Sania Shakoor

BackgroundYouth adversity is associated with persistence of depression and anxiety symptoms. This association may be greater for disadvantaged societal groups (such as females) compared with advantaged groups (e.g. males). Given that persistent symptoms are observed across a range of disadvantaged, minoritized, and neurodivergent groups (e.g. low compared with high socio-economic status [SES]), the intersection of individual characteristics may be an important moderator of inequality.MethodsData from HeadStart Cornwall (N = 4441) was used to assess the effect of youth adversity on combined symptoms of depression and anxiety (Strengths and Difficulties Questionnaire emotional problems subscale) measured at three time-points in 11–14-year-olds. Latent trajectories and regressions were estimated for eight intersectionality profiles (based on gender, SES, and hyperactivity/inattention), and …

BackgroundAlthough genetic and environmental factors are involved in the aetiology of bipolar disorder [BD], studies focused on their interplay are lacking. The current investigation examines interactions and correlations between polygenic risk scores [PRS] for BD and major depressive disorder [MDD] with stressful life events [SLEs] in liability for BD.MethodsThis study used data from 1715 participants (862 bipolar cases and 853 controls) taken from UK and Canadian samples. The List of Threatening Experiences Questionnaire recorded SLEs that occurred 6 months before interview for controls and 6 months prior to the first (Canadian sample) and worst (UK sample) depressive and manic episodes for bipolar cases. PRS-BD and PRS-MDD were calculated from the Psychiatric Genomics Consortium.ResultsFor the worst depressive episode, the PRS-MDD was significantly correlated with total number of SLEs (β …

BackgroundPerinatal risk factors are implicated in the development of psychopathology, but their role in bipolar disorder (BD) and hypomania is unclear. Using data from a prospective community cohort, this is the first study to investigate the association between a range of perinatal risk factors, hypomanic symptoms, and ‘high-risk’for BD in the general population. MethodsParent report of perinatal events were available for 26,040 eighteen-month-olds from the Twins Early Development Study. Subsequent self-report hypomania was measured at ages 16 (Hypomania Checklist-16; N= 2,943) and 26 (Mood Disorders Questionnaire; N= 7,748). Participants were categorised as ‘high-risk’for BD using established classifications. Linear and logistic regressions were conducted within a generalised estimating equations framework to account for relatedness in the sample. Results Prenatal alcohol exposure (β= 0.08, SE= 0.04, p=. 0002) and number of alcohol units consumed (β= 0.09, SE= 0.02, p<. 0001) were associated with hypomanic symptoms at age 16, and number of alcohol units (OR= 1.13, 95% CI: 1.06–1.21, p=. 0003) and maternal stress (OR= 1.68, 95% CI: 1.21–2.34, p=. 002) were associated with ‘high-risk’for BD age 16. Prenatal tobacco exposure (β= 0.10, SE= 0.04, p<. 0001) and number of cigarettes smoked (β= 0.10, SE= 0.01, p<. 0001) were associated with hypomanic symptoms and ‘high-risk’for BD at age 26, although these result were attenuated controlling for parental psychiatric history. LimitationsFamilial confounding could not be fully adjusted for. Rater reports include some biases. ConclusionsThese findings show perinatal risk …

Bullying behaviors and conduct problems are two forms of antisocial behavior that frequently co-occur in childhood. However, it remains unclear whether their developmental trajectories are distinct, and the extent to which different aspects of cognitive functioning account for their development. We aimed to disentangle the developmental trajectories of bullying behaviors and conduct problems, test their interrelations across childhood, and assess associations with children’s early cognitive functioning (executive functions, IQ, and theory of mind). Participants included 2,232 children from the Environmental Risk (E-Risk) Longitudinal Twin Study. We performed dual group-based trajectory modeling on combined parent and teacher reports of children’s bullying behaviors and conduct problems at 5, 7, 10, and 12 years. We assessed associations with age-5 cognitive functioning using regression analyses. We identified five developmental trajectories for bullying behaviors and four for conduct problems. The developmental course of both behaviors was interrelated most strongly amongst those with high levels. A subgroup of children was likely to transition from conduct problems to bullying behaviors as they got older. Lower IQ was associated with both antisocial behavior trajectories, whereas lower theory of mind was only associated with conduct problems trajectories. The developmental course of bullying behaviors and conduct problems is distinct, but linked across childhood. Interventions targeting bullying behaviors or conduct problems could benefit from more integration and should take into account children’s cognitive functioning.

Background Youth adversity (e.g., abuse and bullying victimisation) is robust risk factor for later mental health problems (e.g., depression and anxiety). Research shows the prevalence of youth adversity and rates of mental health problems vary by individual characteristics, identity or social groups (e.g., gender and ethnicity). However, little is known about whether the impact of youth adversity on mental health problems differ across the intersections of these characteristics (e.g., white female). This paper reports on a component of the ATTUNE research programme (work package 2) which aims to investigate the impact and mechanisms of youth adversity on depressive and anxiety symptoms in young people by intersectionality profiles. Methods The data are from 4 UK adolescent cohorts: HeadStart Cornwall, Oxwell, REACH, and DASH. These cohorts were assembled for adolescents living in distinct geographical locations representing coastal, suburban and urban places in the UK. Youth adversity was assessed using a series of self-report questionnaires and official records. Validated self-report instruments measured depressive and anxiety symptoms.  A range of different variables were classified as possible social and cognitive mechanisms. Results and analysis Structural equation modelling (e.g., multiple group models, latent growth models) and multilevel modelling will be used, with adaptation of methods to suit the specific available data, in accord with statistical and epidemiological conventions. Discussion The results from this research programme will broaden our understanding of the association between youth adversity and mental …

ObjectivesResearch shows that rates of adverse childhood experiences (ACEs) and mental health difficulties vary based on interpersonal characteristics (eg, gender, ethnicity) and their intersection (eg, White females). Little is known about the moderating role of intersectionality on the impact of ACEs on adolescent depressive/anxiety symptoms, which is the focus of the current study. It was hypothesized that the impact of ACEs would be greatest for the profile considered a priori to be most societally disadvantaged compared to the most advantaged.MethodsThe data were from 12,336 individuals aged 13 to 14 years in Cornwall, United Kingdom. ACEs were measured using local government data (eg, homelessness, household domestic violence) and self-reports of being bullied. Depressive/anxiety symptoms were measured using the SDQ. Intersectionality profiles were based on self-reported gender …

BackgroundThe current study is a secondary analysis of qualitative data collected as part of EURIPIDES, a study which assessed how patient experience data were used to improve the quality of care in National Health Service (NHS) mental health services.ObjectiveWe undertook a detailed realist secondary qualitative analysis of 10 interviews in which expressions of racialisation were unexpectedly reported. This theme and these data did not form part of the primary realist evaluation.MethodsInterviews were originally conducted with the patients (18–65 years: 40% female, 60% male) from four different geographically located NHS England mental health trusts between July and October 2017. Secondary qualitative data analysis was conducted in two phases: (1) reflexive thematic analysis and retroduction; (2) refinement of context–mechanism–outcome configurations to explore the generative mechanisms …

Background Youth adversity (e.g., abuse and bullying victimisation) is robust risk factor for later mental health problems (e.g., depression and anxiety). Research shows the prevalence of youth adversity and rates of mental health problems vary by individual characteristics, identity or social groups (e.g., gender and ethnicity). However, little is known about whether the impact of youth adversity on mental health problems differ across the intersections of these characteristics (e.g., white females). This paper reports on a component of the ATTUNE research programme (work package 2) which aims to investigate the impact and mechanisms of youth adversity on depressive and anxiety symptoms in young people by intersectionality profiles. Methods The data are from 4 UK adolescent cohorts: HeadStart Cornwall, Oxwell, REACH, and DASH. These cohorts were assembled for adolescents living in distinct geographical locations representing coastal, suburban and urban places in the UK. Youth adversity was assessed using a series of self-report questionnaires and official records. Validated self-report instruments measured depressive and anxiety symptoms. A range of different variables were classified as possible social and cognitive mechanisms. Results and analysis Structural equation modelling (e.g., multiple group models, latent growth models) and multilevel modelling will be used, with adaptation of methods to suit the specific available data, in accord with statistical and epidemiological conventions. Discussion The results from this research programme will broaden our understanding of the association between youth adversity and mental …

Background: Adolescents exposed to adversity show higher levels of depression and anxiety, with the strongest links seen in disadvantaged (eg, females, low socioeconomic status [SES]), as well as neurodivergent, groups. The intersection of these characteristics may moderate the impact of youth adversity on adolescent mental health.Aims:To investigate the moderating influence of intersectionality on the relation between youth adversity and depression and anxiety symptoms in adolescence.Methods:Depression and anxiety symptoms were measured in 13-14-year-olds in the HeadStart Cornwall cohort (N= 12,067) using the emotional problems subscale of the Strengths and Difficulties Questionnaire. Multiple group structural equation modelling was used to estimate the effects of youth adversity on combined depression and anxiety symptoms across eight intersectionality profiles. Group assignment was based on gender (female/male), SES (lower/higher), and hyperactivity/inattention (high/low). Moderation effects attributable to these characteristics and their intersections were estimated.Results:Youth adversity was associated with higher levels of depression and anxiety (compared to an absence of youth adversity), across intersectional profiles. This association was moderated by gender (stronger in males than females (β= 0.22 [0.11, 0.36])), and SES (stronger in higher compared to lower SES (β= 0.26 [0.14, 0.40])); with indications of moderation attributable to the intersection of gender and hyperactivity/inattention (β= 0.21 [-0.02, 0.44]).Conclusions:Youth adversity detrimentally impacts the mental health of 13-14-year-olds, across …

Childhood maltreatment is associated with the etiology and clinical course of bipolar disorder. Most studies employ retrospective maltreatment self-reports which are vulnerable to bias, raising questions about their validity and reliability. This study examined the test-retest reliability over 10 years, the convergent validity and the impact of current mood on retrospective reports of childhood maltreatment in a bipolar sample. 85 participants with bipolar I disorder completed the Childhood Trauma Questionnaire [CTQ] and the Parental Bonding Instrument [PBI] at baseline. Beck Depression Inventory and Self Report Mania Inventory assessed depressive and manic symptoms, respectively. 53 participants completed the CTQ at baseline and 10-year follow-up. Good levels of convergent validity were observed between the CTQ and PBI. Correlations ranged from rs= -0.35 (CTQ emotional abuse and PBI paternal care) to rs …

Adverse childhood experiences are significantly associated with a worse clinical expression of bipolar disorder, however, the literature has mainly focused on childhood maltreatment (abuse and neglect) with little attention paid to other forms of adversity, such as childhood bullying victimisation (referred to here as bullying), although this is known to have a negative impact on different psychiatric illnesses. The current study aimed to investigate the association between bullying victimisation and the clinical expression of bipolar disorder individually and in combination with childhood maltreatment. This investigation consisted of 63 individuals with a diagnosis of bipolar disorder (mean age 61.4 years) who completed the Retrospective Bullying Questionnaire and the Childhood Trauma Questionnaire to measure exposure to bullying and childhood maltreatment, respectively. The clinical expression variables were …

Background: Youth adversity is associated with persistence of depression and anxiety symptoms over time. Evidence suggests that this association may be greater for disadvantaged societal groups (such as females) compared with advantaged groups (eg, males). However, given that persistent symptoms are observed across a range of disadvantaged groups (eg, low compared with high socio-economic status [SES]), the intersection of individual characteristics may be an important moderator of inequality. Methods: Data from HeadStart Cornwall (N= 5,336) was used to assess the effect of youth adversity on symptoms of depression and anxiety, measured using the Strengths and Difficulties Questionnaire emotional problems subscale, at three time-points in 11-14-year-olds. Latent trajectories and regression coefficients were estimated for eight intersectionality profiles (based on gender, SES, and hyperactivity/inattention) within a multiple group structural equation model. Compound parameters were specified to estimate the moderating effects of the individual characteristics and their intersections. Results: Youth adversity, compared with an absence of such, was associated with higher average depression and anxiety symptoms at baseline (11-12-years), across all intersectionality profiles. The magnitude of the effect of youth adversity differed across profiles, and there was weak evidence to suggest that the effect of youth adversity on the average rate of change in depression and anxiety symptoms was moderated by the intersection of, i) gender and SES, and ii) gender, SES, and hyperactivity/inattention. Conclusions: Youth adversity has …

Adverse childhood experiences (ACEs) can harm mental health across the lifespan and reduce life expectancy. We provide a commentary of evidence on the health impacts, and how creative arts and digital interventions may support prevention and recovery.

Islamic identity is a way of life which guides and determines various aspects of behaviours and interactions amongst Muslim populations. Islamic norms, values, and practices can present unique challenges and conflicting discourse for Muslim adolescents living in the United Kingdom. The presence of acculturative pressures to maintain and negotiate traditional, cultural, and religious identities, in addition to exposure to violence in the form of increasing Islamophobic narratives (including bullying in schools), highlights this population as having unique needs when maintaining mental wellbeing. This chapter presents a discussion of the wellbeing of Muslim adolescents attending British schools within the context of bullying and cultural diversity and identity.

Intimate partner violence (IPV) is a continuum of abuse that is associated with a number of negative outcomes including substance misuse, depression, and suicidal ideation. This study aims to investigate the intergenerational transmission of IPV perpetration and the mechanisms involved. Intergenerational transmission was investigated using information from two generations of the Cambridge Study in Delinquent Development which is a prospective longitudinal study of 411 males from an inner London area in the UK who have been followed up over a period of 50 years. Information with regard to IPV perpetration, specifically physical violence, was garnered from self-reports by the male at age 32, from their female partner at age 48, and from their male and female children in early adulthood. Regression analyses were used to investigate intergenerational transmission and examine whether psychosocial risk …

Adverse childhood experiences (ACEs) are a serious public health concern. They effect mental health across the lifespan, lead to social, emotional and cognitive impairment and reduce life expectancy by up to 20 years. Young people experiencing ACEs are highly vulnerable, and therapeutic service provision has limited capacity and in some places poor access (eg isolated rural localities). Research, policy and practice is becoming more cognisant of the needs of people living with the consequences of ACEs. However, individual and social factors (ie age, ethnic and gender identity, neurodiversity) are neglected. Arts interventions are recognised as offering significant benefits, especially for culturally diverse groups and young people, and for those with limited literacy or inability to verbally express and articulate their emotional worries. Digital and creative arts interventions offer a range of creative opportunities, involving emotional activation and processing, and all self-determined in terms of the degree of participation in preferred creative activities. So the interventions may be personalised and ensure ACE exposed young people are not re-traumatised and have a positive experience of therapeutic efforts. This paper provides a rapid scoping review of the empirical evidence on creative arts and digital interventions for prevention of ACEs and recovery from the mental health consequences of ACEs.

Purpose Bullying behaviours and other conduct problems often co-occur. However, we do not yet know whether bullying behaviours are associated with early factors and later poor outcomes independently of conduct problems. While there are differing, specific interventions for bullying behaviours and for conduct problems, it is unclear if such specificity is justified given parallels between both behaviours. Methods We used prospective data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative sample of 2232 children. Mothers and teachers reported on children’s bullying behaviours and conduct problems at ages 7 and 10. We collected measures of risk factors, including temperament and family factors, when children were age 5. We assessed behavioural, emotional, educational and social problems when participants …

Bullying‐victimisation has been associated with sleep disturbances. This study investigated the degree to which subtypes of bullying‐victimisation in adolescence are linked with sleep disturbances. Genetic and environmental contributions underlying bullying‐victimisation and sleep disturbances were investigated. Participants (3,242–5,076 pairs) from a longitudinal community twin study reported on their bullying‐victimisation at the age of 14 years, and sleep quality and insomnia symptoms at age 16. Regression analyses were used, accounting for the role of individual and family factors. Structural equation twin model fitting was conducted. Bullying‐victimisation was modestly associated with sleep quality and insomnia symptoms (r = 0.22–0.23) and a similar strength of associations was found across bullying‐victimisation subtypes (r = 0.11–0.22). Bullying‐victimisation, sleep quality and insomnia symptoms were …