̽��ֱ�� of Cambridge - Anne-Laura van Harmelen

Study identifies brain networks that play crucial role in suicide risk

cjb250 — Mon, 02 Dec 2019 01:00:15 +0000

̽��ֱ��facts in relation to suicide are stark: 800,000 people die globally by suicide every year, the equivalent of one every 40 seconds. Suicide is the second leading cause of death globally among 15-29 year olds. More adolescents die by suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease combined. As many as one in three adolescents think about ending their lives and one in three of these will attempt suicide.

“Imagine having a disease that we knew killed almost a million people a year, a quarter of them before the age of thirty, and yet we knew nothing about why some individuals are more vulnerable to this disease,” said Dr Anne-Laura van Harmelen, co-first author from the ̽��ֱ�� of Cambridge. “This is where we are with suicide. We know very little about what’s happening in the brain, why there are sex differences, and what makes young people especially vulnerable to suicide.”

A team of researchers, including Hilary Blumberg, MD, John and Hope Furth Professor of Psychiatric Neuroscience at Yale, carried out a review of two decades’ worth of scientific literature relating to brain imaging studies of suicidal thoughts and behaviour. In total, they looked at 131 studies, which covered more than 12,000 individuals, looking at alterations in brain structure and function that might increase an individual’s suicide risk.

Combining the results from all of the brain imaging studies available, the researchers looked for evidence of structural, functional, and molecular alterations in the brain that could increase risk of suicide. They identified two brain networks – and the connections between them – that appear to play an important role.

̽��ֱ��first of these networks involves areas towards the front of the brain known as the medial and lateral ventral prefrontal cortex and their connections to other brain regions involved in emotion. Alterations in this network may lead to excessive negative thoughts and difficulties regulating emotions, stimulating thoughts of suicide.

̽��ֱ��second network involves regions known as the dorsal prefrontal cortex and inferior frontal gyrus system. Alterations in this network may influence suicide attempt, in part, due to its role in decision making, generating alternative solutions to problems, and controlling behaviour.

̽��ֱ��researchers suggest that if both networks are altered in terms of their structure, function or biochemistry, this might lead to situations where an individual thinks negatively about the future and is unable to control their thoughts, which might lead to situations where an individual is at higher risk for suicide.

“ ̽��ֱ��review provides evidence to support a very hopeful future in which we will find new and improved ways to reduce risk of suicide,” said Professor Hilary Blumberg. “ ̽��ֱ��brain circuitry differences found to converge across the many studies provide important targets for the generation of more effective suicide prevention strategies. “It is especially hopeful that scientists, such as my co-authors on this paper, are coming together in larger collaborative efforts that hold terrific promise.”

̽��ֱ��majority of studies so far have been cross-sectional, meaning that they take a ‘snapshot’ of the brain, rather than looking over a period of time, and so can only relate to suicidal thoughts or behaviours in the past. ̽��ֱ��researchers say there is an urgent need for more research that looks at whether their proposed model relates to future suicide attempts and at whether any therapies are able to change the structure or function of these brain networks and thereby perhaps reduce suicide risk.

̽��ֱ��review highlighted the paucity of research into suicide, particularly into sex differences and among vulnerable groups. Despite suicidal thoughts often first occurring as early as during adolescence, the majority of studies focused on adults.

“ ̽��ֱ��biggest predictor of death by suicide is previous suicide attempt, so it’s essential that we can intervene as early as possible to reduce an individual’s risk,” said co-first author Dr Lianne Schmaal from the ̽��ֱ�� of Melbourne. “For many individuals, this will be during adolescence. If we can work out a way to identify those young people at greatest risk, then we will have a chance to step in and help them at this important stage in their lives.”

Even more striking, despite the fact that transgender individuals are at increased risk for suicide, just one individual in the 131 samples included for the review was identified to be transgender.

“There are very vulnerable groups who are clearly not being served by research for a number of reasons, including stigma and the need to prioritise treatment,” said van Harmelen. “We urgently need to study these groups and find ways to help and support them.”

In 2018, the researchers launched the HOPES (Help Overcome and Prevent the Emergence of Suicide) study, supported by the mental health research charity MQ. HOPES brings together data from around 4,000 young people across 15 different countries in order to develop a model to predict who is at risk of suicide. Over the course of the project, the team will analyse brain scans, information on young people's environment, psychological states and traits in relation to suicidal behaviour from young people from across the world, to identify specific, universal risk-factors.

̽��ֱ��research was supported by the mental health charity MQ Brighter Futures Award Program, National Institutes of Health, Department of Veterans Affairs, NHMRC, Royal Society Dorothy Hodgkin Fellowship, American Foundation for Suicide Prevention, Brain and Behavior Foundation, Robert E. Leet and Clara M. Guthrie Patterson Trust, and For the Love of Travis Foundation.

Reference
Schmaal, L, van Harmelen, A.-L. et al. Imaging suicidal thoughts and behaviors: a comprehensive review of 2 decades of neuroimaging studies. Molecular Psychiatry; 2 Dec 2019; DOI: 10.1038/s41380-019-0587-x

An international team of researchers has identified key networks within the brain which they say interact to increase the risk that an individual will think about – or attempt – suicide. Writing in Molecular Psychiatry, the researchers say that their review of existing literature highlights how little research has been done into one of the world’s major killers, particularly among the most vulnerable groups.

Imagine having a disease that we knew killed almost a million people a year, a quarter of them before the age of thirty, and yet we knew nothing about why some individuals are more vulnerable to this disease. This is where we are with suicide

Anne-Laura van Harmelen

_LewiZ

Depression

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Cambridge Science Festival returns for milestone 25th year

Anonymous — Fri, 25 Jan 2019 15:48:27 +0000

Celebrating its 25th year, the Festival runs for two weeks from 11-24 March and explores the theme of ‘discoveries’. An impressive line-up of acclaimed scientists includes microscopist Professor Dame Pratibha Gai, Astronomer Royal Professor Lord Martin Rees, 2018 Nobel prize winner Sir Gregory Winter, geneticist Dr Giles Yeo, statistician Professor David Spiegelhalter, engineer Dr Hugh Hunt, marine biologist and author Helen Scales, THIS Institute Director Professor Mary Dixon-Woods, futurist Mark Stevenson, and science presenter Steve Mould.

̽��ֱ��full programme is teeming with events ranging from debates, talks, exhibitions, workshops and interactive activities to films, comedy and performances, held in lecture theatres, museums, cafes and galleries around Cambridge. There are events for all ages and most are free.
With so many events on offer, audiences will be spoilt for choice. Some of the biggest events in week one include:

Is technology making us miserable? (11 March). Virtually every interaction we have is mediated through technology. Despite being ‘always-on’, are we any better off? Are we better connected? Or is technology making us miserable?
Putting radioactivity in perspective (12 March). Following a renewal of electricity generated by nuclear power, Professors Ian Farnan and Gerry Thomas, Imperial College London, discuss radioactivity in the natural world and the outcomes of decades of study on the health effects of radiation. Could these research outcomes reset attitudes towards radiation and the risks?
̽��ֱ��universe of black holes (13 March). Christopher Reynolds, Plumian Professor of Astronomy, describes how future research into black holes may yet again change our view of reality.
̽��ֱ��long-term perspective of climate change (14 March). Professors Ulf Büntgen, Mike Hulme, Christine Lane, Hans W Linderholm, Clive Oppenheimer, Baskar Vira, and Paul J Krusic discuss how we investigate past climate and the challenges we face in applying this to the policy-making process.
Catalytic activation of renewable resources to make polymers and fuels (15 March). Professor Charlotte Williams, ̽��ֱ�� of Oxford, discusses the development of catalysts able to transform carbon dioxide into methanol, a process which may deliver more sustainable liquid transport fuels in the future.
Does the mother ever reject the fetus? (15 March). Professor Ashley Moffett discusses fetal rejection and explores new discoveries that show that there are multiple mechanisms to ensure there is a peaceful environment in the uterus, where the placenta is allowed to grow and develop to support the fetus.

Top picks for the second week include:

Cambridge gravity lecture: Sir Gregory Winter (18 March). Sir Gregory is a molecular biologist and 2018 Nobel Laureate best known for his work on developing technologies to make therapeutic monoclonal antibodies. His research has led to antibody therapies for cancer, rheumatoid arthritis and multiple sclerosis.
Discoveries leading to new treatments for dementia (18 March). Professor of Clinical Neurosciences and Associate Director of the UK Dementia Research Institute, Giovanna Mallucci discusses how new research leading to insights into dementia and degenerative brain diseases may lead to new treatments.
Improving quality and safety in healthcare (19 March). THIS Institute Director Professor Mary Dixon-Woods looks at the challenges to improving quality and safety in healthcare and considers why it’s so hard to answer the question: Does quality improvement actually improve quality? With Dr Fiona Godlee, Editor in Chief of ̽��ֱ��BMJ.
Immunology: the future of medicine? (19 March) Professor Clare Bryant and a panel of Cambridge immunologists discuss how understanding disease triggers may enable entirely new approaches to treating and potentially preventing disease.
Polar ocean: the dead end of plastic debris (19 March). An estimated 80% of all the litter in our oceans is plastic, and a significant concentration of plastics debris is found in both polar oceans. ̽��ֱ��impact of this debris on the sensitive polar ecosystem could be profound. Pelagic marine ecologist Dr Clara Manno, British Antarctic Survey, explores the current research and existing situation in the polar regions.
Reluctant futurist (19 March). Old models for healthcare, education, food production, energy supply and government are creaking under the weight of modern challenges. Futurist Mark Stevenson looks at the next 30 years and asks, how can we re-invent ourselves for the future?
Adolescent mental health: resilience after childhood adversity (20 March). Adolescence is characterised by huge physiological changes as well as a rapid rise in mental health disorders. Around 45% of adolescent mental health problems are caused by childhood difficulties but fortunately not all who experience difficulties develop mental health disorders. Dr Anne-Laura van Harmelen discusses mechanisms that may help adolescents with a history of childhood difficulty to become more resilient.
Making algorithms trustworthy (21 March). Increasingly, algorithms are being used to make judgements about sensitive parts of our lives. How do we check how their conclusions were arrived at, and if they are valid and fair? Professor David Spiegelhalter looks at efforts to make algorithms transparent and trustworthy, using systems that make predictions for people with cancer as an example.
On the future: prospects for humanity (22 March). Professor Lord Martin Rees argues that humanity’s prospects on Earth and in space depend on our taking a different approach to planning for tomorrow.

This year’s Cambridge Science Festival also celebrates significant milestones in science, including the 200th anniversary of Cambridge Philosophical Society, Cambridge’s oldest scientific society, and 150 years since the publication of the modern Periodic Table.

Speaking ahead of the Festival, Dr Lucinda Spokes, Festival Manager, said: “We are tremendously proud of this year’s programme due to the variety of events and the calibre of our speakers from a range of institutions and industries.

“Alongside the meatier topics we have an array of events for all ages and interests across both weekends. We have everything from the science of perfumery and how your mood affects your taste, to a science version of 'Would I Lie to You?'

“One of my personal top picks are the open days at the various institutes and departments based at the West Cambridge site on Saturday 23 March. As always, the site is hosting some truly fascinating events, everything from the future of construction and how to make Alexa smarter, to how nanotechnology is opening up new routes in healthcare, and state-of-the-art approaches to low-cost solar energy and high-efficiency lighting solutions.

“A Festival of this magnitude would not be possible without the help from many people; we thank all our scientists, supporters, partners and sponsors, without whom the Festival would not happen. Most of all, we thank the audiences – there are more than 60,000 visits to the Festival events every year. We very much look forward to welcoming everyone from all ages to join us in March to explore the fabulous world of science.”

You can download the full programme here.

Bookings open on Monday 11 February at 11am.

This year’s Festival sponsors and partners are Cambridge ̽��ֱ�� Press, AstraZeneca, MedImmune, Illumina, TTP Group, Science AAAS, Anglia Ruskin ̽��ֱ��, Astex Pharmaceuticals, Cambridge Science Centre, Cambridge Junction, IET, Hills Road 6th Form College, British Science Week, Cambridge ̽��ֱ�� Health Partners, Cambridge Academy for Science and Technology, and Walters Kundert Charitable Trust. Media Partners: BBC Radio Cambridgeshire and Cambridge Independent.

̽��ֱ��2019 Cambridge Science Festival is set to host more than 350 events as it explores a range of issues that affect today’s world, from challenges around climate change policy, improving safety and quality in healthcare, and adolescent mental health, to looking at what the next 25 years holds for us and whether quantum computers can change the world.

We have everything from the science of perfumery and how your mood affects your taste, to a science version of 'Would I Lie to You?'

Dr Lucinda Spokes

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Recalling happy memories during adolescence can reduce risk of depression

cjb250 — Mon, 14 Jan 2019 16:04:02 +0000

Depression is now the leading cause of disability worldwide, affecting more than 300 million people. ̽��ֱ��condition often first emerges in adolescence, a critical developmental time period when an individual experiences substantial changes in their brain structure and chemistry. A known risk factor of depression is exposure to early life stress, such as illness, parents’ separation or death, or adverse family circumstances.

“Mental health disorders that first occur in adolescence are more severe and more likely to recur in later life,” says Dr Anne-Laura van Harmelen from the Department of Psychiatry at the ̽��ֱ�� of Cambridge, the study’s senior author. “With child and adult mental health services underfunded and overstretched, it is critical that we identify new ways to build resilience, particularly in those adolescents who are most at risk for depression.”

People often engage in reminiscing about past events during their everyday lives, sometimes as a strategy for lifting their mood when they feel sad. A team of researchers from the ̽��ֱ�� of Cambridge and ̽��ֱ�� College London set out to examine whether remembering positive experiences could prove an important way of protecting ourselves against stress when it occurs in adolescence.

To test their hypothesis, the researchers analysed data from 427 young people, average age of 14 years, from Cambridge and the surrounding area, all of whom were considered to be at risk of depression. They examined the effect of recalling positive memories on two signs of vulnerability to depression: negative self-related thoughts and high morning levels of the stress hormone cortisol. ̽��ֱ��results are published today in Nature Human Behaviour.

At the start of the experiment, all participants took part in a ‘cued recall Autobiographical Memory Test’. This involved giving the participants a word – either positive or negative – and asking them to recall a specific memory related to the word. Previous studies have shown that people who are depressed find it difficult to recall specific memories, relying instead on more general recollections.

In a semi-structured interview, the participants reported on the frequency of moderate to severe negative life events in the past 12 months. In addition, they self-reported any symptoms of depression during the previous two weeks and negative self-related thoughts. ̽��ֱ��interviews were then repeated 12 months later. ̽��ֱ��researchers also took saliva samples across four days at both the start of the study and after a year to examine levels of morning cortisol.

̽��ֱ��team found that recalling specific positive memories was associated with fewer negative self-related thoughts and with lower levels of cortisol 12 months later. In other words, remembering more specific positive events reduced their vulnerability to depression over the course of one year. Further investigation showed that recalling positive events only reduced negative self-related thoughts and depressive symptoms in response to stressful life events, but not if the adolescents had experienced no stressful life events.

“Our work suggests that ‘remembering the good times’ may help build resilience to stress and reduce vulnerability to depression in young people,” says Adrian Dahl Askelund, the study’s lead author. “This is important as we already know that it is possible to train people to come up with specific positive memories. This could be a beneficial way of helping support those young people at risk of depression.”

̽��ֱ��research was funded by the Aker Scholarship, the Royal Society and Wellcome.

Reference
Askelund, A. D. et al. Positive memory specificity is associated with reduced vulnerability to depression. Nature Human Behaviour; 14 Jan 2019; DOI: 10.1038/s41562-018-0504-3

Recalling positive events and experiences can help protect young people against depression in later life, suggests new research published today.

Our work suggests that ‘remembering the good times’ may help build resilience to stress and reduce vulnerability to depression in young people

Adrian Dahl Askelund

minanfotos

Friends at sunrise

Researcher profile: Dr Anne-Laura van Harmelen

“From the very beginning of my research career, I have been determined to understand what happens in individuals suffering from the consequences of childhood adversity,” says Dr Anne-Laura van Harmelen.

Anne-Laura is a Royal Society Dorothy Hodgkin Fellow at the Department of Psychiatry, and a fellow of Lucy Cavendish College. She currently leads the Risk and Resilience group that examines the social, cognitive and neurobiological mechanisms that help build resilience in adolescents with a history of adversity, and the interplay between negative social experiences and the brain.

“Our research aims to understand why some young people with a history of childhood adversity develop mental health disorders, whereas others do not,” she explains. Her work has revealed the social, psychological and behavioural factors that build resilience in adolescents with a history of child abuse, including high self-esteem, good adolescent friendships and remembering positive events in response to stress.

While her research is ultimately about improving early identification of vulnerable young people with a view to providing better support and interventions, Anne-Laura also hopes that by increasing people’s understanding and awareness of adolescent mental health problems, her research will reduce social stigma surrounding adolescent mental health problems. “Reducing stigma is crucial for encouraging vulnerable adolescents to seek help.”

Robust, generalisable studies require strong designs and large samples, and children and adolescents with childhood adversity and/or mental health disorders are notoriously difficult to recruit and retain in research studies. This is why Anne-Laura’s work would not be possible without national and international collaborations, she says.

“Cambridge hosts world leaders who are at the forefront of many of the advances in our understanding of the mechanisms that underlie mental health and in the development of new treatments and ways of supporting those at risk. That’s why Cambridge is such an exciting place to be able to conduct my research.”

Anne-Laura’s work is funded by the Royal Society and MQ.

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Inside the mind of a young person

cjb250 — Thu, 15 Nov 2018 17:18:17 +0000

Mental health disorders: risks and resilience in adolescence

lw355 — Wed, 10 Oct 2018 08:25:17 +0000

When Charly Cox was diagnosed in her teenage years with depression and other mental health disorders, what lay ahead for her was “a long and painful ordeal of trial and error, guesswork and delay. I felt loss and frustration more times than I was ever gifted hope, knowledge or effective treatment.”

For Flo Sharman, who suffered from mental illness from the age of eight: “I lost my childhood to the stigma surrounding mental health.”

James Downs recovered from disordered eating and extreme emotions, but he describes the process as being “like an experimental DIY project rather than something with clear oversight and a plan.”

One in four of us experience the debilitating, isolating and traumatic effects of mental health disorders. Around 75% of adult mental health problems begin before the age of 18, disrupting education and social interactions, affecting relationships with family and friends and future job opportunities, and in some cases, costing lives.

Charly, Flo and James are among those who have lent their support – and their stories – to the mental health charity MQ to help work towards a future in which adolescents no longer face the life-altering challenge of living with these disorders.

Dr Anne-Laura van Harmelen from Cambridge’s Department of Psychiatry leads a project funded by MQ, called HOPES, and shares this vision: “Our brains undergo complex neural development during the teenage years to prepare us to take care of ourselves. However, some of these changes may be linked to a vulnerability to mental health disorders. If we can better understand what these vulnerabilities are, we can identify those at risk and treat them early, before the disorders emerge.”

But, until recently, remarkably little has been known about what’s going on inside a teenager’s head. Unravelling some of the complexity has required the combined input of psychiatrists, neuroscientists, psychologists, social scientists, computational biologists and statisticians – and the brains of hundreds of healthy teenage volunteers. ̽��ֱ��teenagers were scanned as part of the NeuroScience in Psychiatry Network (NSPN), set up in 2012 by Professor Ian Goodyer from the Department of Psychiatry with funding from the Wellcome Trust.

So far, 2,300 healthy volunteers aged 14 to 24 years have been recruited by the ̽��ֱ�� of Cambridge and ̽��ֱ�� College London for analysis through behavioural questionnaires, cognitive tests, and medical and socio-economic history. Some 300 adolescents have also had their brain anatomy and activity scanned millimetre by millimetre using MRI, a method that can reveal connections between brain activity centres.

̽��ֱ��result is one of the most comprehensive ‘circuit diagrams’ of the teenage brain ever attempted. “ ̽��ֱ��project has been a big step forward in looking inside the black box of the teenage brain,” explains Professor Ed Bullmore, who leads the NSPN. “We found that there were distinctive patterns of developmental change in brain structure and function during adolescence that could help to explain why mental health disorders often arise during late adolescence.”

For instance, Bullmore’s colleagues Dr Kirstie Whitaker and Dr Petra Vértes discovered that the outer region of the brain, known as cortical grey matter, shrinks, becoming thinner during adolescence. As this happens, the levels of myelin – the sheath that ‘insulates’ nerve fibres, allowing the fibres to communicate efficiently in the white matter – increase.

In a separate study, Dr František Váša designed a method to combine all of the scans of the structural changes in the brain through a ‘sliding window’ – as if viewing the changes in the brain network of an ‘average’ adolescent as they mature from 14 to 24 years of age. It sounds simple enough but this innovation was so complex that it took several years of statistical and computational analysis to perfect.

“We saw that the changes are greatest in the most connected ‘hub’ parts of the brain. Our interpretation is that when the brain develops it builds too many connections; then, during the teenage years, those that are used frequently are strengthened and others are ‘pruned’,” says Váša, whose PhD studies were funded by the Gates Cambridge Trust.

What makes this especially interesting is that Vértes and Whitaker also discovered that the brain areas undergoing the greatest structural changes during adolescence are those in which genes linked to risk of mental health disorders are most strongly expressed.

One of the disorders is schizophrenia, which affects 1% of the population and often starts in adolescence or early adult life. Vértes has recently been funded by MQ to search for unique patterns of brain connectivity among those who develop symptoms of schizophrenia, and to cross-reference them with patterns of gene expression across the brain. “Not only is this knowledge important for identifying new treatments that are more effective for a greater number of patients at an earlier stage, but it could also help in predicting those who are at risk,” she explains.

Another area where there has been little improvement in predicting behaviours is that of suicide – the second leading cause of death among the young.

“Around 16% of teens think about suicide and 8% report making an attempt, yet there has been little improvement in our ability to predict suicidal behaviours in 50 years,” says van Harmelen, who is a Royal Society Dorothy Hodgkin fellow. ̽��ֱ��HOPES project she leads aims to develop a model to predict who is at risk of suicide by analysing brain scans and data on suicidal behaviour of young people from across the world to identify specific, universal risk factors.

“These risk factors may be connected with traumatic and stressful events early in their lives,” she adds. “In fact, we know that about a third of all mental health problems are attributable to events such as bullying, abuse and neglect. Much of my work has been to understand the impact of these factors on the developing brain.”

She discovered that childhood adversity is related to an altering of the structure and function of parts of the brain, and that this increases vulnerability to mental health problems. Intriguingly, some adolescents with traumatic early life experiences fared a lot better than would be predicted. This ‘resilience’ was enhanced by receiving the right kind of support at the right time. She calls this ‘social buffering’ and finds that for 14-year-olds it most often comes from family members, and for 19-year-olds from friendships.

With funding from the Royal Society, she is now starting to look for biological factors that underpin resilient functioning – for instance, how does the immune system interact with the brain during periods of psychosocial stress in resilient adolescents? Are there biomarkers that can be used to predict resilience after childhood adversity?

“We are diving deeper into the factors and mechanisms that might help,” says van Harmelen. “We know there are lots of social, emotional and behavioural factors that help to build resilience, and that these factors are amenable to intervention by therapists – but which are the most important, or is it a specific combination of these factors?

“If you speak to anyone who has had a mental health problem, you will know the effect it’s had on them and their families,” she adds. “Even a minor contribution to lowering this effect through early diagnosis and treatment is worth a lot of effort.”

Video: In this video you can see the regions of the brain coloured by how much they change between 14 and 24 years of age. ̽��ֱ��darker the colour the more the myelin changes. ̽��ֱ��size of the 'nodes' of the network represents how well connected they are and halfway through the movie the smallest nodes are removed and only the hubs remain. ̽��ֱ��edges that are added in are the strongest connections between these hub regions and represent the brain's 'rich club'. Data taken from 'Adolescence is associated with genomically patterned consolidation of the hubs of the human brain connectome' by Whitaker, Vertes et al. published in PNAS in July 2016. DOI: 10.1073/pnas.1601745113 Link: http://dx.doi.org/10.1073/pnas.160174.

Read a profile of Dr František Váša on the Gates Cambridge website.

Deeper understanding of the wiring and rewiring of the adolescent brain is helping scientists pinpoint why young people are especially vulnerable to mental health problems – and why some are resilient.

If you speak to anyone who has had a mental health problem, you will know the effect it’s had on them and their families. Even a minor contribution to lowering this effect through early diagnosis and treatment is worth a lot of effort

Anne-Laura van Harmelen

Photo by Jon Tyson on Unsplash

Yes

Support from family and friends important to help prevent depression in teenagers

cjb250 — Fri, 20 May 2016 07:19:46 +0000

Adolescence is a key time in an individual’s development, and is a period where some teenagers begin to show signs of major depression. One of the major risk factors for depression in adolescence is childhood family adversity, such as poor parenting and lack of affection, emotional, physical or sexual abuse, family financial problems or the loss of a family member. Another major risk factor for depression is bullying by peers – and the combined experience of childhood family adversity and peer bullying is associated with increased severity of depression symptoms.

Studies suggest that friendships and supportive family environments may help protect adolescents from depression if they have experienced peer bullying and childhood family adversity. However, no study has simultaneously examined the complex interplay of early life adversity, bullying, family support and friendships on later adolescent depression.

Researchers at the Department of Psychiatry at the ̽��ֱ�� of Cambridge studied almost 800 teenagers (322 boys and 449 girls), and used mathematical modelling to examine the impact of friendships and family support at age 14 on depressive symptoms at age 17 in adolescents who had previously experienced childhood family adversity and primary school bullying.

“Teenage years can be difficult for everyone, but we found that this is particularly the case for those teens who have had a difficult family environment,” explains Dr Anne-Laura van Harmelen, the study’s first author. “Adolescents who had experienced negative family environments are more likely to be bullied at school, and less likely to receive family support in adolescence. We also found that children who were bullied in primary school were less likely to have supportive friendships in adolescence.

“In fact, we found a strong relationship between having a negative family environment and being bullied at primary school. This puts teens at a double disadvantage and means they are more likely to experience more severe symptoms of depression in their late teens.”

Boys who had been bullied were less likely than girls to develop strong friendships in adolescence, which the researchers suggest may be because boys experienced more severe bullying or were more sensitive to bullying.

Crucially, the researchers also found that supportive family or friends in early adolescence could help reduce depressive symptoms in later teenage years. It is not clear from the results how social support influences later life mental health. However, the researchers suggest several possibilities, including that supportive friends and family environments may help enhance children’s ability to cope with adverse situations by improving their self-esteem and offering stress-relief and through helping them develop effective interpersonal skills.

“Our work really shows how important it is that children and teenagers have strong support from their family and friends, particularly if their childhood has been a difficult one,” adds Professor Ian Goodyer, senior author. “It also suggests a role for interventions such as helping parents in at-risk families develop their parenting and support skills or helping bullied teens build their confidence and social skills to help find and maintain friendships.”

̽��ֱ��research was funded primarily by the Wellcome Trust and the Netherlands Organization for Scientific Research.

Reference
Van Harmelen, AL et al. Friendships and Family Support Reduce Subsequent Depressive Symptoms in At-Risk Adolescents. PLOS ONE; 4 May 2016; DOI: 10.1371/journal.pone.0153715

̽��ֱ��importance of friendships and family support in helping prevent depression among teenagers has been highlighted in research from the ̽��ֱ�� of Cambridge. ̽��ֱ��study, published in the open access journal PLOS ONE, also found that teenagers who had grown up in a difficult family environment were more likely than their peers to be bullied at school.

Teenage years can be difficult for everyone, but we found that this is particularly the case for those teens who have had a difficult family environment

Anne-Laura van Harmelen

Michael Coghlan

Zoe and Friend

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

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