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Husky MM, Sadikova E, Lee S, Alonso J, Auerbach RP, Bantjes J, Bruffaerts R, Cuijpers P, Ebert DD, Garcia RG, Hasking P, Mak A, McLafferty M, Sampson NA, Stein DJ, Kessler RC. Childhood adversities and mental disorders in first-year college students: results from the World Mental Health International College Student Initiative. Psychol Med 2023; 53:2963-2973. [PMID: 37449483 PMCID: PMC10349206 DOI: 10.1017/s0033291721004980] [Citation(s) in RCA: 1] [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] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study investigates associations of several dimensions of childhood adversities (CAs) with lifetime mental disorders, 12-month disorder persistence, and impairment among incoming college students. METHODS Data come from the World Mental Health International College Student Initiative (WMH-ICS). Web-based surveys conducted in nine countries (n = 20 427) assessed lifetime and 12-month mental disorders, 12-month role impairment, and seven types of CAs occurring before the age of 18: parental psychopathology, emotional, physical, and sexual abuse, neglect, bullying victimization, and dating violence. Poisson regressions estimated associations using three dimensions of CA exposure: type, number, and frequency. RESULTS Overall, 75.8% of students reported exposure to at least one CA. In multivariate regression models, lifetime onset and 12-month mood, anxiety, and substance use disorders were all associated with either the type, number, or frequency of CAs. In contrast, none of these associations was significant when predicting disorder persistence. Of the three CA dimensions examined, only frequency was associated with severe role impairment among students with 12-month disorders. Population-attributable risk simulations suggest that 18.7-57.5% of 12-month disorders and 16.3% of severe role impairment among those with disorders were associated with these CAs. CONCLUSION CAs are associated with an elevated risk of onset and impairment among 12-month cases of diverse mental disorders but are not involved in disorder persistence. Future research on the associations of CAs with psychopathology should include fine-grained assessments of CA exposure and attempt to trace out modifiable intervention targets linked to mechanisms of associations with lifetime psychopathology and burden of 12-month mental disorders.
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Affiliation(s)
- Mathilde M. Husky
- Laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | - Ekaterina Sadikova
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, US
| | - Sue Lee
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute; Pompeu Fabra University (UPF); and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, South Africa
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David D. Ebert
- Department for Sport and Health Sciences, Chair for Psychology & Digital Mental Health Care, Technical University Munich, Germany
| | - Raùl Gutiérrez Garcia
- Department of Social Sciences and Humanities, De La Salle Bajio University, Salamanca, Guanajuato, Mexico
| | - Penelope Hasking
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Arthur Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR
| | | | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Dan J. Stein
- Department of Psychiatry & Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, Republic of South Africa
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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Bond N, McLafferty M, Lapsley C, Ennis E, Murray E, Heenan D, O’Neill S. Familial and Bullying Victimisation: The Impact of Early Adversity Within the Home and Peer Settings on Late Adolescence and Adult Psychopathology. J Child Adolesc Trauma 2023; 16:43-53. [PMID: 36776629 PMCID: PMC9908779 DOI: 10.1007/s40653-022-00481-2] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Awareness of adverse childhood experiences and their impact on adult psychopathology primarily focuses on adversities within the home. There is limited insight into the impact of adversities across peer environments. OBJECTIVE This study investigates 19 items related to adverse experiences across the home, school and peer environments and their relationship to 12-month and lifetime psychopathology. DATA Secondary analysis of the Ulster University Student Well-being Study. The dataset included completed responses across all selected variables for 729 participants. METHOD AND RESULTS Latent profile analysis identified a low adversity profile, bullying adversity profile and higher prevalence adversity profile. Regression analysis of the three profiles and demographics variables indicated their impact on adult psychopathology lifetime and 12-month prevalence rates. CONCLUSION Schools and HE institutions should acknowledge the impact of childhood adversities. In doing so, it is important to consider the deeper impact of bullying due to its links with psychopathology across the lifespan. Educational institutions should take appropriate steps to mitigate continued exposure as students' progress through the education system.
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Affiliation(s)
- N.I. Bond
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - M. McLafferty
- Centre for Personalised Medicine, Ulster University, Derry/Londonderry, Northern Ireland
| | - C. Lapsley
- Centre for Personalised Medicine, Ulster University, Derry/Londonderry, Northern Ireland
| | - E. Ennis
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - E. Murray
- Centre for Personalised Medicine, Ulster University, Derry/Londonderry, Northern Ireland
| | - D. Heenan
- School of Applied Social and Policy Sciences, Ulster University, Jordanstown, Northern Ireland
| | - S.M. O’Neill
- School of Psychology, Ulster University, Coleraine, Northern Ireland
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3
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Brown N, McLafferty M, O’Neill SM, McHugh R, Ward C, McBride L, Brady J, Bjourson AJ, Walsh CP, Murray EK. The Mediating Roles of Mental Health and Substance Use on Suicidal Behavior Among Undergraduate Students With ADHD. J Atten Disord 2022; 26:1437-1451. [PMID: 35118906 PMCID: PMC9277323 DOI: 10.1177/10870547221075844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the prevalence of suicidal ideation (SI), plans and attempts, and non-suicidal self-injury (NSSI) among students with attention deficit hyperactivity disorder (ADHD). Furthermore, we explored the mediating effects of depression, anxiety, alcohol and substance use on the association between ADHD and suicidal behaviors and NSSI. METHOD Participants were first-year undergraduate students (n = 1,829) recruited as part of the World Mental Health International College Student Initiative. Participants completed validated clinical measures online. RESULTS The prevalence of suicide behaviors and NSSI were significantly higher among students with ADHD than those without. Mediation analyses indicated that ADHD directly and indirectly increased suicidal behaviors and NSSI. While ADHD increased suicidal behaviors and NSSI through depression, ADHD and the co-variates age and gender also had indirect effects on suicidal behaviors via substance use. CONCLUSIONS Specific predictors of risk were identified for students with ADHD which may inform the development of more targeted mental health and suicide prevention strategies across campuses.
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Affiliation(s)
- Natasha Brown
- Letterkenny Institute of
Technology, Co. Donegal, Ireland
| | - Margaret McLafferty
- Northern Ireland Centre for
Stratified Medicine, School of Biomedical Sciences, C-TRIC, Altnagelvin
Hospital, Ulster University, Derry/Londonderry, UK
| | - Siobhan M. O’Neill
- School of Psychology, Coleraine
Campus, Ulster University, Coleraine, Co. Derry, UK
| | - Rachel McHugh
- School of Psychology, Coleraine
Campus, Ulster University, Coleraine, Co. Derry, UK
| | - Caoimhe Ward
- Northern Ireland Centre for
Stratified Medicine, School of Biomedical Sciences, C-TRIC, Altnagelvin
Hospital, Ulster University, Derry/Londonderry, UK
| | - Louise McBride
- Letterkenny Institute of
Technology, Co. Donegal, Ireland
| | - John Brady
- Western Health and Social Care
Trust, Tyrone and Fermanagh Hospital, Omagh, Co. Tyrone, UK
| | - Anthony J. Bjourson
- Northern Ireland Centre for
Stratified Medicine, School of Biomedical Sciences, C-TRIC, Altnagelvin
Hospital, Ulster University, Derry/Londonderry, UK
| | - Colum P. Walsh
- Genomics Medicine Research Group,
School of Biomedical Sciences, Coleraine Campus, Ulster University,
Coleraine, Co. Derry, UK
| | - Elaine K. Murray
- Northern Ireland Centre for
Stratified Medicine, School of Biomedical Sciences, C-TRIC, Altnagelvin
Hospital, Ulster University, Derry/Londonderry, UK,Elaine K. Murray, Northern Ireland
Centre for Stratified Medicine, School of Biomedical Sciences, Ulster
University, C-TRIC, Altnagelvin Hospital, Glenshane Road,
Derry/Londonderry BT47 6SB, UK.
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4
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Travers Á, McDonagh T, McLafferty M, Armour C, Cunningham T, Hansen M. Adverse experiences and mental health problems in perpetrators of intimate partner violence in Northern Ireland: A latent class analysis. Child Abuse Negl 2022; 125:105455. [PMID: 35078089 DOI: 10.1016/j.chiabu.2021.105455] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/23/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Trauma and adverse experiences among perpetrators of intimate partner violence (IPV) have been associated with more serious patterns of offending. OBJECTIVE To examine 1) how traumatic and adverse experiences cluster together and co-occur among IPV perpetrators, and 2) whether different patterns of trauma exposure are associated with specific mental health problems. PARTICIPANTS AND SETTING The sample consisted of 405 convicted IPV perpetrators from Northern Ireland. METHODS Data was collected between 2018 and 2019. Latent class analysis identified typologies of exposure to traumatic and adverse experiences. A series of binary logistic regression analyses explored associations between the identified classes and five categories of probable mental health problems. RESULTS Three adversity classes were identified: a baseline class (59.2%), characterised by relatively low levels of exposure to most types of adversity; a 'childhood adversity' class (32.9%), with high levels of childhood adversity; and a 'community violence and disadvantage' class (7.9%), which had high probabilities of endorsing adversities related to economic hardship and community violence. Regression analyses showed that the childhood adversity class was significantly associated with increased likelihood of all categories of mental health problems, except for neurodevelopmental disorders (ORs = 1.77-3.25). The community violence and disadvantage class was significantly associated with probable mood and anxiety disorder (ORs 3.92 and 8.42, respectively). CONCLUSIONS Different patterns of exposure to adversities were associated with distinct mental health problems in the present sample. Early intervention to prevent poly-victimisation, the clustering of adversities in childhood and the resulting accumulation of risk may be a useful component of preventive responses for IPV in Northern Ireland.
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Affiliation(s)
- Áine Travers
- ThRIVE, Psychology Department, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark.
| | - Tracey McDonagh
- ThRIVE, Psychology Department, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark.
| | - Margaret McLafferty
- School of Biomedical Science, Ulster University, Magee Campus, Londonderry BT48 7JL, United Kingdom of Great Britain and Northern Ireland.
| | - Cherie Armour
- Centre for Stress, Trauma and Related Conditions (STARC), School of Psychology, Queen's University Belfast, University Rd, Belfast BT7 1NN, United Kingdom of Great Britain and Northern Ireland.
| | - Twylla Cunningham
- Psychology Department, Probation Board for Northern Ireland, 80-90 North St, Belfast BT1 1LD, United Kingdom of Great Britain and Northern Ireland.
| | - Maj Hansen
- ThRIVE, Psychology Department, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark.
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5
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Ward C, McLafferty M, McLaughlin J, McHugh R, McBride L, Brady J, Bjourson AJ, Walsh CP, O'Neill SM, Murray EK. Suicidal behaviours and mental health disorders among students commencing college. Psychiatry Res 2022; 307:114314. [PMID: 34864232 DOI: 10.1016/j.psychres.2021.114314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/19/2021] [Revised: 11/09/2021] [Accepted: 11/25/2021] [Indexed: 11/29/2022]
Abstract
The increase in psychological disorders and suicidal behaviour in students is a reason for growing concern. Some may start university with pre-existing problems, while others develop problems during this time. It is important to evaluate mental health and wellbeing early, identifying those at risk. The aim of this study was to compare mental health problems and help-seeking behaviour between students in Northern Ireland (NI) and the Republic of Ireland (ROI). Whilst geographically proximate, the institutions span a cross-border region with distinct education and healthcare systems. First-year undergraduate students (n = 1828) were recruited in September 2019 as part of the World Mental Health International College Student Initiative. Suicidal behaviour, mental health and substance disorders were investigated using the World Mental Health- Composite International Diagnostic Interview. Prevalence of disorders was high, with more ROI students experiencing problems than NI students. Students were significantly more likely to experience mental health problems if they were female (p<0.001), non-heterosexual (p<0.0001), and over the age of 21 (p<0.0001). These findings show that many students are starting university with high levels of psychopathology and suicidal behaviour, highlighting the importance of early intervention which may need to be tailored to different student populations.
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Affiliation(s)
- Caoimhe Ward
- Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden
| | - Margaret McLafferty
- Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden
| | - Jonathon McLaughlin
- Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden
| | - Rachel McHugh
- School of Psychology, Ulster University, Coleraine Campus, Coleraine, Co. Derry, UK; Letterkenny Institute of Technology, Co. Donegal, Ireland
| | - Louise McBride
- Letterkenny Institute of Technology, Co. Donegal, Ireland
| | - John Brady
- Western Health and Social Care Trust, Tyrone and Fermanagh Hospital, Omagh, Co. Tyrone, UK
| | - Anthony J Bjourson
- Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden
| | - Colum P Walsh
- Genomics Medicine Research Group, School of Biomedical Sciences, Ulster University, Coleraine Campus, Coleraine, Co. Derry, UK
| | - Siobhan M O'Neill
- School of Psychology, Ulster University, Coleraine Campus, Coleraine, Co. Derry, UK
| | - Elaine K Murray
- Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden
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6
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McLafferty M, Brown N, McHugh R, Ward C, Stevenson A, McBride L, Brady J, Bjourson AJ, O'Neill SM, Walsh CP, Murray EK. Depression, anxiety and suicidal behaviour among college students: Comparisons pre-COVID-19 and during the pandemic. Psychiatry Res Commun 2021; 1:100012. [PMID: 34977911 PMCID: PMC8574925 DOI: 10.1016/j.psycom.2021.100012] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/04/2021] [Indexed: 01/08/2023]
Abstract
Background Many students struggle with psychological problems during their college years. These problems may be even more apparent during the COVID-19 pandemic with the accompanying restrictions and transition to an online learning environment, but few longitudinal studies have been conducted to date. The aim of this study was to compare symptoms of depression, anxiety and suicidality prior to and during the pandemic, and identify stressors. Methods This study was conducted among students attending Ulster University, Northern Ireland (NI) and LYIT, Republic of Ireland (ROI), as part of the World Mental Health International College Student Initiative (WMH-ICS). Data was collected from first year students in September 2019. The completed response rate was 25.22% (NI) and 41.9% (ROI) in relation to the number of first-year students registered. A follow up study was conducted in Autumn 2020, with 884 students fully completing the online survey in both years, equating to just under half of those who completed initially. Results High levels of mental health problems were found in year 1, especially in the ROI. Levels of depression increased significantly in year 2, particularly among students in NI, however, levels of anxiety decreased. No significant variations were found for suicidal behaviour. Several stressors were revealed, including increased social isolation, and worrying about loved ones. Limitations The findings may not be generalised to other student populations. Conclusions This study reveals variation in symptoms of depression and anxiety since the onset of the pandemic. In particular, the large increase in students with depression is of concern.
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Affiliation(s)
- Margaret McLafferty
- Northern Ireland Centre for Stratified Medicine, School of Biomedical Sciences, Ulster University, C-TRIC, Altnagelvin Hospital, Derry, Londonderry, UK
| | - Natasha Brown
- Letterkenny Institute of Technology, Letterkenny, Co. Donegal, Ireland
| | - Rachel McHugh
- School of Psychology, Ulster University, Coleraine Campus, Coleraine, Co. Derry, UK
| | - Caoimhe Ward
- Northern Ireland Centre for Stratified Medicine, School of Biomedical Sciences, Ulster University, C-TRIC, Altnagelvin Hospital, Derry, Londonderry, UK
| | - Ailis Stevenson
- Northern Ireland Centre for Stratified Medicine, School of Biomedical Sciences, Ulster University, C-TRIC, Altnagelvin Hospital, Derry, Londonderry, UK
| | - Louise McBride
- Letterkenny Institute of Technology, Letterkenny, Co. Donegal, Ireland
| | - John Brady
- Western Health and Social Care Trust, Tyrone and Fermanagh Hospital, Omagh, Co. Tyrone, UK
| | - Anthony J Bjourson
- Northern Ireland Centre for Stratified Medicine, School of Biomedical Sciences, Ulster University, C-TRIC, Altnagelvin Hospital, Derry, Londonderry, UK
| | - Siobhan M O'Neill
- School of Psychology, Ulster University, Coleraine Campus, Coleraine, Co. Derry, UK
| | - Colum P Walsh
- Genomics Medicine Research Group, School of Biomedical Sciences, Ulster University, Coleraine Campus, Coleraine, Co. Derry, UK.,Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden
| | - Elaine K Murray
- Northern Ireland Centre for Stratified Medicine, School of Biomedical Sciences, Ulster University, C-TRIC, Altnagelvin Hospital, Derry, Londonderry, UK
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7
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McLafferty M, McGlinchey E, Travers A, Armour C. The mediating role of resilience on psychopathology following childhood adversities among UK armed forces veterans residing in Northern Ireland. Eur J Psychotraumatol 2021; 12:1978176. [PMID: 34992757 PMCID: PMC8725712 DOI: 10.1080/20008198.2021.1978176] [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: 10/29/2022] Open
Abstract
BACKGROUND Childhood adversities can have a deleterious impact on mental health. Elevated levels of such adversities have been reported in veteran populations. Levels of resilience may be protective but early adverse experiences may impact on the development of resilience in the first instance. OBJECTIVE This study aims to identify classes of childhood adversities among UK military veterans residing in Northern Ireland (NI) and explore levels of resilience and the mediating role resilience may play following such experiences in relation to mental health. METHOD The study utilizes data from the Northern Ireland Veterans' Health and Wellbeing Study (n = 656). All participants were UK Armed Forces veterans who were residents of NI with an average age of 56 (586 males, 70 females). RESULTS Four childhood adversity classes were revealed, with almost a half of the sample experiencing early adverse experiences. Individuals who experienced a range of adversities, particularly those related to maltreatment were more likely to have PSTD, depression and anxiety disorders and lower levels of resilience. However, those who experienced adversity related to family dysfunction had similar levels of resilience as the low risk class, suggesting tentatively that some adversity may be protective. Mediation analyses revealed that veterans with elevated levels of resilience were less likely to have psychological problems following negative childhood experiences. CONCLUSIONS The study highlights the importance of promoting resilience building programmes among military veterans, especially among those who experienced maltreatment as a child.
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Affiliation(s)
- Margaret McLafferty
- School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Emily McGlinchey
- Stress Trauma and Related Conditions (STARC) Research Centre, School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Aine Travers
- Stress Trauma and Related Conditions (STARC) Research Centre, School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Cherie Armour
- Stress Trauma and Related Conditions (STARC) Research Centre, School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK
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8
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Karyotaki E, Cuijpers P, Albor Y, Alonso J, Auerbach RP, Bantjes J, Bruffaerts R, Ebert DD, Hasking P, Kiekens G, Lee S, McLafferty M, Mak A, Mortier P, Sampson NA, Stein DJ, Vilagut G, Kessler RC. Sources of Stress and Their Associations With Mental Disorders Among College Students: Results of the World Health Organization World Mental Health Surveys International College Student Initiative. Front Psychol 2020; 11:1759. [PMID: 32849042 PMCID: PMC7406671 DOI: 10.3389/fpsyg.2020.01759] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/25/2020] [Indexed: 11/30/2022] Open
Abstract
The college years are stressful for many students. Identifying the sources of stress and their relative importance in leading to clinically significant emotional problems may assist in the development of targeted stress management interventions. The current report examines the distribution and associations of perceived stress across major life areas with 12-month prevalence of common mental disorders in a cross-national sample of first-year college students. The 20,842 respondents were from 24 universities in 9 countries that participated in the World Health Organization World Mental Health International College Student Initiative. Logistic regression analysis examined associations of current perceived stress in six life areas (financial situation, health, love life, relationships with family, relationships at work/school, problems experienced by loved ones) with six types of 12-month mental disorders (major depressive disorder, bipolar disorder, generalized anxiety disorder, panic disorder, alcohol use disorder, drug use disorder). Population attributable risk proportions (PARPs) were calculated to estimate the upper-bound potential effects of interventions focused on perceived stress in reducing prevalence of mental disorders. The majority of students (93.7%) reported at least some stress in at least one of the six areas. A significant dose-response association was found between extent of stress in each life area and increased odds of at least one of the six disorders. The multivariable models that included all stress measures were significant for all disorders (F = 20.6–70.6, p < 0.001). Interpretation of PARPs as representing causal effects of stresses on disorders suggests that up to 46.9–80.0% of 12-month disorder prevalence might be eliminated if stress prevention interventions were developed to block the associations of stress with these disorders.
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Affiliation(s)
- Eirini Karyotaki
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States.,Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Yesica Albor
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Jordi Alonso
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain.,CIBER en Epidemiología y Salud Pública, Madrid, Spain.,Pompeu Fabra University, Barcelona, Spain
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Jason Bantjes
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven, Leuven, Belgium
| | - David D Ebert
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | | | - Glenn Kiekens
- Center for Public Health Psychiatry, Katholieke Universiteit, Leuven, Belgium
| | - Sue Lee
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Margaret McLafferty
- School of Biomedical Sciences, Ulster University, Londonderry, United Kingdom
| | - Arthur Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Philippe Mortier
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain.,CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Dan J Stein
- Department of Psychiatry and Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Gemma Vilagut
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain.,CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
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9
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Lapsley CR, Irwin R, McLafferty M, Thursby SJ, O'Neill SM, Bjourson AJ, Walsh CP, Murray EK. Methylome profiling of young adults with depression supports a link with immune response and psoriasis. Clin Epigenetics 2020; 12:85. [PMID: 32539844 PMCID: PMC7477873 DOI: 10.1186/s13148-020-00877-7] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 05/28/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Currently the leading cause of global disability, clinical depression is a heterogeneous condition characterised by low mood, anhedonia and cognitive impairments. Its growing incidence among young people, often co-occurring with self-harm, is of particular concern. We recently reported very high rates of depression among first year university students in Northern Ireland, with over 25% meeting the clinical criteria, based on DSM IV. However, the causes of depression in such groups remain unclear, and diagnosis is hampered by a lack of biological markers. The aim of this exploratory study was to examine DNA methylation patterns in saliva samples from individuals with a history of depression and matched healthy controls. RESULTS From our student subjects who showed evidence of a total lifetime major depressive event (MDE, n = 186) we identified a small but distinct subgroup (n = 30) with higher risk scores on the basis of co-occurrence of self-harm and attempted suicide. Factors conferring elevated risk included being female or non-heterosexual, and intrinsic factors such as emotional suppression and impulsiveness. Saliva samples were collected and a closely matched set of high-risk cases (n = 16) and healthy controls (n = 16) similar in age, gender and smoking status were compared. These showed substantial differences in DNA methylation marks across the genome, specifically in the late cornified envelope (LCE) gene cluster. Gene ontology analysis showed highly significant enrichment for immune response, and in particular genes associated with the inflammatory skin condition psoriasis, which we confirmed using a second bioinformatics approach. We then verified methylation gains at the LCE gene cluster at the epidermal differentiation complex and at MIR4520A/B in our cases in the laboratory, using pyrosequencing. Additionally, we found loss of methylation at the PSORSC13 locus on chromosome 6 by array and pyrosequencing, validating recent findings in brain tissue from people who had died by suicide. Finally, we could show that similar changes in immune gene methylation preceded the onset of depression in an independent cohort of adolescent females. CONCLUSIONS Our data suggests an immune component to the aetiology of depression in at least a small subgroup of cases, consistent with the accumulating evidence supporting a relationship between inflammation and depression. Additionally, DNA methylation changes at key loci, detected in saliva, may represent a valuable tool for identifying at-risk subjects.
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Affiliation(s)
- Coral R Lapsley
- Northern Ireland Centre for Stratified Medicine, School of Biomedical Sciences, Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry, UK
| | - Rachelle Irwin
- Genomics Medicine Research Group, School of Biomedical Sciences, Ulster University, Coleraine Campus, Coleraine, UK
| | - Margaret McLafferty
- Northern Ireland Centre for Stratified Medicine, School of Biomedical Sciences, Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry, UK.,School of Psychology, Ulster University, Coleraine Campus, Coleraine, UK
| | - Sara Jayne Thursby
- Genomics Medicine Research Group, School of Biomedical Sciences, Ulster University, Coleraine Campus, Coleraine, UK
| | - Siobhan M O'Neill
- School of Psychology, Ulster University, Coleraine Campus, Coleraine, UK
| | - Anthony J Bjourson
- Northern Ireland Centre for Stratified Medicine, School of Biomedical Sciences, Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry, UK
| | - Colum P Walsh
- Genomics Medicine Research Group, School of Biomedical Sciences, Ulster University, Coleraine Campus, Coleraine, UK
| | - Elaine K Murray
- Northern Ireland Centre for Stratified Medicine, School of Biomedical Sciences, Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry, UK.
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McLafferty M, Armour C, Bunting B, Ennis E, Lapsley C, Murray E, O'Neill S. Coping, stress, and negative childhood experiences: The link to psychopathology, self‐harm, and suicidal behavior. Psych J 2019; 8:293-306. [DOI: 10.1002/pchj.301] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 05/07/2019] [Accepted: 05/15/2019] [Indexed: 01/06/2023]
Affiliation(s)
| | - Cherie Armour
- Psychology Research InstituteUlster University Coleraine UK
| | | | - Edel Ennis
- Psychology Research InstituteUlster University Coleraine UK
| | - Coral Lapsley
- Northern Ireland Centre for Stratified MedicineBiomedical Sciences Research Institute, Ulster University, Clinical Translational Research and Innovation Centre Altnagelvin Hospital Site, Londonderry UK
| | - Elaine Murray
- Northern Ireland Centre for Stratified MedicineBiomedical Sciences Research Institute, Ulster University, Clinical Translational Research and Innovation Centre Altnagelvin Hospital Site, Londonderry UK
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Auerbach RP, Mortier P, Bruffaerts R, Alonso J, Benjet C, Cuijpers P, Demyttenaere K, Ebert DD, Green JG, Hasking P, Lee S, Lochner C, McLafferty M, Nock MK, Petukhova MV, Pinder-Amaker S, Rosellini AJ, Sampson NA, Vilagut G, Zaslavsky AM, Kessler RC. Mental disorder comorbidity and suicidal thoughts and behaviors in the World Health Organization World Mental Health Surveys International College Student initiative. Int J Methods Psychiatr Res 2019; 28:e1752. [PMID: 30450753 PMCID: PMC6877246 DOI: 10.1002/mpr.1752] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [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: 07/04/2018] [Revised: 10/04/2018] [Accepted: 10/12/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Comorbidity is a common feature of mental disorders. However, needs assessment surveys focus largely on individual disorders rather than on comorbidity even though the latter is more important for predicting suicidal thoughts and behaviors. In the current report, we take a step beyond this conventional approach by presenting data on the prevalence and correlates (sociodemographic factors, college-related factors, and suicidal thoughts and behaviors) of the main multivariate profiles of common comorbid Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV disorders among students participating in the first phase of the World Health Organization World Mental Health International College Student initiative. METHOD A web-based mental health survey was administered to first year students in 19 colleges across eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States; 45.5% pooled response rate) to screen for seven common DSM-IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, attention-deficit/hyperactivity disorder, alcohol use disorder, and drug use disorder. We focus on the 14,348 respondents who provided complete data; 38.4% screened positive for at least one 12-month disorder. RESULTS Multivariate disorder profiles were detected using latent class analysis (LCA). The least common class (C1; 1.9% of students) was made up of students with high comorbidity (four or more disorders, the majority including mania/hypomania). The remaining 12-month cases had profiles of internalizing-externalizing comorbidity (C2; 5.8%), internalizing comorbidity (C3; 14.6%), and pure disorders (C4; 16.1%). The 1.9% of students in C1 had much higher prevalence of suicidal thoughts and behaviors than other students. Specifically, 15.4% of students in C1 made a suicide attempt in the 12 months before the survey compared with 1.3-2.6% of students with disorders in C2-4, 0.2% of students with lifetime disorders but no 12-month disorders (C5), and 0.1% of students with no lifetime disorders (C6). CONCLUSIONS In line with prior research, comorbid mental disorders were common; however, sociodemographic correlates of LCA profiles were modest. The high level of comorbidity underscores the need to develop and test transdiagnostic approaches for treatment in college students.
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Affiliation(s)
- Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, New York
| | - Philippe Mortier
- Universitair Psychiatrisch Centrum, Campus Gasthuisberg, Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum, Campus Gasthuisberg, Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium
| | - Jordi Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), CIBER en Epidemiología y Salud Pública (CIBERESP), Pompeu Fabra University (UPF), Barcelona, Spain
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Koen Demyttenaere
- Universitair Psychiatrisch Centrum, Campus Gasthuisberg, Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium
| | - David D Ebert
- Department for Psychology, Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen Nuremberg, Erlangen, Germany
| | - Jennifer Greif Green
- Wheelock College of Education and Human Development, Boston University, Boston, Massachusetts
| | - Penelope Hasking
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Sue Lee
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Christine Lochner
- MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Maria V Petukhova
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | | | | | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Gemma Vilagut
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), CIBER en Epidemiología y Salud Pública (CIBERESP), Pompeu Fabra University (UPF), Barcelona, Spain
| | - Alan M Zaslavsky
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
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Ennis E, McLafferty M, Murray E, Lapsley C, Bjourson T, Armour C, Bunting B, Murphy S, O'Neill S. Readiness to change and barriers to treatment seeking in college students with a mental disorder. J Affect Disord 2019; 252:428-434. [PMID: 31003112 DOI: 10.1016/j.jad.2019.04.062] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 08/18/2018] [Revised: 03/11/2019] [Accepted: 04/08/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND College students have high prevalence of mental disorders and suicidal thoughts and behaviours, and low rates of treatment uptake. This study assesses treatment access, intentions to seek help, and perceived barriers to help-seeking, considering gender and suicidal thoughts or behaviours (STBs) as predictors. METHODS Data is from the Ulster University Student Wellbeing study (2015) conducted in Northern Ireland (NI), as part of the WHO World Mental Health Surveys International College Student Project. Participants are 392 new college entrants (162 males (41.3%)/230 females (58.7%)), who all reported some lifetime mental disorder or STBs. RESULTS Receipt of treatment was low (37.8%), particularly among males and those with no STBs. Males were less likely to intend to access external professional services and were less likely than females to rate embarrassment (OR = 0.60) or worry about being treated differently (OR = 0.63) as important reasons for not seeking treatment. Those with STBs rated wanting to handle things on their own as a more important barrier those with no STBs (OR = 0.55 for non STBs group) and rated being unsure where to go as a less important barrier than those with no STBs (OR = 1.80 for non STBs group). LIMITATIONS Data is correlational and concerns lifetime criteria for mental disorder, with no consideration of current mental status nor disorder type. CONCLUSIONS These findings have implications for the active screening and intervention for vulnerable college students, particularly males and those with mental disorders but no STBs.
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Affiliation(s)
- Edel Ennis
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, Coleraine, Northern Ireland.
| | - Margaret McLafferty
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, Coleraine, Northern Ireland
| | - Elaine Murray
- Northern Ireland Centre for Stratified Medicine, Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry BT47 6SB, Coleraine, Northern Ireland
| | - Coral Lapsley
- Northern Ireland Centre for Stratified Medicine, Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry BT47 6SB, Coleraine, Northern Ireland
| | - Tony Bjourson
- Northern Ireland Centre for Stratified Medicine, Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry BT47 6SB, Coleraine, Northern Ireland
| | - Cherie Armour
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, Coleraine, Northern Ireland
| | - Brendan Bunting
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, Coleraine, Northern Ireland
| | - Sam Murphy
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, Coleraine, Northern Ireland
| | - Siobhan O'Neill
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, Coleraine, Northern Ireland
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McLafferty M, Ross J, Waterhouse-Bradley B, Armour C. Childhood adversities and psychopathology among military veterans in the US: The mediating role of social networks. J Anxiety Disord 2019; 65:47-55. [PMID: 31158649 DOI: 10.1016/j.janxdis.2019.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 05/01/2019] [Accepted: 05/03/2019] [Indexed: 11/15/2022]
Abstract
Childhood adversities can impact negatively on psychological health across the lifespan. Many military veterans have a history of adverse childhood experiences, which when combined with deployment related traumas, can lead to high levels of psychopathology. Social networks can however be protective. The current study aimed to identify typologies of childhood adversity in U.S. military veterans (n = 3092) and explore relationships between the adversity typologies and PTSD, mood and anxiety disorders, utilising data from the National Epidemiological Survey on Alcohol and Related Conditions-III (NESARC-III). The mediating role of quality and quantity of social networks were examined. Latent class analysis identified four adversity classes; 1) baseline, 2) household dysfunction, 3) maltreatment, and 4) multi-adversity. Individuals in the adversity classes (2-4), especially those who experienced multi-adversity had higher rates of psychopathology. The quality of social networks played an important mediating role, while quantity of networks did not. Those who experienced adversity were less likely to have supportive social networks, therefore adversity had both a direct and indirect impact on psychopathology. The findings highlight the importance of developing and maintaining social networks following military life. Recommendations include interpersonal skills training and programmes which may help them engage back into the community and enhance relationships.
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Affiliation(s)
- M McLafferty
- Ulster University, Cromore Road, Coleraine, Northern Ireland, United Kingdom.
| | - J Ross
- Ulster University, Cromore Road, Coleraine, Northern Ireland, United Kingdom
| | | | - C Armour
- Ulster University, Cromore Road, Coleraine, Northern Ireland, United Kingdom
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14
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McLafferty M, O’Neill S, Armour C, Murphy S, Ferry F, Bunting B. The impact of childhood adversities on the development of Posttraumatic Stress Disorder (PTSD) in the Northern Ireland population. European Journal of Trauma & Dissociation 2019. [DOI: 10.1016/j.ejtd.2018.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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15
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O'Neill S, McLafferty M, Ennis E, Lapsley C, Bjourson T, Armour C, Murphy S, Bunting B, Murray E. Socio-demographic, mental health and childhood adversity risk factors for self-harm and suicidal behaviour in College students in Northern Ireland. J Affect Disord 2018; 239:58-65. [PMID: 29990663 DOI: 10.1016/j.jad.2018.06.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 03/13/2018] [Revised: 05/04/2018] [Accepted: 06/01/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Prevalence estimates of suicidal behaviour in the college student population are consistently higher than rates for the general adult population. This study examines mental health disorders and childhood adversities as predictors of self-harm and suicidal behaviours. METHODS The Ulster University Student Wellbeing study commenced in September 2015 as part of the WHO World Mental Health Surveys International College Student Project. In Northern Ireland (NI) 739 students participated (462 female, 274 male and 3 other specified), with the WMH-CIDI used to examine psychopathology. Mean age was 21 years old. RESULTS Thirty-one percent endorsed suicidal ideation (24.3% of males and 36.9% of females) with almost 1 in 5 students having made a plan for suicide in the 12 months prior to the survey. Latent profile analysis revealed three profiles of childhood adversity (high, moderate, and low risk). Logistic regression analyses showed that there was an increased likelihood of all queried self-harm and suicidal behaviours in those who were not heterosexual orientation, and among those with either moderate or high levels of childhood adversities. Probable alcohol dependence was associated with a significantly increased likelihood of suicide attempt or self-harm with either a suicide plan or a suicide attempt. LIMITATIONS Influences of self-report measures and the generalizability of the sample are discussed. CONCLUSIONS Policies and strategies for early identification of those with mental illnesses or adversities that increase their risk, should be prioritised. It would also be useful to identify individuals at risk in secondary schools to allow for additional support to be offered to them during the key time of transitioning into higher education.
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Affiliation(s)
- Siobhan O'Neill
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, United Kingdom
| | - Margaret McLafferty
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, United Kingdom
| | - Edel Ennis
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, United Kingdom.
| | - Coral Lapsley
- Northern Ireland Centre for Stratified Medicine, Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry, United Kingdom
| | - Tony Bjourson
- Northern Ireland Centre for Stratified Medicine, Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry, United Kingdom
| | - Cherie Armour
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, United Kingdom
| | - Sam Murphy
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, United Kingdom
| | - Brendan Bunting
- Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, United Kingdom
| | - Elaine Murray
- Northern Ireland Centre for Stratified Medicine, Ulster University, C-TRIC, Altnagelvin Hospital, Derry/Londonderry, United Kingdom
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McLafferty M, O'Neill S, Armour C, Murphy S, Bunting B. The mediating role of various types of social networks on psychopathology following adverse childhood experiences. J Affect Disord 2018; 238:547-553. [PMID: 29936395 DOI: 10.1016/j.jad.2018.06.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 03/25/2018] [Revised: 05/20/2018] [Accepted: 06/04/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Adverse childhood events can have a very negative impact on psychopathology. Those with good social support networks may benefit from these relationships, with social networks protecting a person against the negative effect of childhood adversities. However, individuals who suffer early adversity may have lower levels of social networks due to these experiences. The primary aims of the current study were: 1) to examine the mediating effects of social networks on psychopathology following adverse childhood experiences and 2) to assess if childhood adversities impact on the development of social networks. METHOD Data was obtained from the Northern Ireland Study of Health and Stress (NISHS), conducted as part of the World Mental Health Survey Initiative, n = 1986, response rate 64.8%. The WMHCIDI was used to assess mental health disorders along with risk and protective factors. RESULTS Individuals who experienced childhood adversities had increased odds of psychopathology, especially those who experienced high levels of maltreatment. This was partially mediated by various types of social networks, including family and friend support and family harmony. However, individuals who experienced adversity were less likely to have good social networks in the first instance. LIMITATIONS The cross-sectional nature of the study which is based on the population in Northern Ireland may limit the findings. CONCLUSION The study illustrates the importance of social networks following adverse childhood experiences. The findings provide support for initiatives to help children gain skills to develop and maintain social networks following childhood adversities, thereby reducing the negative mental health impact of such experiences.
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McLafferty M, O'Neill S, Murphy S, Armour C, Ferry F, Bunting B. The moderating impact of childhood adversity profiles and conflict on psychological health and suicidal behaviour in the Northern Ireland population. Psychiatry Res 2018; 262:213-220. [PMID: 29459280 DOI: 10.1016/j.psychres.2018.02.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 03/26/2017] [Revised: 02/02/2018] [Accepted: 02/11/2018] [Indexed: 10/18/2022]
Abstract
Childhood adversities are key etiological factors in the onset and persistence of psychopathology. In Northern Ireland the Troubles also impacted on the population's psychological health. This study used data from the Northern Ireland Study of Health and Stress a collaborative epidemiological study which used the WMH-CIDI to assess mental health disorders in a nationally representative sample (Part 2, n = 1986). The aims of the study were to assess co-occurrences of childhood adversities and investigate the impact of adversity profiles and conflict experience on psychopathology and suicidal behaviour. Latent Class Analysis uncovered 3 discrete childhood adversity profiles, a low, medium, and high risk class. Individuals from higher risk adversity profiles displayed significantly increased odds of having psychological problems, with conflict exposure also impacting on psychopathology. However, the study revealed that the impact of conflict exposure on suicidal behaviour was moderated by latent class membership and that some adversity may actually be protective. The findings highlight the need to consider that, while adversity can have a negative impact on psychopathology, a lack of adversity early in life may hinder some people from developing adequate coping strategies. Further research is required to identify adversity patterns and other interacting factors that are protective.
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Affiliation(s)
- Margaret McLafferty
- Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland BT48 7JL, UK
| | - Siobhan O'Neill
- Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland BT48 7JL, UK. sm.o'
| | - Sam Murphy
- Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland BT48 7JL, UK
| | - Cherie Armour
- Ulster University, Coleraine Campus, Cromore Road, Coleraine, Northern Ireland BT52 1SA, UK
| | - Finola Ferry
- Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland BT48 7JL, UK
| | - Brendan Bunting
- Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland BT48 7JL, UK
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McLafferty M, O'Neill S, Murphy S, Armour C, Bunting B. Population attributable fractions of psychopathology and suicidal behaviour associated with childhood adversities in Northern Ireland. Child Abuse Negl 2018; 77:35-45. [PMID: 29294415 DOI: 10.1016/j.chiabu.2017.12.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 05/14/2017] [Revised: 12/11/2017] [Accepted: 12/14/2017] [Indexed: 06/07/2023]
Abstract
Childhood adversities are strong predictors of psychopathology and suicidality. However, specific adversities are associated with different outcomes, with cross-national variations reported. The current study examined rates of adversities reported in Northern Ireland (NI), and associations between adverse childhood experiences and psychopathology and suicidal behaviour were explored. Data was obtained from the Northern Ireland Study of Health and Stress (NISHS), conducted as part of the World Mental Health (WMH) survey initiative (2004-2008); response rate 68.4% (n = 1,986). The on-line survey used, the WHO Composite International Diagnostic Interview (CIDI) to examine psychopathology and associated risk factors in the NI population. Prevalence rates of retrospectively reported childhood adversities were calculated, with gender and age variations explored. Females were more likely to experience sexual abuse. Individuals who grew up during the worst years of the civil conflict in NI experienced elevated levels of childhood adversities. Participants who endured childhood adversities were more likely to have mental health problems but variations in risk factors were found for different disorders. Parental mental illness was associated with all disorders however, with ORs ranging from 2.20 for mood disorders to 4.07 for anxiety disorders. Population attributable fractions (PAF) estimated the reduction in psychopathology and suicidal behaviour in the population if exposure to adverse childhood events had not occurred. The highest PAF values were revealed for parental mental illness and sexual abuse. The findings indicate that a substantial proportion of psychopathology and suicide risk in NI are attributable to childhood adversities, providing support for early intervention and prevention initiatives.
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Affiliation(s)
- Margaret McLafferty
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, N. Ireland, United Kingdom.
| | - Siobhan O'Neill
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, N. Ireland, United Kingdom.
| | - Sam Murphy
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, N. Ireland, United Kingdom
| | - Cherie Armour
- School of Psychology, Ulster University, Coleraine Campus, Cromore Road, Coleraine, N. Ireland, United Kingdom
| | - Brendan Bunting
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, N. Ireland, United Kingdom
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19
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McLafferty M, Armour C, O'Neill S, Murphy S, Ferry F, Bunting B. Suicidality and profiles of childhood adversities, conflict related trauma and psychopathology in the Northern Ireland population. J Affect Disord 2016; 200:97-102. [PMID: 27130959 DOI: 10.1016/j.jad.2016.04.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/24/2016] [Accepted: 04/16/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Over 30 years of conflict in Northern Ireland (NI) has impacted on the population's mental health. However, childhood adversities may add to the psychological impact of conflict. The aims of the study were to assess co-occurrence across childhood adversities, conflict related traumas, and psychological health, then explore demographic variations between identified classes, and examine the impact of class membership on suicidal ideation and behaviour. METHOD Data was obtained from the Northern Ireland Study of Health and Stress, a representative epidemiological study which used the CIDI to assess psychopathology and related risk factors in the NI population (N=4340, part 2 n=1986; response rate 64%). RESULTS Latent Class Analysis uncovered 4 discrete profiles; a conflict class (n=191; 9.6%), a multi-risk class endorsing elevated levels of childhood adversities, conflict related traumas and psychopathology (n=85; 4.3%), a psychopathology class (n=290; 14.6%), and a low risk class (n=1420; 71.5%). Multinomial logistic regression analysis revealed that individuals who grew up during the worst years of the Troubles were more likely to have experienced multiple traumas and psychopathology. Individuals in the multi-risk class were more than fifteen times more likely to endorse suicidal ideation and behaviour. LIMITATIONS The main limitations are that the study may not be fully representative of the NI population due to the exclusion criteria applied and also the possible misclassification of conflict related events. CONCLUSIONS The findings indicate that treatment providers should be cognisant that those with wide ranging adversity profiles are those also likely to be reporting psychological distress and suicidality.
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Affiliation(s)
- Margaret McLafferty
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom.
| | - Cherie Armour
- School of Psychology, Ulster University, Coleraine Campus, Cromore Road, Coleraine, Northern Ireland, United Kingdom
| | - Siobhan O'Neill
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom
| | - Sam Murphy
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom
| | - Finola Ferry
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom
| | - Brendan Bunting
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom
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McLafferty M, Armour C, McKenna A, O'Neill S, Murphy S, Bunting B. Childhood adversity profiles and adult psychopathology in a representative Northern Ireland study. J Anxiety Disord 2015; 35:42-8. [PMID: 26343560 DOI: 10.1016/j.janxdis.2015.07.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [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: 02/24/2015] [Revised: 06/10/2015] [Accepted: 07/24/2015] [Indexed: 12/01/2022]
Abstract
Childhood adversities are key aetiological factors in the onset and persistence of psychopathology. The aims of this study were to identify childhood adversity profiles, and investigate the relationship between the adversity classes and psychopathology in Northern Ireland. The study utilized data from the Northern Ireland Study of Health and Stress, an epidemiological survey (N=1986), which used the CIDI to examine mental health disorders and associated risk factors. Latent Class Analysis revealed 3 distinct typologies; a low risk class (n=1709; 86%), a poly-adversity class (n=122; 6.1%), and an economic adversity class (n=155; 7.8%). Logistic Regression models revealed that individuals in the economic adversity class had a heightened risk of anxiety and substance disorders, with individuals in the poly-adversity class more likely to have a range of mental health problems and suicidality. The findings indicate the importance of considering the impact of co-occurring childhood adversities when planning treatment, prevention, and intervention programmes.
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Affiliation(s)
- Margaret McLafferty
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom.
| | - Cherie Armour
- School of Psychology, Ulster University, Coleraine Campus, Cromore Road, Coleraine, Northern Ireland, United Kingdom
| | - Aine McKenna
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom
| | - Siobhan O'Neill
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom
| | - Sam Murphy
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom
| | - Brendan Bunting
- School of Psychology, Ulster University, Magee Campus, Northland Road, Derry, Northern Ireland, United Kingdom
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