: 31984238 DOI: 10.12688/wellcomeopenres.15087.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background: The Avon Longitudinal Study of Parents and Children-Generation 2 (ALSPAC-G2) was set up to provide a unique multi-generational cohort. It builds on the existing ALSPAC resource, which recruited 14,541 pregnancies to women resident in the South West of England who were expected to deliver between 01/04/1991 and 31/12/1992. Those women and their partners (Generation 0; ALSPAC-G0) and their offspring (ALSPAC-G1) have been followed for the last 26 years. This profile describes recruitment and data collection on the next generation (ALSPAC-G2)-the grandchildren of ALSPAC-G0 and children of ALSPAC-G1. Recruitment: Recruitment began on the 6 th of June 2012 and we present details of recruitment and participants up to 30 th June 2018 (~6 years). We knew at the start of recruitment that some ALSPAC-G1 participants had already become parents and ALSPAC-G2 is an open cohort; we recruit at any age. We hope to continue recruiting until all ALSPAC-G1 participants have completed their families. Up to 30 th June 2018 we recruited 810 ALSPAC-G2 participants from 548 families. Of these 810, 389 (48%) were recruited during their mother's pregnancy, 287 (35%) before age 3 years, 104 (13%) between 3-6 years and 30 (4%) after 6 years. Over 70% of those invited to early pregnancy, late pregnancy, second week of life, 6-, 12- and 24-month assessments (whether for their recruitment, or a follow-up, visit) have attended, with attendance being over 60% for subsequent visits up to 7 years (to few are eligible for the 9- and 11-year assessments to analyse). Data collection: We collect a wide-range of social, lifestyle, clinical, anthropometric and biological data on all family members repeatedly. Biological samples include blood (including cord-blood), urine, meconium and faeces, and placental tissue. In subgroups detailed data collection, such as continuous glucose monitoring and videos of parent-child interactions, are being collected.
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Affiliation(s)
- Deborah A Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, BS8 2BN, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Melanie Lewcock
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,ALSPAC, University of Bristol, Bristol, UK
| | - Louise Rena-Jones
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,ALSPAC, University of Bristol, Bristol, UK
| | - Claire Rollings
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,ALSPAC, University of Bristol, Bristol, UK
| | - Vikki Yip
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,ALSPAC, University of Bristol, Bristol, UK
| | - Daniel Smith
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,ALSPAC, University of Bristol, Bristol, UK
| | - Rebecca M Pearson
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, BS8 2BN, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,NIHR Bristol Biomedical Research Centre, Bristol, UK.,Centre for Academic Mental Health, University of Bristol, Bristol, UK
| | - Laura Johnson
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, BS8 2BN, UK.,NIHR Bristol Biomedical Research Centre, Bristol, UK.,Centre for Exercise, Nutrition and Health Science, School for Policy Studies, University of Bristol, Bristol, UK
| | - Louise A C Millard
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, BS8 2BN, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,Intelligent Systems Laboratory, University of Bristol, Bristol, UK
| | - Nashita Patel
- Department of Women and Children's Health, School of Life Course Sciences, Kings College London, London, UK
| | - Andy Skinner
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, BS8 2BN, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, BS8 2BN, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,NIHR Bristol Biomedical Research Centre, Bristol, UK
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40
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Irish M, Solmi F, Mars B, King M, Lewis G, Pearson RM, Pitman A, Rowe S, Srinivasan R, Lewis G. Depression and self-harm from adolescence to young adulthood in sexual minorities compared with heterosexuals in the UK: a population-based cohort study. Lancet Child Adolesc Health 2019; 3:91-98. [PMID: 30552054 DOI: 10.1016/s2352-4642(18)30343-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/17/2018] [Accepted: 10/23/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND There are few population-based cohort studies of the emergence, development, and persistence of mental health problems in sexual minorities compared with heterosexuals. We compared trajectories of depressive symptoms in sexual-minority adolescents and heterosexual adolescents from when they were aged 10 years to 21 years, and examined self-harm at ages 16 years and 21 years. METHODS The study included 4828 adolescents born between April 1, 1991, and Dec 31, 1992, from the Avon Longitudinal Study of Parents and Children birth cohort (Bristol, UK) who reported their sexual orientation when aged 16 years. Depressive symptoms were assessed with the short Mood and Feelings Questionnaire (sMFQ) at seven timepoints between ages 10 years and 21 years. A self-harm questionnaire was completed at ages 16 years and 21 years. Analyses were linear multilevel models with growth curves (depressive symptoms), logistic multilevel models (self-harm in the previous year at ages 16 years and 21 years), and multinomial regression (lifetime self-harm with and without suicidal intent at age 21 years). FINDINGS At age 10 years, depressive symptoms were higher in sexual minorities (mean sMFQ 4·58 [SD 3·59]) than in heterosexuals (3·79 [3·36]) and increased with age to a larger extent. Depressive symptoms increased at each timepoint by 0·31 sMFQ points in hetereosexuals (95% CI 0·27-0·34), and by 0·49 sMFQ points in sexual minorities (0·40-0·59). Sexual-minority adolescents were more likely than heterosexual adolescents to report self-harm in the previous year at ages 16 years and 21 years (adjusted odds ratio 4·23, 95% CI 2·90-6·16), with no evidence that this estimate decreased with age (p=0·80). When aged 21 years, sexual minorities were 4·53 (95% CI 3·02 to 6·78) times more likely to report lifetime self-harm (ie, on at least one previous occasion) with suicidal intent than heterosexuals. INTERPRETATION Mental health disparities between heterosexuals and sexual minorities are present early in adolescence and increase throughout the school years, persisting to young adulthood. Prevention of these mental health problems and early intervention must be a priority. FUNDING Medical Research Council, Wellcome Trust.
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Affiliation(s)
- Madeleine Irish
- Department of Psychological Medicine, King's College London, London, UK
| | - Francesca Solmi
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Becky Mars
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Michael King
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | | | - Alexandra Pitman
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Sarah Rowe
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Ramya Srinivasan
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Gemma Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK.
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Rochat TJ, Houle B, Stein A, Pearson RM, Newell ML, Bland RM. Cohort Profile: The Siyakhula Cohort, rural South Africa. Int J Epidemiol 2018; 46:1755-1756n. [PMID: 29025088 PMCID: PMC5837732 DOI: 10.1093/ije/dyx148] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- T J Rochat
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa.,Human and Social Development Research Programme, Human Sciences Research Council, Durban, South Africa.,MRC Developmental Pathways to Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - B Houle
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,School of Demography, Australian National University, Canberra, Australia.,Institute of Behavioural Science, University of Colorado at Boulder, Boulder, CO, USA
| | - A Stein
- Department of Psychiatry, University of Oxford, Oxford, UK.,MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - R M Pearson
- Department of Psychiatry, University of Oxford, Oxford, UK.,Centre for Academic Mental Health, University of Bristol, Bristol, UK
| | - M L Newell
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.,Global Health Research Institute, Human Development and Health, University of Southampton, UK
| | - R M Bland
- Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa.,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.,Institute of Health and Wellbeing and Royal Hospital for Children, University of Glasgow, Glasgow, UK
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Rochat TJ, Houle B, Stein A, Pearson RM, Bland RM. Prevalence and risk factors for child mental disorders in a population-based cohort of HIV-exposed and unexposed African children aged 7-11 years. Eur Child Adolesc Psychiatry 2018; 27:1607-1620. [PMID: 29680970 DOI: 10.1007/s00787-018-1146-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 05/21/2017] [Accepted: 03/14/2018] [Indexed: 10/17/2022]
Abstract
Despite being home to a large population of vulnerable children there is a dearth of population-based evidence on childhood mental disorders in sub-Saharan Africa. Parent and child mental health are rarely measured concurrently, despite potential for confounding with other risk factors, including parental HIV. Using the parent-report Child Behaviour Checklist (CBCL) we assessed children's mental health in a population-based cohort of 1536 HIV-negative children (31% HIV-exposed, 18% HIV-affected, 51% HIV-unexposed) aged 7-11 years. CBCL was scored using CBCL Rating-to-Score software. A binary indicator was determined using the clinical threshold ≥ 65. We modelled mental disorders using logistic regression, including covariates associated with the mother, child, household, and parenting. Structural equation modelling techniques also derived continuous latent variables representing the underlying mental health and parent-relationship constructs. Prevalence of conduct disorders (11.8%) was high, regardless of HIV exposure, while HIV-affected children had increased odds of affective disorders. Maternal depression increased odds of externalising disorders; maternal anxiety was associated with affective and anxiety disorders. Mother-child relationship dysfunction increased odds of all disorders, including: affective [aOR = 5.1 (2.6-9.9)]; oppositional [aOR = 7.9 (4.0-15.5)]; conduct [aOR = 4.3 (2.6-7.2)] disorders. Food insecurity and male gender increased odds of somatic disorders; breastfeeding halved odds of conduct disorders. In the latent model, associations were substantially stronger for the mother-child relationship and externalising disorders (Oppositional 0.464 p < 0.001; Conduct 0.474 p = <0.001). Conduct disorders were high for all children regardless of HIV exposure. The mother-child relationship was strongly related to all child disorders, suggesting potential for concurrent interventions targeting child behaviours and the parent-child or mother-child relationship.
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Affiliation(s)
- Tamsen J Rochat
- Africa Health Research Institute, Durban, Kwazulu-Natal, South Africa.
- Human and Social Development Research Programme, Human Sciences Research Council, Pretoria, South Africa.
- MRC/Developmental Pathways to Health Research Unit, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa.
- Department of Psychiatry, University of Oxford, Oxford, UK.
| | - Brian Houle
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Demography, The Australian National University, Canberra, Australia
- CU Population Center, Institute of Behavioral Science, University of Colorado at Boulder, Boulder, CO, USA
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rebecca M Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, Bristol University, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Ruth M Bland
- Africa Health Research Institute, Durban, Kwazulu-Natal, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Royal Hospital for Sick Children and Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Bornstein MH, Hahn CS, Putnick DL, Pearson RM. Stability of core language skill from infancy to adolescence in typical and atypical development. Sci Adv 2018; 4:eaat7422. [PMID: 30474055 PMCID: PMC6248911 DOI: 10.1126/sciadv.aat7422] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 10/24/2018] [Indexed: 05/15/2023]
Abstract
Command of language is a fundamental life skill, a cornerstone of cognitive and socioemotional development, and a necessary ingredient for successful functioning in society. We used 15-year prospective longitudinal data from the Avon Longitudinal Study of Parents and Children to evaluate two types of stability of core language skill in 5036 typically developing and 1056 atypically developing (preterm, dyslexic, autistic, and hearing impaired) children in a multiage, multidomain, multimeasure, multireporter framework. A single core language skill was extracted from multiple measures at multiple ages, and this skill proved stable from infancy to adolescence in all groups, even accounting for child nonverbal intelligence and sociability and maternal age and education. Language skill is a highly conserved and robust individual-differences characteristic. Lagging language skills, a risk factor in child development, would profitably be addressed early in life.
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Affiliation(s)
- Marc H. Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
- Institute for Fiscal Studies, London, UK
| | - Chun-Shin Hahn
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Diane L. Putnick
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Rebecca M. Pearson
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Rai D, Culpin I, Heuvelman H, Magnusson CMK, Carpenter P, Jones HJ, Emond AM, Zammit S, Golding J, Pearson RM. Association of Autistic Traits With Depression From Childhood to Age 18 Years. JAMA Psychiatry 2018; 75:835-843. [PMID: 29898212 PMCID: PMC6143081 DOI: 10.1001/jamapsychiatry.2018.1323] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/12/2018] [Indexed: 12/13/2022]
Abstract
Importance Population-based studies following trajectories of depression in autism spectrum disorders (ASD) from childhood into early adulthood are rare. The role of genetic confounding and of potential environmental intermediaries, such as bullying, in any associations is unclear. Objectives To compare trajectories of depressive symptoms from ages 10 to 18 years for children with or without ASD and autistic traits, to assess associations between ASD and autistic traits and an International Statistical Classification of Diseases, 10th Revision (ICD-10) depression diagnosis at age 18 years, and to explore the importance of genetic confounding and bullying. Design, Setting, and Participants Longitudinal study of participants in the Avon Longitudinal Study of Parents and Children birth cohort in Bristol, United Kingdom, followed up through age 18 years. Data analysis was conducted from January to November 2017. Main Outcomes and Measures Depressive symptoms were assessed using the Short Mood and Feelings Questionnaire (SMFQ) at 6 time points between ages 10 and 18 years. An ICD-10 depression diagnosis at age 18 years was established using the Clinical Interview Schedule-Revised. Exposures were ASD diagnosis and 4 dichotomized autistic traits (social communication, coherence, repetitive behavior, and sociability). An autism polygenic risk score was derived using the Psychiatric Genomics Consortium autism discovery genome-wide association study summary data. Bullying was assessed at ages 8, 10, and 13 years. Results The maximum sample with complete data was 6091 for the trajectory analysis (48.8% male) and 3168 for analysis of depression diagnosis at age 18 years (44.4% male). Children with ASD and autistic traits had higher average SMFQ depressive symptom scores than the general population at age 10 years (eg, for social communication 5.55 [95% CI, 5.16-5.95] vs 3.73 [95% CI, 3.61-3.85], for ASD 7.31 [95% CI, 6.22-8.40] vs 3.94 [95% CI, 3.83-4.05], remaining elevated in an upward trajectory until age 18 years (eg, for social communication 7.65 [95% CI, 6.92-8.37] vs 6.50 [95% CI, 6.29-6.71], for ASD 7.66 [95% CI, 5.96-9.35] vs 6.62 [95% CI, 6.43-6.81]). Social communication impairments were associated with depression at age 18 years (adjusted relative risk, 1.68; 95% CI, 1.05-2.70), and bullying explained a substantial proportion of this risk. There was no evidence of confounding by the autism polygenic risk score. Analysis in larger samples using multiple imputation led to similar but more precise results. Conclusions and Relevance Children with ASD and ASD traits have higher depressive symptom scores than the general population by age 10 years, which persist to age 18 years, particularly in the context of bullying. Social communication impairments are an important autistic trait in relation to depression. Bullying, as an environmental intermediary, could be a target for interventions.
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Affiliation(s)
- Dheeraj Rai
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- BASS Autism Services for Adults, Avon and Wiltshire Mental Health Partnership National Health Service (NHS) Trust, Bristol, United Kingdom
- National Institute for Health Research (NIHR) Biomedical Research Centre, University of Bristol, Bristol, United Kingdom
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Iryna Culpin
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Hein Heuvelman
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia M. K. Magnusson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Health Care Services, Stockholm, Sweden
| | - Peter Carpenter
- BASS Autism Services for Adults, Avon and Wiltshire Mental Health Partnership National Health Service (NHS) Trust, Bristol, United Kingdom
| | - Hannah J. Jones
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research (NIHR) Biomedical Research Centre, University of Bristol, Bristol, United Kingdom
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, United Kingdom
| | - Alan M. Emond
- Centre for Child and Adolescent Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Stanley Zammit
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research (NIHR) Biomedical Research Centre, University of Bristol, Bristol, United Kingdom
- Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Jean Golding
- Centre for Child and Adolescent Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Rebecca M. Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research (NIHR) Biomedical Research Centre, University of Bristol, Bristol, United Kingdom
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Pearson RM, Carnegie RE, Cree C, Rollings C, Rena-Jones L, Evans J, Stein A, Tilling K, Lewcock M, Lawlor DA. Prevalence of Prenatal Depression Symptoms Among 2 Generations of Pregnant Mothers: The Avon Longitudinal Study of Parents and Children. JAMA Netw Open 2018; 1:e180725. [PMID: 30646025 PMCID: PMC6324308 DOI: 10.1001/jamanetworkopen.2018.0725] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
IMPORTANCE Depression during pregnancy (prenatal depression) is common and has important consequences for mother and child. Evidence suggests an increasing prevalence of depression, especially in young women. It is unknown whether this is reflected in an increasing prevalence of prenatal depression. OBJECTIVE To compare the prevalence of depression during pregnancy in today's young mothers with their mothers' generation. DESIGN, SETTING, AND PARTICIPANTS In a longitudinal cohort study, we compared prenatal depressive symptoms in 2 generations of women who participated in the Avon Longitudinal Study of Parents and Children. Participants were the original mothers (recruited when they were pregnant) and their female offspring, or female partners of male offspring, who became pregnant. Both groups were limited to the same age range (19-24 years). The first generation of pregnancies occurred in 1990 to 1992 (n = 2390) and the second in 2012 to 2016 (n = 180). In both generations, women were born in the same geographical area (southwest England). MAIN OUTCOMES AND MEASURES Depressed mood measured prenatally using the Edinburgh Postnatal Depression Scale in self-reported surveys in both generations. A score of 13 or greater on a scale of 0 to 30 indicated depressed mood. RESULTS Of 2390 pregnant women in the first generation who were included in analysis (mean [SD] age, 22.1 [2.5] years), 408 (17%) had high depressive symptom scores (≥13). Of 180 pregnant women in the second generation who were included in the analysis (mean [SD] age, 22.8 [1.3] years), 45 (25%) had high depressive symptom scores. Having high depressive symptom scores was more common in the second generation of young pregnant women than in their mothers' generation (relative risk, 1.51; 95% CI, 1.15-1.97), with imputation for missing confounding variable data and adjustment for age, parity, education, smoking, and body mass index not substantially changing this difference. Results were essentially the same when analyses were restricted to the 66 mother-offspring pairs. Maternal prenatal depression was associated with daughters' prenatal depression (relative risk, 3.33; 95% CI, 1.65-6.67). CONCLUSIONS AND RELEVANCE In this unique study of 2 generations of women who answered identical questionnaires in pregnancy, evidence was found that depressed mood may be higher in young pregnant women today than in their mothers' generation. Because of the multiple and diverse consequences of prenatal depression, an increase in prevalence has important implications for families, health care professionals, and society.
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Affiliation(s)
- Rebecca M. Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Rebecca E. Carnegie
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Callum Cree
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Claire Rollings
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Louise Rena-Jones
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jonathan Evans
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Kate Tilling
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol, United Kingdom
| | - Melanie Lewcock
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Debbie A. Lawlor
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research Bristol Biomedical Research Centre, Bristol, United Kingdom
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Culpin I, Mars B, Pearson RM, Golding J, Heron J, Bubak I, Carpenter P, Magnusson C, Gunnell D, Rai D. Autistic Traits and Suicidal Thoughts, Plans, and Self-Harm in Late Adolescence: Population-Based Cohort Study. J Am Acad Child Adolesc Psychiatry 2018; 57:313-320.e6. [PMID: 29706160 PMCID: PMC5942156 DOI: 10.1016/j.jaac.2018.01.023] [Citation(s) in RCA: 42] [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: 10/19/2017] [Revised: 01/10/2018] [Accepted: 03/08/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To examine the hypothesis that autism spectrum disorders (ASD) diagnosis and traits in childhood are associated with suicidal thoughts, plans and self-harm at 16 years, and that any observed associations are explained by depression at 12 years. METHOD We examined associations between ASD diagnosis and 4 dichotomized ASD traits (social communication, pragmatic language, repetitive behavior, and sociability) with suicidal and nonsuicidal self-harm, suicidal thoughts, and suicidal plans at age 16 years in 5,031 members of the United Kingdom-based birth cohort study the Avon Longitudinal Study of Parents and Children. We assessed whether any associations were explained by depressive symptoms in early adolescence measured by the Short Moods and Feelings Questionnaire at 12 years. RESULTS Children with impaired social communication had a higher risk of self-harm with suicidal intent (relative risk [RR] = 2.14, 95% CI = 1.28-3.58), suicidal thoughts (RR = 1.42, 95% CI = 1.06-1.91), and suicidal plans (RR = 1.95, 95% CI = 1.09-3.47) by age 16 years as compared to those without. There was no evidence for an association between ASD diagnosis and outcomes, although these analyses were imprecise because of small numbers. There was also no evidence of an association between other autism traits and the outcomes. Approximately 32% of the total estimated association between social communication impairment and self-harm was explained by depressive symptoms at 12 years. CONCLUSION Social communication impairments are an important autistic trait in relation to suicidality. Early identification and management of depression may be a preventative mechanism, and future research identifying other potentially modifiable mechanisms may lead to interventions against suicidal behavior in this high-risk group.
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Affiliation(s)
| | | | | | | | | | | | - Peter Carpenter
- Avon and Wiltshire Partnership National Health Service (NHS) Trust, Bristol, UK
| | | | | | - Dheeraj Rai
- University of Bristol, Bristol, UK,Avon and Wiltshire Partnership National Health Service (NHS) Trust, Bristol, UK
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Lewis G, Wen S, Pearson RM, Lewis G. The association between paternal depressogenic cognitive styles during pregnancy and offspring depressogenic cognitive styles: an 18-year prospective cohort study. J Child Psychol Psychiatry 2018; 59:604-614. [PMID: 29171666 PMCID: PMC5947551 DOI: 10.1111/jcpp.12847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 10/13/2017] [Indexed: 12/04/2022]
Abstract
BACKGROUND Preventing the development of depressogenic or negative cognitive styles could also prevent the development of depression, a leading public health problem worldwide. Maternal negative cognitive styles are a modifiable risk factor for the development of negative cognitive styles in offspring. However, evidence on the role of paternal negative cognitive styles is inconclusive and there have only been a few small studies, which may also have lacked statistical power. METHODS We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to investigate the association between paternal negative cognitive styles, measured when mothers were 18 weeks pregnant, and offspring negative cognitive styles 18 years later (N = 6,123). Associations were calculated using linear regression models, before and after adjustment for confounders including maternal negative cognitive styles. We compared associations before and after controlling for depression in parents and offspring, and used multiple imputation to reduce biases that may have arisen due to missing data. RESULTS A two-standard deviation increase in paternal negative cognitive style was associated with a 3-point increase in offspring negative cognitive style (95% CI 1.36-4.37). This association remained after adjustment for confounders and was independent of depression in both parents and offspring. The effect size was equivalent to that of maternal negative cognitive style, and was also independent of maternal negative cognitive style. CONCLUSIONS Our results suggest that fathers should be included in individual- and family-based interventions designed to prevent the development of depressogenic cognitive styles in adolescent offspring. This could possibly also prevent the development of depression.
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Affiliation(s)
- Gemma Lewis
- Division of PsychiatryFaculty of Brain SciencesUniversity College LondonLondonUK
| | - Siying Wen
- Division of PsychiatryFaculty of Brain SciencesUniversity College LondonLondonUK
| | | | - Glyn Lewis
- Division of PsychiatryFaculty of Brain SciencesUniversity College LondonLondonUK
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49
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Netsi E, Pearson RM, Murray L, Cooper P, Craske MG, Stein A. Association of Persistent and Severe Postnatal Depression With Child Outcomes. JAMA Psychiatry 2018; 75:247-253. [PMID: 29387878 PMCID: PMC5885957 DOI: 10.1001/jamapsychiatry.2017.4363] [Citation(s) in RCA: 331] [Impact Index Per Article: 55.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 12/01/2017] [Indexed: 01/14/2023]
Abstract
Importance Maternal postnatal depression (PND) is common and associated with adverse child outcomes. These effects are not inevitable, and it is critical to identify those most at risk. Previous work suggests that the risks of adverse outcomes are increased when PND is severe and persistent, but this has not been systematically studied. Objective To examine the association between differing levels of persistence and severity of PND and long-term child outcomes. Design, Setting, and Participants The sample for this observational study comprised participants in the Avon Longitudinal Study of Parents and Children in the United Kingdom. Three thresholds of PND severity-moderate, marked, and severe-were defined using the self-rated Edinburgh Postnatal Depression Scale (EPDS). Depression was defined as persistent when the EPDS score was above the threshold level at both 2 and 8 months after childbirth. For each of these severity and persistence categories, the following were examined: (1) the trajectories of later EPDS scores (6 time points between 21 months and 11 years after childbirth) and (2) child outcomes-behavioral problems at 3.5 years of age, school-leaving mathematics grades at 16 years of age, and depression at 18 years of age. Data analysis was conducted from July 12, 2016, to February 8, 2017. Main Outcomes and Measures Child behavioral problems at 3.5 years of age using the Rutter total problems scale, school-leaving mathematics grades at 16 years of age extracted from records of external national public examinations, and offspring depression at 18 years of age using the Clinical Interview Schedule-Revised. Results For the 9848 mothers in the sample, the mean (SD) age at delivery was 28.5 (4.7) years. Of the 8287 children, 4227 (51%) were boys and 4060 (49%) were girls. Compared with women with PND that was not persistent and women who did not score above the EPDS threshold, for all 3 severity levels, women with persistent PND showed elevated depressive symptoms up to 11 years after childbirth. Whether persistent or not, PND doubled the risk of child behavior disturbance. The odds ratio (OR) for child behavioral disturbance for mothers with moderate PND was 2.22 (95% CI, 1.74-2.83), for mothers with marked PND was 1.91 (95% CI, 1.36-2.68), and for mothers with severe PND was 2.39 (95% CI, 1.78-3.22). Persistence of severe PND was particularly important to child development, substantially increasing the risk for behavioral problems at 3.5 years of age (OR, 4.84; 95% CI, 2.94-7.98), lower mathematics grades at 16 years of age (OR, 2.65; 95% CI, 1.26-5.57), and higher prevalence of depression at 18 years of age (OR, 7.44; 95% CI, 2.89-19.11). Conclusions and Relevance Persistent and severe PND substantially raises the risk for adverse outcome on all child measures. Meeting criteria for depression both early and late in the postnatal year, especially when the mood disturbance is severe, should alert health care professionals to a depression that is likely to be persistent and to be associated with an especially elevated risk of multiple adverse child outcomes. Treatment for this group should be prioritized.
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Affiliation(s)
- Elena Netsi
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Rebecca M. Pearson
- School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol, United Kingdom
| | - Lynne Murray
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
- Department of Psychology, Stellenbosch University, Matieland, Stellenbosch, South Africa
- Department of Psychology, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Peter Cooper
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
- Department of Psychology, Stellenbosch University, Matieland, Stellenbosch, South Africa
- Department of Psychology, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Michelle G. Craske
- Department of Psychology, University of California, Los Angeles
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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50
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Redinger S, Norris SA, Pearson RM, Richter L, Rochat T. First trimester antenatal depression and anxiety: prevalence and associated factors in an urban population in Soweto, South Africa. J Dev Orig Health Dis 2018; 9:30-40. [PMID: 28877770 DOI: 10.1017/s204017441700071x] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [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: 12/12/2022]
Abstract
Depression and anxiety in the antenatal period are of public health concern given potential adverse effects for both mother and infant. Both are under-researched in the first trimester of pregnancy, especially in Africa. We examine the prevalence of first trimester antenatal depression and anxiety in a cohort of South African women and investigate associated risk factors. Data were collected from 946 women (2014-2016) in the Soweto First 1000 Days Cohort, a prospective pregnancy cohort in Soweto, South Africa. Antenatal depression was assessed using the Edinburgh Postnatal Depression Scale with a score of ⩾13 indicating probable depression. Anxiety was assessed using the short form of the State-Trait Anxiety Index with a score ⩾12 indicating probable anxiety. Prevalence of antenatal depression was 27% [95% confidence interval (CI) 24.2-29.8] and anxiety 15.2% (95% CI 12.9-17.5). Factors associated with antenatal depression and anxiety were predominantly relationship- and family-centred. Women who perceived that their partner made life harder for them had three-fold increased odds for depression [(odds ratio (OR) 3.33 [2.28-4.85] P<0.001], whereas those with family stressors had almost double the odds for depression (OR 1.78 [1.22-2.59] P=0.003) and anxiety (OR 1.75 [1.44-2.69] P=0.0011). Antenatal depression and anxiety are common in the first trimester of pregnancy, and partner and family relationship stressors are central. Longitudinal analysis is needed to determine if this is a phase of adjustment to pregnancy or onset of persistent symptomology. Early intervention may have secondary preventative effects and should involve the partner and family.
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Affiliation(s)
- S Redinger
- 1MRC/Developmental Pathways to Health Research Unit,School of Clinical Medicine, Faculty of Health Sciences,University of the Witwatersrand,Johannesburg,South Africa
| | - S A Norris
- 1MRC/Developmental Pathways to Health Research Unit,School of Clinical Medicine, Faculty of Health Sciences,University of the Witwatersrand,Johannesburg,South Africa
| | - R M Pearson
- 5School of Social and Community Medicine,Centre for Academic Mental Health,Bristol University,Bristol,UK
| | - L Richter
- 2DST-NRF Centre of Excellence in Human Development,University of Witwatersrand,Johannesburg,South Africa
| | - T Rochat
- 1MRC/Developmental Pathways to Health Research Unit,School of Clinical Medicine, Faculty of Health Sciences,University of the Witwatersrand,Johannesburg,South Africa
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