Optimizing adult mental health outcomes in children with neurodevelopmental problems: interplay of social and genetic factors
Application deadline: 23 November 2018
Start date: October 2019
Research theme: Neuroscience and mental health
Attention deficit hyperactivity disorder (ADHD) is a common, impairing and stigmatising condition that typically first presents in early childhood. Many, but not all individuals with ADHD also develop mental health problems such as anxiety and depression as they grow older. It is not clear why children with ADHD are at high risk of later mental health problems nor why some children with ADHD fare better than others when they grow older.Understanding risk and resilience mechanisms is essential for informing future prevention and intervention programmes.
Project aims and method
The PhD will address these questions using new data from the Avon Longitudinal Study of Parents and Children (ALSPAC). The study includes repeated assessments of ADHD, co-occurring “neurodevelopmental” problems (such as autistic spectrum difficulties) and mental health problems (depression, anxiety, antisocial behaviour) from ages 4 to 25 years.
The longitudinal design allows us to chart ADHD and mental health symptom trajectories over time, and to test the interplay and direction of associations between ADHD and mental health over development. The study also includes detailed information on social and genetic risk and protective factors. This is the first prospective population-based study to track individuals from childhood to adulthood using the same multi-informant assessments of ADHD and mental health.
Almost all prior studies have focused on highly specialized samples unrepresentative of individuals with ADHD in the population. Where longitudinal follow-ups have been undertaken, studies have switched informant and assessment methods between childhood, adolescence and adulthood. This means that it has not previously been possible to longitudinally model the interplay of ADHD and mental health symptoms.
The prospective research design proposed here is essential for testing the direction of associations over time between ADHD and mental health, and for testing risk and protective factors that can impact on developmental trajectories over time. The study will test four hypotheses:
- ADHD severity and persistence predict a worsening of mental health problems over time taking account of the possibility of reverse causation,
- co-occurring neurodevelopmental problems have additional risk effects on mental health symptom trajectories in children with ADHD,
- ADHD genetic risk (polygenic risk scores) further predicts adverse mental health outcomes
- potentially modifiable protective factors in childhood (e.g. positive parenting and peer relationships) and adulthood (e.g. positive adult relationships and social support) are associated with adult mental health resilience, mitigating the combined impacts of ADHD severity and persistence, neurodevelopmental problems, and genetic risk on mental health outcomes.
This PhD project provides a unique opportunity to develop advanced methodological and analytic skills in the field of developmental psychopathology.
Dr Gemma Hammerton, University of Bristol.
Dr Jon Heron, University of Bristol.