Search

Background: The coronavirus disease 2019 (COVID-19) pandemic led to measures that reduced social contact and support. We explored whether UK residents with more frequent or supportive social contact had fewer depressive symptoms during March−August 2020, and potential factors moderating the relationship. Methods: A convenience sample of UK dwelling participants aged ⩾18 in the internet-based longitudinal COVID-19 Social Study completed up to 22 weekly questionnaires about face-to-face and phone/video social contact frequency, perceived social support, and depressive symptoms using the PHQ-9. Mixed linear models examined associations between social contact and support, and depressive symptoms. We examined for interaction by empathic concern, perspective taking and pre-COVID social contact frequency. Results: In 71 117 people with mean age 49 years (standard deviation 15), those with high perceived social support scored 1.836 (1.801–1.871) points lower on PHQ-9 than those with low support. Daily face-to-face or phone/video contact was associated with lower depressive symptoms (0.258 (95% confidence interval 0.225–0.290) and 0.117 (0.080–0.154), respectively) compared to no contact. The negative association between social relationships and depressive symptoms was stronger for those with high empathic concern, perspective taking and usual sociability. Conclusions: We found during lockdown that those with higher quality or more face-to-face or phone/video contact had fewer depressive symptoms. Contact quality was more strongly associated than quantity. People who were usually more sociable or had higher empathy had more depressive symptoms during enforced reduced contact. The results have implications for COVID-19 and potential future pandemic management, and for understanding the relationship between social factors and mental health. [ABSTRACT FROM AUTHOR]

Background: Posttraumatic stress disorder (PTSD) is highly prevalent within prison settings, yet is often unidentified and undertreated. Complex PTSD (CPTSD) has been recently formally recognised in the International Classification of Diseases 11th revision (ICD-11) diagnostic framework but has never been explored in prison settings. We aimed to establish the prevalence of ICD-11 PTSD and CPTSD in a UK prison sample using a validated instrument (the International Trauma Questionnaire). We also explored the associations of these two diagnoses with their traumatic antecedents and psychiatric comorbidities. Method: Randomly selected male, sentenced prisoners in a large medium-security prison in south London (N = 221) took part in a clinical interview which assessed PTSD, CPTSD, trauma histories, and comorbid disorders. Multinomial logistic regression was performed to examine differences between those with PTSD or CPTSD, and those without symptoms. Results: A total of 7.7% (95% CI 4.5–12) of the male sentenced prisoners met diagnostic criteria for ICD-11 PTSD and 16.7% (95% CI 12.1–22.3) for CPTSD. A diagnosis of PTSD was associated with more recent traumatic exposure, comorbid generalised anxiety disorder, alcohol dependence, and Cluster B personality disorder. A diagnosis of CPTSD was associated with complex trauma exposure antecedents (developmental, interpersonal, repeated, or multiple forms), and comorbid with anxiety, depression, substance misuse, psychosis, and ADHD. Conclusions: This study confirms that CPTSD is a very common and comorbid condition in male prisoners. There is an urgent need to develop trauma-informed care in prisons. [ABSTRACT FROM AUTHOR]

Background: The Patient Health Questionnaire (PHQ-9), the Beck Depression Inventory (BDI-II) and the Generalised Anxiety Disorder Assessment (GAD-7) are widely used in the evaluation of interventions for depression and anxiety. The smallest reduction in depressive symptoms that matter to patients is known as the Minimum Clinically Important Difference (MCID). Little empirical study of the MCID for these scales exists. Methods: A prospective cohort of 400 patients in UK primary care were interviewed on four occasions, 2 weeks apart. At each time point, participants completed all three questionnaires and a 'global rating of change' scale (GRS). MCID estimation relied on estimated changes in symptoms according to reported improvement on the GRS scale, stratified by baseline severity on the Clinical Interview Schedule (CIS-R). Results: For moderate baseline severity, those who reported improvement on the GRS had a reduction of 21% (95% confidence interval (CI) −26.7 to −14.9) on the PHQ-9; 23% (95% CI −27.8 to −18.0) on the BDI-II and 26.8% (95% CI −33.5 to −20.1) on the GAD-7. The corresponding threshold scores below which participants were more likely to report improvement were −1.7, −3.5 and −1.5 points on the PHQ-9, BDI-II and GAD-7, respectively. Patients with milder symptoms require much larger reductions as percentage of their baseline to endorse improvement. Conclusions: An MCID representing 20% reduction of scores in these scales, is a useful guide for patients with moderately severe symptoms. If treatment had the same effect on patients irrespective of baseline severity, those with low symptoms are unlikely to notice a benefit. Funding: Funding. National Institute for Health Research. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual and queer (LGBQ) women living in the United Kingdom (UK) experience worse health than their heterosexual peers throughout their lives, but less is known about health inequalities in older age. This study uses population-level data to examine inequalities among LGBQ older women and women who prefer not to disclose their sexuality, compared to heterosexual women. Analyses use data from women aged 50 and older who were active in Waves 3 and 7 of the UK Household Longitudinal Study (also known as Understanding Society) (N = 8,209) to examine inequalities in socio-economic conditions, health and alcohol consumption across sexual orientation groups. LGBQ older women are on average younger and have higher socio-economic resources than their heterosexual peers. In contrast, women who prefer not to disclose their sexual orientation are older and have the lowest income and educational qualifications. Results of the health inequalities analyses show that LGBQ older women are almost twice as likely as heterosexual older women to engage in harmful alcohol consumption. Older women who prefer not to disclose their sexuality have worse physical and mental health than heterosexual older women. The health of LGBQ older women and women who prefer not to disclose their sexual orientation is one of the most neglected research areas in UK gerontology. Findings of this study contribute to our understanding of their social and health circumstances, and illuminate methodological limitations in existing data. [ABSTRACT FROM AUTHOR]

There is conflicting empirical evidence regarding the role of awareness in second language learning. Possible explanations for the contradictory results include the modality in the exposure and assessment phases of previous experiments. Our study investigated the acquisition of a novel determiner system under incidental exposure conditions and examined the effect of modality in both exposure and assessment phases. Animacy served as a hidden regularity in the determiners, which were embedded in sentences and presented to Chinese speakers of English either in auditory or in visual mode. Learning was assessed by a two-alternative forced-choice test either auditorily or in writing. Implicit and explicit knowledge were measured using retrospective verbal reports and source judgements. Bayesian analysis provided moderate evidence for above chance level learning. Significant learning effects were observed regardless of whether participants based their accuracy judgements on explicit or implicit knowledge. Bayesian analysis showed moderate evidence for above chance learning effects for aware participants. Generalized linear mixed-effects modeling revealed a small-size significant benefit of the auditory exposure modality over the written modality but indicated no significant effect of the modality of assessment or awareness. Our research underscores the importance of considering the role of modality of exposure in incidental second language learning contexts. [ABSTRACT FROM AUTHOR]

Background. The relationship between childhood adversity (CA) and psychotic disorder is well documented. As the adequacy of the current categorical diagnosis of psychosis is being increasingly questioned, we explored independent associations between different types of CA and specific psychotic symptom dimensions in a well-characterized sample of first-episode psychosis (FEP) patients. Method. This study involved 236 FEP cases aged 18-65 years who presented for the first time to psychiatric services in South London, UK. Psychopathology was assessed with the Positive and Negative Syndrome Scale and confirmatory factor analysis was used to evaluate the statistical fit of the Wallwork/Fortgang five-factor model of psychosis. CA prior to 17 years of age (physical abuse, sexual abuse, parental separation, parental death, and being taken into care) was retrospectively assessed using the Childhood Experience of Care and Abuse Questionnaire. Results. Childhood sexual abuse [β = 0.96, 95% confidence interval (CI) 0.40-1.52], childhood physical abuse (β = 0.48, 95% CI 0.03-0.93) and parental separation (β = 0.60, 95% CI 0.10-1.11) showed significant associations with the positive dimension; while being taken into care was associated with the excited dimension (β = 0.36, 95% CI 0.08-0.65), independent of the other types of CA. No significant associations were found between parental death and any of the symptom dimensions. Conclusions. A degree of specificity was found in the relationships between different types of CA and psychosis symptom dimensions in adulthood, suggesting that distinct pathways may be involved in the CA-psychosis association. These potentially different routes to developing psychosis merit further empirical and theoretical exploration. [ABSTRACT FROM AUTHOR]

BackgroundExtensive evidence has shown that experiencing a traumatic event and post-traumatic stress disorder (PTSD) are associated with experiences of psychosis. However, less is known about specific PTSD symptoms and their relationship with psychotic experiences. This study aimed to examine the relationship between symptoms of PTSD with paranoia and auditory hallucinations in a large-scale sample.MethodThe Adult Psychiatric Morbidity Survey (APMS) was utilized to examine the prevalence of lifetime trauma, symptoms of PTSD, and experiences of paranoia and auditory hallucinations (n = 7403).ResultsThere were significant bivariate associations between symptoms of PTSD and psychotic experiences. Multiple logistic regression analyses indicated that reliving and arousal symptoms were significant predictors for paranoia while reliving, but not arousal symptoms, also significantly predicted auditory hallucinations. A dose-response relationship was found, the greater the number of PTSD symptoms, the greater the odds were of experiencing both paranoia and hallucinations.ConclusionsThese findings illustrate that symptoms of PTSD are associated with increased odds of experiencing auditory hallucinations and paranoia. Overlaps appear to be present between the symptoms of PTSD and psychotic experiences. Increasing awareness of this association may advance work in clinical practice. [ABSTRACT FROM AUTHOR]

BackgroundIdentifying childhood predictors of binge eating and understanding risk mechanisms could help improve prevention and detection efforts. The aim of this study was to examine whether features of attention-deficit/hyperactivity disorder (ADHD), as well as childhood eating disturbances, predicted binge eating later in adolescence.MethodWe studied specific risk factors for the development of binge eating during mid-adolescence among 7120 males and females from the Avon Longitudinal Study of Parents and Children (ALSPAC), a cohort study of children in the UK, using data from multiple informants to develop structural equation models. Repeated assessment of eating disturbances during childhood (mid-childhood overeating, late-childhood overeating and early-adolescent strong desire for food), as well as teacher- and parent-reported hyperactivity/inattention during mid- and late childhood, were considered as possible predictors of mid-adolescent binge eating.ResultsPrevalence of binge eating during mid-adolescence in our sample was 11.6%. The final model of predictors of binge eating during mid-adolescence included direct effects of late-childhood overeating [standardized estimate 0.145, 95% confidence interval (CI) 0.038–0.259, p = 0.009] and early-adolescent strong desire for food (standardized estimate 0.088, 95% CI −0.002 to 0.169, p = 0.05). Hyperactivity/inattention during late childhood indirectly predicted binge eating during mid-adolescence (standardized estimate 0.085, 95% CI 0.007–0.128, p = 0.03) via late-childhood overeating and early-adolescent strong desire for food.ConclusionsOur findings indicate that early ADHD symptoms, in addition to an overeating phenotype, contribute to risk for adolescent binge eating. These findings lend support to the potential role of hyperactivity/inattention in the development of overeating and binge eating. [ABSTRACT FROM AUTHOR]

BackgroundThe objective of the present study was to estimate the association between different leisure-time physical activity (LTPA) parameters from 11 to 50 years and cognitive functioning in late mid-adulthood.MethodThe study used a prospective birth cohort study including participants in the UK National Child Development Study (NCDS) from age 11 to 50 years. Standardized z scores for cognitive, memory and executive functioning at age 50 represented the primary outcome measures. Exposures included self-reported LTPA at ages 11, 16, 33, 42, 46 and 50 years. Analyses were adjusted for important confounders including educational attainment and long-standing illness.ResultsThe adjusted difference in cognition score between women who reported LTPA for at least 4 days/week in five surveys or more and those who never reported LTPA for at least 4 days/week was 0.28 [95% confidence interval (CI) 0.20–0.35], 0.10 (95% CI 0.01–0.19) for memory score and 0.30 (95% CI 0.23–0.38) for executive functioning score. For men, the equivalent differences were: cognition 0.12 (95% CI 0.05–0.18), memory 0.06 (95% CI − 0.02 to 0.14) and executive functioning 0.16 (95% CI 0.10–0.23).ConclusionsThis study provides novel evidence about the lifelong association between LTPA and memory and executive functioning in mid-adult years. Participation in low-frequency and low-intensity LTPA was positively associated with cognitive functioning in late mid-adult years for men and women. The greatest benefit emerged from participating in lifelong intensive LTPA. [ABSTRACT FROM PUBLISHER]

Background. Retrospective studies have consistently indicated an association between maladaptive parenting and borderline personality disorder (BPD). This requires corroboration with prospective, longitudinal designs. We investigated the association between suboptimal parenting and parent conflict in childhood and BPD symptoms in late childhood using a prospective sample. Method. A community sample of 6050 mothers and their children (born between April 1991 and December 1992) were assessed. Mothers' family adversity was assessed during pregnancy and parenting behaviours such as hitting, shouting, hostility and parent conflict across childhood. Intelligence quotient (IQ) and DSM-IV Axis I diagnoses were assessed at 7-8 years. Trained psychologists interviewed children at 11 years (mean age 11.74 years) to ascertain BPD symptoms. Results. After adjustment for confounders, family adversity in pregnancy predicted BPD probable 1 to 2 adversities: odds ratio (OR) = 1.34 [95% confidence interval (CI) 1.01-1.77]; >2 adversities: OR 1.99 (95% CI 1.34-2.94) and definite 1 to 2 adversities: OR 2.48 (95% CI 1.01-6.08) symptoms. Each point increase in the suboptimal parenting index predicted BPD probable: OR 1.13 (95% CI 1.05-1.23) and definite: OR 1.28 (95% CI 1.03-1.60) symptoms. Parent conflict predicted BPD probable: OR 1.19 (95% CI 1.06-1.34) and definite: OR 1.42 (95% CI 1.06-1.91) symptoms. Within the path analysis, the association between suboptimal parenting and BPD outcome was partially mediated by DSM-IV diagnoses and IQ at 7-8 years. Conclusions. Children from adverse family backgrounds, who experience suboptimal parenting and more conflict between parents, have poor cognitive abilities and a DSM-IV diagnosis, are at increased risk of BPD symptoms at 11 years. [ABSTRACT FROM AUTHOR]