Look after me too: an exploration of the Adoptive Parent Experience (APEx)

This thesis explored the lived experience of adoptive parents with emphasis on psychological wellbeing. Paper 1 examines the transition to adoptive motherhood from point of decision to adopt to end of first-year post-placement (the ‘transition’ period). Nine semi-structured interviews were analysed using Reflexive Thematic Analysis (RTA) revealing five key themes: ‘Reality not living up to expectation’, ‘Uncertainty and Powerlessness’, ‘Emotional and Physical Fatigue’, ‘Uniqueness, Difference and Isolation’ and ‘Love, Loss and Ambivalence’. Most notably, adopters reported high level of negative mental health, specifically Post Adoption Depression. Paper 2 draws from the same data set as paper 1; however, explored adopters’ sense of psychological wellbeing from transition through to time of interview. Analysis (RTA) revealed factors which challenge (‘Demands of “extreme parenting”’, ‘Strains within and across relationships’ and ‘Deprioritising self-care’) and protect (‘Development of love, attachment and sense of family identity’, ‘Learning, competence and “Therapeutic Parenting”’ and ‘The ability to “off-load”’) psychological wellbeing. Overarching, was a cry from adopters to be heard, respected and their mental wellbeing supported. Paper 3 explored the impact of COVID-19 on adopters’ psychological wellbeing. Through a mixed-method online study, 170 adopters reported on their wellbeing 3 months v post-pandemic lockdown, with a subset of 65 adopters providing longitudinal data: 6- and 9-months post-pandemic lockdown. Quantitative results indicated a robustness to adopter’s resilience as wellbeing levels remained in the ‘normal’ range at all timepoints with quality of parenting experience a significant predictive factor. Qualitative analysis (RTA) revealed themes concerning the challenges and protectors of wellbeing with the importance of connection (‘Along but not alone’ and ‘Isolation’), merging work-school-parenting-family life domains (‘Dysregulation of Family Functioning’ and ‘Merging of Life Domains’) and the value of resilience (‘Self-Care’, ‘Engaging in Self-Care’ and ‘Personal Qualities of Resilience’) highlighted. Implications for clinical practice, policy and research are discussed

‘Look after me too’: a qualitative exploration of the transition into adoptive motherhood

This qualitative retrospective recall study utilised nine in-depth, semi-structured interviews with adoptive mothers involved with an online support group often used by adoptive parents facing difficulties. The aim was to explore their transition to adoptive motherhood. The study was unusual because it covered a lengthy period, from pre-adoption and the motivation to adopt to 12 months post child placement and used Reflexive Thematic Analysis to analyse the data. Findings include the mothers’ sense of misaligned expectation, uncertainty, powerlessness, isolation, and emotional and physical fatigue. The most prominent findings centred on the high level of mental health issues reported by the mothers which included post-adoption depression, anxiety and trauma. New insights are discussed along with implications for future research and practice, along with the limitations of the study

CSF1R inhibitor JNJ-40346527 attenuates microglial proliferation and neurodegeneration in P301S mice

Neuroinflammation and microglial activation are significant processes in Alzheimer’s disease pathology. Recent genome-wide association studies have highlighted multiple immune-related genes in association with Alzheimer’s disease, and experimental data have demonstrated microglial proliferation as a significant component of the neuropathology. In this study, we tested the efficacy of the selective CSF1R inhibitor JNJ-40346527 (JNJ-527) in the P301S mouse tauopathy model. We first demonstrated the anti-proliferative effects of JNJ-527 on microglia in the ME7 prion model, and its impact on the inflammatory profile, and provided potential CNS biomarkers for clinical investigation with the compound, including pharmacokinetic/pharmacodynamics and efficacy assessment by TSPO autoradiography and CSF proteomics. Then, we showed for the first time that blockade of microglial proliferation and modification of microglial phenotype leads to an attenuation of tau-induced neurodegeneration and results in functional improvement in P301S mice. Overall, this work strongly supports the potential for inhibition of CSF1R as a target for the treatment of Alzheimer’s disease and other tau-mediated neurodegenerative diseases

Inflammatory biomarkers in Alzheimer's disease plasma

Introduction:Plasma biomarkers for Alzheimer’s disease (AD) diagnosis/stratification are a“Holy Grail” of AD research and intensively sought; however, there are no well-established plasmamarkers.Methods:A hypothesis-led plasma biomarker search was conducted in the context of internationalmulticenter studies. The discovery phase measured 53 inflammatory proteins in elderly control (CTL;259), mild cognitive impairment (MCI; 199), and AD (262) subjects from AddNeuroMed.Results:Ten analytes showed significant intergroup differences. Logistic regression identified five(FB, FH, sCR1, MCP-1, eotaxin-1) that, age/APOε4 adjusted, optimally differentiated AD andCTL (AUC: 0.79), and three (sCR1, MCP-1, eotaxin-1) that optimally differentiated AD and MCI(AUC: 0.74). These models replicated in an independent cohort (EMIF; AUC 0.81 and 0.67). Twoanalytes (FB, FH) plus age predicted MCI progression to AD (AUC: 0.71).Discussion:Plasma markers of inflammation and complement dysregulation support diagnosis andoutcome prediction in AD and MCI. Further replication is needed before clinical translatio

Parenting in the “extreme”: An exploration into the psychological well‐being of long‐term adoptive mothers

Objective: The objective of this study was to increase understanding of factors that influence adoptive mothers' psychological and emotional well‐being. The aims were to compare mothers' self‐reported emotional state 12 months after child placement to the time of the interview and to identify factors that challenge and support maternal mental health. Background: Mothers who adopt children face unique challenges that put them at a heightened risk of negative mental health. There is a need for better understanding of the influences on their psychological and emotional well‐being. Method: This qualitative study involved nine in‐depth semistructured interviews. Transcripts were analyzed using reflexive thematic analysis. Results: The themes offered broad insights, including the consistency of negative mental health across time associated with demands of 'extreme parenting,' strains within and across relationships, and deprioritizing self‐care. Factors associated with positive mental health included development of love; attachment and sense of family identity; learning, competence, and 'therapeutic parenting,' and the ability to 'offload.' Conclusion: The emotional and psychological well‐being of mothers who adopt children should be validated and recognized as important to the overall adjustment of adoptive families. Implications: Adoption agencies should take a proactive approach to addressing the mental health needs of adoptive mothers, providing comprehensive information, ongoing support, and regular assessments

Parenting in the “extreme”: an exploration into the psychological wellbeing of long-term adoptive mothers

ObjectiveThe objective of this study was to increase understanding of factors that influence adoptive mothers' psychological and emotional well-being. The aims were to compare mothers' self-reported emotional state 12 months after child placement to the time of the interview and to identify factors that challenge and support maternal mental health.BackgroundMothers who adopt children face unique challenges that put them at a heightened risk of negative mental health. There is a need for better understanding of the influences on their psychological and emotional well-being.MethodThis qualitative study involved nine in-depth semistructured interviews. Transcripts were analyzed using reflexive thematic analysis.ResultsThe themes offered broad insights, including the consistency of negative mental health across time associated with demands of “extreme parenting,” strains within and across relationships, and deprioritizing self-care. Factors associated with positive mental health included development of love; attachment and sense of family identity; learning, competence, and “therapeutic parenting,” and the ability to “offload.”ConclusionThe emotional and psychological well-being of mothers who adopt children should be validated and recognized as important to the overall adjustment of adoptive families.ImplicationsAdoption agencies should take a proactive approach to addressing the mental health needs of adoptive mothers, providing comprehensive information, ongoing support, and regular assessments.</p

Inflammatory biomarkers in Alzheimer's disease plasma

Plasma biomarkers for Alzheimer's disease (AD) diagnosis/stratification are a "Holy Grail" of AD research and intensively sought; however, there are no well-established plasma markers. A hypothesis-led plasma biomarker search was conducted in the context of international multicenter studies. The discovery phase measured 53 inflammatory proteins in elderly control (CTL; 259), mild cognitive impairment (MCI; 199), and AD (262) subjects from AddNeuroMed. Ten analytes showed significant intergroup differences. Logistic regression identified five (FB, FH, sCR1, MCP-1, eotaxin-1) that, age/APOε4 adjusted, optimally differentiated AD and CTL (AUC: 0.79), and three (sCR1, MCP-1, eotaxin-1) that optimally differentiated AD and MCI (AUC: 0.74). These models replicated in an independent cohort (EMIF; AUC 0.81 and 0.67). Two analytes (FB, FH) plus age predicted MCI progression to AD (AUC: 0.71). Plasma markers of inflammation and complement dysregulation support diagnosis and outcome prediction in AD and MCI. Further replication is needed before clinical translation