Early childhood adversities and its risk to eating disorders.
Eating Disorders in Young People, PhD Scholarship 2021 - University College London
Supervisors: Dr Francesca Solmi and Dr Amy Harrison
Lay Summary:
Eating disorders are severe psychiatric disorders that usually emerge in early to mid-adolescence and are becoming more common. Adolescents with eating disorders often have problems regulating or identifying their emotions. They also often present with low mood or anxiety (i.e. internalising symptoms) or conduct problems (i.e. externalising symptoms). To date, very little research has studied whether these difficulties and symptoms are present before the onset of eating disorders. This evidence is necessary to understand whether it is likely that these could be one of the factors causing eating disorders, as opposed to some of their symptoms. There is also no research that has investigated whether genetic predisposition for an eating disorder leads to difficulties regulating emotions, as well as internalising and externalising symptoms in childhood. This would suggest that these could be early signs of eating disorder risk, which could be a target for intervention.
This project will explore these questions using a range of data sources: from large longitudinal general population cohort studies, such as the Millennium Cohort Study (18,000 UK children born in 2001-2002), to primary care data on approximately 20,000 people with a diagnosed eating disorder and 80,000 controls. Taken together, evidence from this research will help to inform preventative strategies in childhood and to understand potential targets for intervention. This programme will also train a new researcher in eating disorder epidemiology, an important area which is currently largely neglected.
Scientific goal:
To investigate the role of emotion regulation, and internalising and externalising symptoms in the aetiology of eating disorders and eating disorder symptoms.
Aims:
There are three areas the student could investigate: (1) Explore the longitudinal association between emotion dysregulation, and internalising and externalising symptoms in childhood and, and disordered eating behaviours and eating disorders in adolescence; (2) Identify the trajectories of emotional and behavioural difficulties that are associated with later eating disorders diagnoses and symptoms in order to identify key developmental stages when these behaviours are associated with increased eating disorders risk; (3) Investigate whether emotion dysregulation, and internalising and externalising symptoms might represent phenotypical manifestations of genetic risk for eating disorders.
Research Student: Jane Hahn
Hi, my name is Jane. I’m starting my PhD at University College London Division of Psychiatry in October 2021.
I obtained my BA in Experimental Psychology from the University of Oxford, and I completed an MSc in Clinical Mental Health Sciences from UCL. I started working with longitudinal population data as a part of the MSc and developed a keen interest for psychiatric epidemiology. During my time as a research assistant in the UCL Division of Psychiatry, I started investigating how demographic characteristics may affect eating disorder presentation in primary care. I am passionate about exploring risk factors for eating disorders that inform preventative and accessible public interventions.
Progress Report Year 2, 2023
Progress on the first aim
This year, I completed the data analyses and drafted a chapter of my thesis based on my project investigating socioeconomic position in childhood and eating disorder symptoms in adolescence. I found that children of parents with lower socioeconomic position had higher odds of experiencing eating disorder symptoms than children of parents with higher socioeconomic position. The current literature shows that individuals of higher socioeconomic position are more likely to be diagnosed, so my results further add to the need to reduce socioeconomic inequalities in receiving diagnoses and treatment. I am hoping to publish and present my findings in conferences in the next academic year.
Progress on the second aim
I started drafting the research proposal for my project on food poverty and dietary patterns in childhood and eating disorder symptoms in adolescence. I started recruiting young people with lived experience of eating disorders in collaboration with the McPin foundation to provide input for this project.
Training & teaching
This year, I learned how to do multilevel modelling using the Bristol Learning Environment for Multilevel Methodologies and Application. Similar to last year, I have continued my role as a post-graduate teaching assistant for the MSc Clinical Mental Health Sciences at UCL. I am also supervising an MSc student’s research project on LGBTQ+ adolescents and eating disorders.
Conferences and presentations
I delivered an oral presentation (“Sociodemographic differences in clinical presentation and time to referral to mental health services of eating disorder patients in UK primary care”) and a symposium presentation (“The Every Mind Matters campaign in England: changes in mental health literacy over 30 months and associations between campaign awareness and outcomes”) at the EPA Section of Epidemiology and Social Psychiatry 20th Biennial Congress.
Progress Report Year 1, 2022
This year, I focused on developing the overarching thesis proposal for my project on childhood risk factors that are associated with eating disorder symptoms at adolescence.
Based on the literature review, I have settled on the following aims and hypothesis:
For my first aim, I will investigate the association between childhood socioeconomic status and eating disorder symptoms in adolescence. For my second aim, I hypothesize that food poverty and dietary patterns will be associated with more eating disorder symptoms in adolescence. For my third aim, I hypothesize that early mental health problem in childhood could lead to higher levels of eating disorder symptoms in adolescence. I decided to use the Avon Longitudinal Study of Parents and Children, a cohort study that contains information on mothers and their children from birth to 24 years of age, to investigate these aims.
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Progress on the first aim
After deciding the overarching narrative of the thesis proposal, I focused on developing the methods and the statistical analysis plan for the first aim. I decided to look at family income, parental occupation status, parental education attainment, financial hardship, and area-level deprivation measured in the period during pregnancy and up to 33 months after the study child is born and how these factors are linked to eating disorder symptoms at 14, 16, 18, and 24 years of age of the study child. These variables have been compiled and sent as a formal data request for ALSPAC in April. I completed the statistical analysis plan and constructed codes for data analysis. I am hoping to complete analysis by the end of the first year.
2.Training
I attended an Institute of Child Health workshop on causal inferencing and Statistics for Researchers Observational Studies to review important concepts in epidemiology. I also attended the South London and Maudsley Online Workshop for carers in order to gain further insight into caring for someone with an eating disorder. Finally, I worked as a post-graduate teaching assistant for the MSc Clinical Mental Health Sciences at UCL. My role involved leading study group, marking, assisting teaching for the epidemiology course, and supervising an MSc student’s project.
3.Further progress
I am currently working on a paper on how sociodemographic characteristics of the patients affect eating disorder detection and treatment in primary care. I will be presenting the findings as an oral presentation at the EPA Section of Epidemiology and Social Psychiatry 20th Biennial Congress.