Optimizing outcomes in children of depressed parents: Identification of modifiable promoters of sustained mental health resilience.

Children and Young People’s Mental Health PhD Scholarship 2020 - University of Cardiff

Supervisors: Stephan Collishaw, Frances Rice, Gemma Hammerton

Lay Summary:

 

Over 1 million children in the UK live with a parent with depression. They are at high risk of depression and other mental health problems. These can have a profound and long-lasting impact on young people’s education, relationships and future health.  However, whilst some develop serious mental health difficulties, others are surprisingly resilient. Very little is known about why this is. This project focuses on protective factors that help promote good mental health in studies that track the development of children of depressed parents into adult life. Previous work has pointed to important modifiable child, family, social and lifestyle factors that could be targeted by mental health intervention to forestall future mental health difficulties. However, the long-term benefits of these protective factors remain unclear. The scholarship will involve new research examining predictors of long-term mental health resilience in children of depressed parents in high-risk and unselected population cohorts. These children are now in their 20s. Young adulthood is a particularly important time, when mental health problems often first emerge and when young people often face major challenges in their lives – leaving home, going to University, gaining employment or starting a family of their own.

 

The objectives of the study are to 1) identify modifiable predictors of mental health resilience; 2) understand why, when and how protective factors have beneficial effects on mental health; and 3) work with affected families to develop new guidelines for promoting mental health in young people at risk for depression.


Aims: 

 

Aims are to 

 

1) identify modifiable child, family, social and lifestyle factors that predict sustained mental health resilience in children of depressed mothers using high-risk and population cohorts followed into adulthood; 

 

2) use longitudinal methods to examine the timing at which identified protective effects have their greatest effect, rule out alternative explanations such as reverse causation, and test whether protective mechanisms vary by gender and by child mental health outcome; and 

 

3) collaborate with stakeholders (young people, families, schools) to refine the objectives of the studentship at the outset, inform ongoing development of school- and health based depression prevention, and develop guidelines for future practice based on the study findings.

Research Student: Eglė Padaigaitė

Hi, my name is Eglė, and I am due to start my PhD in October 2020 at the MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University. I feel very fortunate to have been appointed to this post sponsored by MHRUK studentship and be given the opportunity to further develop my research skills while investigating factors promoting good mental health outcomes in young individuals at high risk for psychopathology.

 

I previously attained my undergraduate degree in Psychology at Vilnius University (Lithuania) and research master’s degree in Clinical and Cognitive Neuroscience with specialization in Psychopathology at Maastricht University (Netherlands). For my master’s thesis, I worked on Cambridge Ultrasound Sibling and Parent Study (CUSP) at the Autism Research Centre, University of Cambridge. My master’s thesis project investigated differential fetal growth trajectories in children exposed to the suboptimal intrauterine environment (i.e. androgen excess during pregnancy), and its association with autism likelihood in a child. Based on my thesis results, I am currently preparing a manuscript for publication.

 

Prior to my placement at the Autism Research Centre, I worked as a student assistant on Addenbrooke’s Cognitive Examination (ACE-R) adaptation and standardization project at Vilnius University and as a research assistant on a ‘Feigning: A cognitive dissonance analysis’ study at Maastricht University. As an undergraduate psychology student, I also interned at primary school, gymnasium, house of correction, and mental health centre. Outside of studying and research, I worked as a simulated patient for undergraduate Psychiatric Anamnesis course at Maastricht University and as an INSPIRE conference assistant at Amsterdam, Netherlands. 

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Progress report Year 1, 2021

My PhD project aims to identify which factors could explain why some young individuals raised by depressed parents do not develop mental health difficulties despite being at high familial risk for depression. I have started my research by conducting a systematic literature review. In addition to reviewing the literature on child, family, and social protective factors, this systematic literature will also aim to see if improvement in parent depression acts as a modifiable protective factor for child’s mental health. I have written the systematic review protocol, registered it in The International Database of Prospectively Registered Systematic Reviews (PROSPERO) and submitted the protocol manuscript for publication. I have also established a collaboration with another researcher who acts as a second reviewer. We have already finished screening 5250 research paper titles and abstracts. Only about 4% of studies will be included in the next full-text screening stage. Besides laying a solid foundation for my PhD project analyses, it helped me improve my data search and synthesis skills, which will be invaluable for my future career in research.  

 

To bring in the perspective of young individuals raised by depressed parents, we also set up a youth advisory group at the Wolfson Centre for Young People’s Mental Health, where I had the opportunity to hear their opinions about mental health resilience and the most important factors that could explain why some individuals face mental health struggles while others do not. I was astonished by young people’s sense of responsibility for their mental health and determination to create a better environment for themselves. It also made me realise that young individuals believe that resilience starts from within, and they are very keen to learn how to improve their mental health. The picture below shows how young adults ranked key categories for mental health resilience in order of importance (from interactive presentation software Mentimeter).

 

 

 

Currently, I am preparing an analysis plan for the first empirical thesis chapter. Working with one of the largest studies of children of depressed parents followed up on four occasions for over a decade (the Early Prediction of Adolescent Depression study), I will use a multifactorial approach to test if an individual (e.g., genetic predisposition, neurobiology, physical health, cognition, and coping skills), family (e.g., conflict and cohesion, parental control, and emotional support), and external support factors (e.g., friendships, social network, community belonging) during adolescence can predict sustained good mental health in young adulthood. Next, I will test if observed associations are causal and identify potential underlying mechanisms. My PhD project will aim to provide a more complete picture of mental health resilience and modifiable factors that could be targeted to improve the lives of depressed parents and their children.

 

Furthermore, I enrolled in various statistical training courses to learn about qualitative research methods and ways to deal with missing data in observational studies. I also presented my research ideas and study progress to the Child and Adolescence Psychiatry team, and made new connections with other postgraduate researchers while co-organising the student-led research conference at Cardiff University. In my free time, I explore Cardiff and Wales's breath-taking nature and get to meet lovely people while doing so. 

 

Finally, I would like to thank Mental Health Research UK for giving me the opportunity to work on this fascinating and very important topic. I am also very grateful to my supervisors and the Child and Adolescence Psychiatry team for such a warm, welcoming, and supportive research environment that gives me the freedom to follow my research interests, learn new things, and maintain a healthy work-life balance.

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