The Seeds of Exclusion

First paragraph: It is in the context of all the factors relating to the social, physical and mental wellbeing of Britain in 2008 that The Salvation Army presents The Seeds of Exclusion report. The research findings must be read in the light of the additional pressures we have identified which may be brought to bear on individuals already living in a society which is becoming increasingly fragmented, chaotic and stressful. The Salvation Army hopes its contribution to this ongoing debate will begin to inform us all, including Government, on how we can avoid the mistakes of the past and begin to mend society

The relationship between the Big Five personality factors, anger-hostility, and alcohol and violence in men and women: A nationally representative cohort of 15,701 young adults

Aims Alcohol consumption is known to have a disinhibiting effect, and is associated with a higher likelihood of aggressive behaviour, especially among men. People with certain personality traits maybe more likely to behave aggressively when intoxicated, and there may also be variation by gender. We aimed to investigate whether the reason why men and women with certain personality traits are more likely to engage in violence may be because of their alcohol use. Method The Big Five personality traits and Anger-Hostility, alcohol consumption and violence were measured by questionnaire in 15,701 nationally representative participants in the USA. We tested the extent to which alcohol mediates the relationship between personality factors and violence in men and women. Results Agreeableness was inversely associated with violence in both genders. Alcohol mediated approximately 11% of the effect in males, but there was no evidence of an effect in females. Anger-hostility was associated with violence in both sexes, but alcohol mediated the effect only in males. We also found that Extraversion was associated with violence and alcohol use in males and females. Alcohol accounted for 15% of the effect of extraversion on violence in males and 29% in females. Conclusion The mechanism by which personality traits relate to violence may be different in men and women. Agreeableness and anger-hostility underpin the relationship between alcohol and violence in men, but not in women. Reducing alcohol consumption in men with disagreeable and angry/hostile traits would have a small but significant effect in reducing violence, whereas in women, reducing alcohol consumption among the extraverted, would have a greater effect

The relationship between the Big Five personality factors, anger-hostility, and alcohol and violence in men and women: A nationally representative cohort of 15,701 young adults

Aims Alcohol consumption is known to have a disinhibiting effect, and is associated with a higher likelihood of aggressive behaviour, especially among men. People with certain personality traits maybe more likely to behave aggressively when intoxicated, and there may also be variation by gender. We aimed to investigate whether the reason why men and women with certain personality traits are more likely to engage in violence may be because of their alcohol use. Method The Big Five personality traits and Anger-Hostility, alcohol consumption and violence were measured by questionnaire in 15,701 nationally representative participants in the USA. We tested the extent to which alcohol mediates the relationship between personality factors and violence in men and women. Results Agreeableness was inversely associated with violence in both genders. Alcohol mediated approximately 11% of the effect in males, but there was no evidence of an effect in females. Anger-hostility was associated with violence in both sexes, but alcohol mediated the effect only in males. We also found that Extraversion was associated with violence and alcohol use in males and females. Alcohol accounted for 15% of the effect of extraversion on violence in males and 29% in females. Conclusion The mechanism by which personality traits relate to violence may be different in men and women. Agreeableness and anger-hostility underpin the relationship between alcohol and violence in men, but not in women. Reducing alcohol consumption in men with disagreeable and angry/hostile traits would have a small but significant effect in reducing violence, whereas in women, reducing alcohol consumption among the extraverted, would have a greater effect

Coordination difficulties, IQ and psychopathology in children with high-risk Copy Number Variants

Background: The prevalence and impact of motor coordination difficulties in children with copy number variants associated with neurodevelopmental disorders (ND-CNVs) remains unknown. This study aims to advance understanding of motor coordination difficulties in children with ND-CNVs and establish relationships between intelligence quotient (IQ) and psychopathology. Methods: 169 children with an ND-CNV (67% male, median age = 8.88 years, range 6.02–14.81) and 72 closest-in-age unaffected siblings (controls; 55% male, median age = 10.41 years, s.d. = 3.04, range 5.89–14.75) were assessed with the Developmental Coordination Disorder Questionnaire, alongside psychiatric interviews and standardised assessments of IQ. Results: The children with ND-CNVs had poorer coordination ability (b = 28.98, p < 0.001) and 91% of children with an ND-CNV screened positive for suspected developmental coordination disorder, compared to 19% of controls (OR = 42.53, p < 0.001). There was no difference in coordination ability between ND-CNV genotypes (F = 1.47, p = 0.184). Poorer coordination in children with ND-CNV was associated with more attention deficit hyperactivity disorder (ADHD) (β = −0.18, p = 0.021) and autism spectrum disorder trait (β = −0.46, p < 0.001) symptoms, along with lower full-scale (ß = 0.21, p = 0.011), performance (β = −0.20, p = 0.015) and verbal IQ (β = 0.17, p = 0.036). Mediation analysis indicated that coordination ability was a full mediator of anxiety symptoms (69% mediated, p = 0.012), and a partial mediator of ADHD (51%, p = 0.001) and autism spectrum disorder trait symptoms (66%, p < 0.001) as well as full scale IQ (40%, p = 0.002), performance IQ (40%, p = 0.005) and verbal IQ (38%, p = 0.006) scores. Conclusions: The findings indicate that poor motor coordination is highly prevalent and closely linked to risk of mental health disorder and lower intellectual function in children with ND-CNVs. Future research should explore whether early interventions for poor coordination ability could ameliorate neurodevelopmental risk

Change in the relationship between drinking alcohol and risk of violence among adolescents and young adults: a nationally representative longitudinal study

ims To quantify the relationship between alcohol and violence with increasing age. Methods Data were from The National Longitudinal Study of Adolescent to Adult Health (ADD Health) of 20,386 people representative of the US population. Mean age at the first wave of interviews was 16.2 years, with subsequent interviews mean of 1, 6.3 and 12.9 years later. We used random-effects models and predictive marginal effects of the association between varying quantities of alcohol consumption and violence while controlling for possible confounders. Results Violence was reported by 19.1% of participants at wave I but just 2.1% at wave IV. The random-effects model showed that consuming 1–4 drinks on each occasion was associated with a modest increase in risk of violence in both males (odds ratio (OR) 1.36, 95% CI 1.13–1.63) and females (OR 1.33, 95% CI 1.03–1.72). For consumption of five or more drinks on each occasion, the risk remained similar for females (OR 1.40 (0.99–1.97)) but increased considerably for males (OR 2.41 (1.96–2.95)). Predictive marginal effects models confirmed that violence rates decreased with age. Conclusions Alcohol is most strongly linked to violence among adolescents, so programmes for primary prevention of alcohol-related violence are best targeted towards this age group, particularly males who engage in heavy episodic drinking

Psychopathology among young homeless people: Longitudinal mental health outcomes for different subgroups

Background Homeless young people are recognized as a very vulnerable group in terms of mental health; however, few studies in the UK have examined this. Furthermore, homeless young people represent a heterogeneous group in terms of their mental health and greater characterization could improve intervention work. Objectives The aims of this study were to examine prevalence and subtypes of psychopathology among a British sample of young homeless people and to investigate potential associations between identified typologies and a priori specified current and past experiences. In addition, the study intended to explore physical health, mental health, and housing outcomes for the different mental health subgroups. Design A prospective longitudinal design was used. Methods Structured interviews including a mental health assessment were conducted with 90 young homeless people aged 16–23 years. Follow-up interviews were conducted approximately 10 and 20 months later. Cluster analysis at baseline was used to identify groups based on lifetime mental health problems. Results The current and lifetime incidence of mental health problems was high (88% and 93%, respectively). Three subgroups of homeless young people were identified: (1) minimal mental health issues; (2) mood, substance, and conduct disorder; and (3) post-traumatic stress disorder, mood, and anxiety issues. These groups differed with respect to follow-up indicators of change and stability of mental health status, service use, and suicide risk, but not housing outcome. Other characteristics (gender ratio, past experiences) also distinguished the subgroups. Conclusions Typologies of young homeless people based on psychopathology reveal differences in lifetime and future experiences including mental health at follow-up. Identified groups could be used to tailor interventions towards differing needs. Practitioner points Low mood, anxiety, post-traumatic stress disorder, and psychosis are common mental health issues among young homeless people in the UK. Subgroups of young homeless people with differing needs can be identified, and these groups can be used to predict outcomes. Tailoring support provision towards specific needs has the potential to improve mental health and other outcomes for vulnerable young homeless people. Young homeless people often do not access the support to which they are entitled. Services need to be adapted to improve access for this group

Vulnerable periods for cognitive development in individuals at high genomic risk of schizophrenia [Conference Abstract]

22q11.2 Deletion Syndrome (22q11.2DS) is caused by the deletion of approximately 60 genes on chromosome 22 and represents one of the strongest known genetic risk factors for schizophrenia. Approximately 1 in 4 adults with 22q11.2DS are diagnosed with schizophrenia spectrum disorders, presenting with psychotic symptomatology analogous to that exhibited in idiopathic schizophrenia. Cognitive deficits are a core feature of schizophrenia. 22q11.2DS presents a valuable model for understanding vulnerable periods of cognitive development which may be associated with psychosis development. Most previous studies report greater deficits in older individuals with 22q11.2DS than younger individuals but these studies have often focused solely on IQ, neglecting other neurocognitive domains associated with schizophrenia. Additionally, many studies of 22q11.2DS have not included adults, missing a crucial group at increased risk for schizophrenia. The first aim was therefore to examine whether there are increasing deficits in cognitive functioning on a wide range of domains in 22q11.2DS across developmental stages (children, adolescents and adults) compared to typically developing (TD) controls. The second aim was to take into account the presence of a psychotic disorder, and whether this explained variance in functioning. Methods We conducted the largest study to date of neurocognitive functioning beyond IQ in 22q11.2DS. This work was the result of international collaboration across 3 sites. The same battery of tasks measuring processing speed, attention and spatial working memory were completed by 219 participants with 22q11.2DS and 107 TD controls. Wechsler IQ tests were completed, yielding Full Scale (FSIQ), Verbal (VIQ) and Performance IQ scores (PIQ). An age-standardised difference score was produced for each participant taking into account TD control performance. The average performance of children (6–10 years), adolescents (10–18 years) and adults (18–56 years) was compared using an ANOVA approach. No children or adolescents reached diagnostic criteria for a psychotic disorder, but 13% of adults with 22q11.2DS were either diagnosed with a DSM-IV psychotic disorder. The cognitive performance of adults with or without a psychotic disorder was compared with independent t-tests with correction for unequal variance. Results Children and adults with 22q11.2DS displayed a greater deficit in working memory than adolescents (p=0.017 and p<0.001 respectively). Adults displayed greater deficits in FSIQ and PIQ than adolescents (p=0.018 and p=0.001 respectively). Adults diagnosed with a psychotic disorder displayed a greater deficit in VIQ than those without a psychotic disorder (p=0.040). Discussion Magnitude of cognitive deficit in individuals with 22q11.2DS varied by cognitive domain and developmental stage. There were specific deficits in working memory, PIQ and FSIQ in adults with 22q11.2DS compared to children and adolescents. The lack of differences between children and adolescents contradicts previous research which proposes that older children exhibit greater cognitive deficits, and suggests that there may be a longer developmental window to intervene and maintain cognitive functioning in a group at high genomic risk of schizophrenia. Adults with 22q11.2DS and psychotic disorder had a greater deficit in VIQ, which supports previous research. This international sample provides unique insights into cognitive functioning in 22q11.2DS across developmental stages

Prenatal smoking might not cause attention-deficit/hyperactivity disorder: evidence from a novel design

Background: It is widely considered that exposure to maternal cigarette smoking in pregnancy has risk effects on offspring attentiondeficit/ hyperactivity disorder (ADHD). This view is supported by consistent observations of association. It is, however, impossible to be certain of adequate control for confounding factors with observational designs. We use a novel "natural experiment" design that separates prenatal environmental from alternative inherited effects. Methods: The design is based on offspring conceived with Assisted Reproductive Technologies recruited from 20 fertility clinics in the United Kingdom and United States who were: 1) genetically unrelated, and 2) related to the woman who underwent the pregnancy. If maternal smoking in pregnancy has true risk effects, association will be observed withADHDregardless of whether mother and offspring are related or unrelated. Data were obtained from 815 families of children ages 4 years-11 years with parent questionnaires and antenatal records. Birth weight was used as a comparison outcome. The key outcome considered was child ADHD symptoms. Results: Association between smoking in pregnancy and lower birth weight was found in unrelated and related mother-offspring pairs, consistent with a true risk effect. However, for ADHD symptoms, the magnitude of association was significantly higher in the related pairs (β=.102, p .10), suggesting inherited effects. Conclusions: Our findings highlight the need to test causal hypotheses with genetically sensitive designs. Inherited confounds are not necessarily removed by statistical controls. The previously observed association between maternal smoking in pregnancy and ADHD might represent an inherited effect. © 2009 Society of Biological Psychiatry