COVID-19: changing fields of social work practice with children and young people

Drawing on the theoretical work of Wacquant, Bourdieu and Foucault, we interrogate how the COVID-19 pandemic has weaponised child and family social work practices through reinvigorated mechanisms of discipline and surveillance. We explore how social workers are caught in the struggle between enforcement and relational welfare support. We consider how the illusio of social work obscures power dynamics impacting children, young people and families caught in child welfare systems, disproportionately affecting classed and racialised individuals

An empirical study validating a measure of service support for CBT and a systematic review of the prevalence of co-occurring Post-traumatic Stress Disorder and Obsessive-Compulsive Disorder

The following large-scale research project (LSRP) comprises of two papers which are thematically distinct. The first half of the LSRP presents an empirical paper which validates a measure of service support for Cognitive Behavioural Therapy (CBT). The second paper is focused on establishing the prevalence of co-occurring PTSD and OCD. Both papers are unrelated to an initial LSRP project planned in 2018-19, which fell through due to service issues. A second empirical project was designed which focused on predictors of therapist competence and NHS ethical approval and sought to recruit practitioners delivering CBT for PTSD as part of a randomised controlled trial. This project used a novel measure of service support for CBT. This measure had not been previously validated and as a result preliminary tests of validity were embedded within the study design. As a result of delays in NHS ethics and recruitment for this project, a third study was designed, which focused primarily on the validation of this measure. This study was approved by Cardiff University’s ethics committee. The systematic review was devised when the second project was in preparation, and as a result is thematically linked to PTSD. CBT has become more widely available to the public through the National Health Service (NHS).. The evidence-base for the effectiveness of CBT is extensive and is predicated on the availability of supports for therapists. The degree to which the delivery of CBT is supported by appropriate infrastructure and resource is not yet clear. The first paper aims to address this issue through validating a measure of service support for CBT. An existing measure is reviewed by a panel of experts before being piloted with a diverse sample of CBT therapists. The resulting measure is shorter and is comprised of six thematically distinct components: access to physical resources; suitability of the clinical environment; clinical supervision; time to offer flexible sessions and prepare; working outside the clinic; professional development. It has demonstrated good content validity, temporal stability and internal consistency. Construct validity is demonstrated through positive correlations with work engagement and practitioner wellbeing. Therapist recruitment stalled during the development of the COVID-19 pandemic and a smaller sample was recruited than planned. The study confirmed that the measure is a valid and reliable index of service support and extends the application of the Job-Demands-Resources (JDR) model (a model of occupational stress) to CBT practitioners. The JDR model suggests that job resources stimulate work engagement which in turn predicts positive organisational outcomes such as work performance. The study confirmed that support for the delivery of CBT was associated with better engagement with work and greater practitioner wellbeing. Future research may therefore wish to address whether job resources can influence practitioner competence or clinical outcomes. The second paper is focused on establishing the prevalence of co-occurring PTSD and OCD. Information available to the public indicates that PTSD and OCD commonly co-occur. However, it is not clear whether this is supported by high quality research evidence. Related systematic reviews have indicated that trauma may lead to the development of OCD, with some authors suggesting that the presence or absence of PTSD is not relevant. This review therefore aimed to clarify the prevalence of co-occurring OCD and PTSD through a systematic review of the literature. A broad search strategy was devised, and four relevant databases were searched. Data was extracted from twenty-five relevant articles, which were quality assessed and reviewed. This review highlighted that there are few studies which address this research question. Most report rates of co-morbidity across multiple psychiatric disorders. As a result, most studies recruit samples which are too small to estimate the prevalence of co-occurring PTSD and OCD specifically. Furthermore, significant methodological differences across studies make it difficult to compare across groups and a wide range of current and lifetime prevalence rates are reported. The review suggested that some populations may show higher rates of co-morbidity, including those accessing specialist treatment, women and veterans. Some studies indicated that OCD is more prevalent among those with diagnoses of PTSD than those with an experience of trauma (but no PTSD). Several studies indicate that a majority of people develop OCD after PTSD, and that this group may also experience more severe symptoms. Both reviews make contributions to clinical practice. The first paper refines and validates an index of service support for CBT which may be used for clinical audit and service development. It also suggests that service providers concerned with employee engagement and wellbeing may look to workplace resources to support staff. The second paper indicates that specific groups may be more vulnerable to developing co-morbid PTSD and OCD and require a thorough assessment to inform treatment planning

Service support, work engagement and psychological wellbeing: Validating an index of resource and infrastructure support for the delivery of CBT

Background: Effective dissemination of cognitive behavioural therapy (CBT) has been assisted by clearly defined competencies, skills and activities, and validated scales used to measure therapist competence and adherence. However, there is no validated measure of the resource and infrastructure support therapists require to enable them to deliver CBT in line with best practice. Aims: This study aimed to validate an index of resource infrastructure and support for the delivery of CBT. Method: This study took an existing questionnaire developed by Groom and Delgadillo (2012) and aimed to establish its psychometric properties through expert review and a pilot study. Results: This resulted in a shorter questionnaire with good content validity, internal consistency (α = 0.80) and temporal stability (r = 0.74, p < .00). The index consists of six components, and construct validity was demonstrated through positive association with measures of work engagement (r = 0.31, p < .00) and practitioner wellbeing (r = 0.47, p < .00). Conclusions: The questionnaire provides a valid and reliable index of service support for delivering CBT, and is positively related to engagement and wellbeing among CBT practitioners

A Facile Method for the Non-Covalent Amine Functionalization of Carbon-Based Surfaces for Use in Biosensor Development

Affinity biosensors based on graphene field-effect transistor (GFET) or resistor designs require the utilization of graphene’s exceptional electrical properties. Therefore, it is critical when designing these sensors, that the electrical properties of graphene are maintained throughout the functionalization process. To that end, non-covalent functionalization may be preferred over covalent modification. Drop-cast 1,5-diaminonaphthalene (DAN) was investigated as a quick and simple method for the non-covalent amine functionalization of carbon-based surfaces such as graphene, for use in biosensor development. In this work, multiple graphene surfaces were functionalized with DAN via a drop-cast method, leading to amine moieties, available for subsequent attachment to receptor molecules. Successful modification of graphene with DAN via a drop-cast method was confirmed using X-ray photoelectron spectroscopy (XPS), Raman spectroscopy and real-time resistance measurements. Successful attachment of receptor molecules also confirmed using the aforementioned techniques. Furthermore, an investigation into the effect of sequential wash steps which are required in biosensor manufacture, on the presence of the DAN layer, confirmed that the functional layer was not removed, even after multiple solvent exposures. Drop-cast DAN is thus, a viable fast and robust method for the amine functionalization of graphene surfaces for use in biosensor development

Correction: The psychiatric phenotypes of 1q21 distal deletion and duplication.

Copy number variants are amongst the most highly penetrant risk factors for psychopathology and neurodevelopmental deficits, but little information about the detailed clinical phenotype associated with particular variants is available. We present the largest study of the microdeletion and -duplication at the distal 1q21 locus, which has been associated with schizophrenia and intellectual disability, in order to investigate the range of psychiatric phenotypes. Clinical and cognitive data from 68 deletion and 55 duplication carriers were analysed with logistic regression analysis to compare frequencies of mental disorders between carrier groups and controls, and linear mixed models to compare quantitative phenotypes. Both children and adults with copy number variants at 1q21 had high frequencies of psychopathology. In the children, neurodevelopmental disorders were most prominent (56% for deletion, 68% for duplication carriers). Adults had increased prevalence of mood (35% for deletion [OR = 6.6 (95% CI: 1.4–40.1)], 55% for duplication carriers [8.3 (1.4–55.5)]) and anxiety disorders (24% [1.8 (0.4–8.4)] and 55% [10.0 (1.9–71.2)]). The adult group, which included mainly genetically affected parents of probands, had an IQ in the normal range. These results confirm high prevalence of neurodevelopmental disorders associated with CNVs at 1q21 but also reveal high prevalence of mood and anxiety disorders in a high-functioning adult group with these CNVs. Because carriers of neurodevelopmental CNVs who show relevant psychopathology but no major cognitive impairment are not currently routinely receiving clinical genetic services widening of genetic testing in psychiatry may be considered

Chromosome 17q12 duplications: Further delineation of the range of psychiatric and clinical phenotypes

Copy number variants at chromosome 17q12 have been associated with a spectrum of phenotypes. Deletions of 17q12 are well described and associated with maturity onset diabetes of the young type 5 (MODY5) and cystic renal disease (HNF1β) as well as cognitive impairment and seizures. Duplication of 17q12 is emerging as a new genetic syndrome, associated with learning disability, seizures, and behavioral problems. The duplication is often inherited from an apparently unaffected parent. Here, we describe a three‐generation family with multiple individuals carrying a17q12 microduplication with varying clinical features, consistent with variable penetrance. The proband who inherited a 1.8 Mb interstitial 17q12 duplication from his mother presented with developmental delay, behavioral problems, and mild dysmorphism. One of his sisters, his maternal uncle, and his maternal grandmother also carry the 17q12 microduplication. Clinical features of the carriers include renal problems, diabetes mellitus, learning difficulties, epilepsy and mental illness. Cognitive abilities range from normal function to moderate impairment (full‐scale IQ range: 52‐99). In light of recent reports of association of this locus with schizophrenia, we performed a detailed psychiatric assessment and confirmed that one family member has symptoms consistent with a diagnosis of schizophrenia and another has a prodromal syndrome with attenuated positive symptoms of psychosis. This report extends the clinical phenotype associated with the 17q12 microduplication and highlights the phenotypic variability

The psychiatric phenotypes of 1q21 distal deletion and duplication

Funder: RCUK | Medical Research Council (MRC); doi: https://doi.org/10.13039/501100000265Funder: Wellcome Trust (Wellcome); doi: https://doi.org/10.13039/100004440Funder: Waterloo Foundation (TWF); doi: https://doi.org/10.13039/100012107Funder: Health and Care Research Wales (Ymchwil Iechyd a Gofal Cymru); doi: https://doi.org/10.13039/100012068Funder: Simons Foundation; doi: https://doi.org/10.13039/100000893Abstract: Copy number variants are amongst the most highly penetrant risk factors for psychopathology and neurodevelopmental deficits, but little information about the detailed clinical phenotype associated with particular variants is available. We present the largest study of the microdeletion and -duplication at the distal 1q21 locus, which has been associated with schizophrenia and intellectual disability, in order to investigate the range of psychiatric phenotypes. Clinical and cognitive data from 68 deletion and 55 duplication carriers were analysed with logistic regression analysis to compare frequencies of mental disorders between carrier groups and controls, and linear mixed models to compare quantitative phenotypes. Both children and adults with copy number variants at 1q21 had high frequencies of psychopathology. In the children, neurodevelopmental disorders were most prominent (56% for deletion, 68% for duplication carriers). Adults had increased prevalence of mood (35% for deletion [OR = 6.6 (95% CI: 1.4–40.1)], 55% for duplication carriers [8.3 (1.4–55.5)]) and anxiety disorders (24% [1.8 (0.4–8.4)] and 55% [10.0 (1.9–71.2)]). The adult group, which included mainly genetically affected parents of probands, had an IQ in the normal range. These results confirm high prevalence of neurodevelopmental disorders associated with CNVs at 1q21 but also reveal high prevalence of mood and anxiety disorders in a high-functioning adult group with these CNVs. Because carriers of neurodevelopmental CNVs who show relevant psychopathology but no major cognitive impairment are not currently routinely receiving clinical genetic services widening of genetic testing in psychiatry may be considered