Prospective study of family adversity and maladaptive parenting in childhood and borderline personality disorder symptoms in a non-clinical population at 11 years

Background Retrospective studies have consistently indicated an association between maladaptive parenting and borderline personality disorder (BPD). This requires corroboration with prospective, longitudinal designs. We investigated the association between suboptimal parenting and parent conflict in childhood and BPD symptoms in late childhood using a prospective sample. Method A community sample of 6050 mothers and their children (born between April 1991 and December 1992) were assessed. Mothers' family adversity was assessed during pregnancy and parenting behaviours such as hitting, shouting, hostility and parent conflict across childhood. Intelligence quotient (IQ) and DSM-IV Axis I diagnoses were assessed at 7–8 years. Trained psychologists interviewed children at 11 years (mean age 11.74 years) to ascertain BPD symptoms. Results After adjustment for confounders, family adversity in pregnancy predicted BPD probable 1 to 2 adversities: odds ratio (OR)=1.34 [95% confidence interval (CI) 1.01–1.77]; >2 adversities: OR 1.99 (95% CI 1.34–2.94) and definite 1 to 2 adversities: OR 2.48 (95% CI 1.01–6.08) symptoms. Each point increase in the suboptimal parenting index predicted BPD probable: OR 1.13 (95% CI 1.05–1.23) and definite: OR 1.28 (95% CI 1.03–1.60) symptoms. Parent conflict predicted BPD probable: OR 1.19 (95% CI 1.06–1.34) and definite: OR 1.42 (95% CI 1.06–1.91) symptoms. Within the path analysis, the association between suboptimal parenting and BPD outcome was partially mediated by DSM-IV diagnoses and IQ at 7–8 years. Conclusions Children from adverse family backgrounds, who experience suboptimal parenting and more conflict between parents, have poor cognitive abilities and a DSM-IV diagnosis, are at increased risk of BPD symptoms at 11 years

Cannabis use and hypomania in young people: a prospective analysis

Background: Cannabis use in young people is common and associated with psychiatric disorders. However, the prospective link between cannabis use and bipolar disorder symptoms has rarely been investigated. The study hypothesis was that adolescent cannabis use is associated with hypomania in early adulthood via several potential etiological pathways. Methods: Data were used from the Avon Longitudinal Study of Parents and Children, a UK birth cohort study. The prospective link between cannabis use at age 17 and hypomania at age 22–23 years was tested using regression analysis, adjusted for gender, early environmental risk factors, alcohol and drug use, and depression and psychotic symptoms at age 18 years. Path analysis examined direct and indirect effects of the link and whether gender, childhood family adversity, or childhood abuse are associated with hypomania via an increased risk of cannabis use. Results: Data were available on 3370 participants. Cannabis use at least 2–3 times weekly was associated with later hypomania (OR = 2.21, 95% CI = 1.49–3.28) after adjustment. There was a dose–response relationship (any use vs weekly). Cannabis use mediated the association of both childhood sexual abuse and hypomania, and male gender and hypomania. The cannabis use-hypomania link was not mediated by depression or psychotic symptoms. Conclusions: Adolescent cannabis use may be an independent risk factor for future hypomania, and the nature of the association suggests a potential causal link. Cannabis use mediates the link between childhood abuse and future hypomania. As such it might be a useful target for indicated prevention of hypomania

School mobility and prospective pathways to psychotic-like symptoms in early adolescence: a prospective birth cohort study

OBJECTIVE: Social adversity and urban upbringing increase the risk of psychosis. We tested the hypothesis that these risks may be partly attributable to school mobility and examined the potential pathways linking school mobility to psychotic-like symptoms. METHOD: A community sample of 6,448 mothers and their children born between 1991 and 1992 were assessed for psychosocial adversities (i.e., ethnicity, urbanicity, family adversity) from birth to 2 years, school and residential mobility up to 9 years, and peer difficulties (i.e., bullying involvement and friendship difficulties) at 10 years. Psychotic-like symptoms were assessed at age 12 years using the Psychosis-like Symptoms Interview (PLIKSi). RESULTS: In regression analyses, school mobility was significantly associated with definite psychotic-like symptoms (odds ratio [OR] =1.60; 95% CI =1.07-2.38) after controlling for all confounders. Within path analyses, school mobility (probit coefficient [β] = 0.108; p = .039), involvement in bullying (β = 0.241; p < .001), urbanicity (β = 0.342; p = .016), and family adversity (β = 0.034; p < .001) were all independently associated with definite psychotic-like symptoms. School mobility was indirectly associated with definite psychotic-like symptoms via involvement in bullying (β = 0.018; p = .034). CONCLUSIONS: School mobility is associated with increased risk of psychotic-like symptoms, both directly and indirectly. The findings highlight the potential benefit of strategies to help mobile students to establish themselves within new school environments to reduce peer difficulties and to diminish the risk of psychotic-like symptoms. Awareness of mobile students as a possible high-risk population, and routine inquiry regarding school changes and bullying experiences, may be advisable in mental health care settings

Sleep problems in childhood and borderline personality disorder symptoms in early adolescence

Sleep disorders, such as insomnia and nightmares, are commonly associated with Borderline Personality Disorder (BPD) in adulthood. Whether nightmares and sleep-onset and maintenance problems predate BPD symptoms earlier in development is unknown. We addressed this gap in the literature using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants included 6,050 adolescents (51.4% female) who completed the UK Childhood Interview for DSM-IV BPD at 11 to 12 years of age. Nightmares and sleep onset and maintenance problems were prospectively assessed via mother report when children were 2.5, 3.5, 4.8 and 6.8 years of age. Psychopathological (i.e., emotional temperament; psychiatric diagnoses; and emotional and behavioural problems) and psychosocial (i.e., abuse, maladaptive parenting, and family adversity) confounders were assessed via mother report. In logistic regressions, persistent nightmares (i.e., regular nightmares at three or more time-points) were significantly associated with BPD symptoms following adjustment for sleep onset and maintenance problems and all confounders (Adjusted Odds Ratio=1.67; 95% Confidence Interval=1.18, 2.38). Persistent sleep onset and maintenance problems were not significantly associated with BPD symptoms. In path analysis controlling for all associations between confounders, persistent nightmares independently predicted BPD symptoms (Probit co-efficient [β] = 0.08, p = 0.013). Emotional and behavioural problems significantly mediated the association between nightmares and BPD (β =0.016, p<0.001), while nightmares significantly mediated associations between emotional temperament (β=0.001, p=0.018), abuse (β=0.015, p=0.018), maladaptive parenting (β=0.002, p=0.021) and subsequent BPD. These findings tentatively support that childhood nightmares may potentially increase the risk of BPD symptoms in early adolescence via a number of aetiological pathways. If replicated, the current findings could have important implications for early intervention, and assist clinicians in the identification of children at risk of developing BPD

Psychopathological outcomes of adolescent borderline personality disorder symptoms

Objective: Despite considerable morbidity and functional losses associated with adolescent Borderline Personality Disorder (BPD), little is known about psychopathological outcomes. This study examined associations between adolescent BPD symptoms and subsequent depressive, psychotic, and hypomanic symptoms. Methods: We used data from the Avon Longitudinal Study of Parents and Children. Participants were adolescents living in the community who had data for all longitudinal outcomes (N=1758). We used logistic regression and path analysis to investigate associations between BPD (5 or more probable/definite symptoms) reported at age 11-12 years and depressive and psychotic symptoms reported at age 12 and 18, and lifetime hypomanic symptoms reported at age 22-23 years. Results: Adolescent BPD symptoms were associated with psychotic symptoms (OR: 2.36, CI: 1.82-3.06) and diagnosis of depression at age 18 years (OR: 1.30, CI: 1.03-1.64), and hypomanic symptoms (OR: 2.89, CI: 2.40-3.48) at 22-23 years. Path analysis controlling for associations between all outcomes, indicated that BPD symptoms were independently associated with depressive symptoms (β=0.97, p<.001) at 12 years and hypomanic (β=0.58, p<.01) symptoms at 22-23 years. BPD symptoms were also associated with psychotic symptoms at age 12 years (β=0.58, p<.01), which were linked (β =0.34, p<0.01) to psychotic symptoms at age 18 years. Conclusion: Adolescents with BPD symptoms are at future risk of psychotic and hypomanic symptoms, and a diagnosis of depression. Future risk is independent of associations between psychopathological outcomes, indicating that adolescent BPD symptoms have multifinal outcomes. Increasing awareness of BPD in early adolescence could facilitate timely secondary prevention of these symptoms subsequently helping to prevent future psychopathology

School mobility during childhood predicts psychotic symptoms in late adolescence

Background: Recently, school mobility was identified as a risk factor for psychotic symptoms in early adolescence. The extent to which this risk continues into late adolescence, and the trajectories via which this risk manifests, remain unexplored. Methods: Psychotic symptoms in 4, 720 adolescents aged 18 were ascertained by trained psychologists using the Psychosis-Like Symptoms Interview. Mothers reported on sociodemographic factors (i.e., family adversity, ethnicity, urbanicity) from pregnancy to 4 years; child’s involvement in bullying at age 6 to 7 years; residential mobility at 11 years and school mobility at 11 to 12 years. Young people reported on their friendships at 8 years, and antisocial behaviour and cannabis use at 15 years. Results: School mobility across childhood significantly predicted psychotic symptoms at 18 years (Adjusted Odds Ratio = 2.17; 95% Confidence Intervals = 1.06, 4.41). Within path analysis, school mobility (β=0.183, p=0.035); involvement in bullying (β=0.133, p=0.013); antisocial behaviour (β=0.052, p=0.004); cannabis use (β= 0.254, p=0.020); and female sex (β=0.420, p<.001) significantly predicted psychotic symptoms. Residential mobility (β=0.375, p<.001), involvement in bullying (β= 0.120, p= 0.022) and poor friendships (β= 0.038, p= 0.014) significantly predicted school mobility. Residential mobility indirectly increased risk of psychotic symptoms via school mobility (β= 0.069, p= 0.041). Conclusions: Children who move schools often are more likely to have experienced peer problems. School mobility, in turn, appears to be a robust marker for psychotic symptoms in late adolescence. Clinicians and teachers should consider school mobility as an important risk indicator for both peer problems and psychopathology

Interpreting Electronic Voice Phenomena: The role of auditory perception, paranormal belief and individual differences

Electronic Voice Phenomena are anomalous voices that appear on audio recordings (Barušs, 2001) and various techniques have been suggested for obtaining these voices. People who investigate potentially paranormal, site based anomalies (ghosthunters) have in recent years been using techniques to obtain EVP voices, and declaring them as proof of the paranormal. Previous studies have examined the role of paranormal belief on various personality factors and on cognition, however individuals who use EVP as a technique (high-EVPers) have not previously been studied to ascertain if they differ from both the sceptical population (non-EVPers) and people who believe in the paranormal but who do not use EVP techniques (low-EVPers). The current studies examined personality variable differences between non-, low and high-EVPers. A new questionnaire, the Paranormal Investigation Experience Questionnaire, proved capable of differentiating between non-, low- and high-EVPers, and displayed high reliability. From the current studies, it does not appear that EVPers can be classified as a separate group of individuals when compared with general paranormal believers when comparing personality traits. It is possible to define them as a group based on their experiences of EVP, but this separation is not found when investigating a number of individual difference measures which have been shown to be able to distinguish between general paranormal believers and non-believers. EVPers demonstrated higher levels of sleep related hallucinations, which may have implications for how they are interpreting noise as EVP voices. There was a commonality in auditory test results between a number of personality factors, individuals high in these measures were all more likely to report hearing non-directional voices in noise, which may have implications for how EVPers are interpreting sound clips depending on how they are listening to those clips. High hallucinators reported hallucinated voices in their right ear, which supports previous research. The results suggest that a number of factors are involved in causing misperception of voices in noise, but these results may be applicable to the general population rather than specifically to a population of EVP experiencers. Suggestions as to future research and comparison with other methods of apparent paranormal communication are discussed

The developmental precursors of borderline personality disorder symptoms at 11 years in a British cohort

Borderline Personality Disorder (BPD) is a severe and chronic mental health disorder, affecting many areas of functioning including: affect regulation, impulse control, interpersonal relationships and self-image. Causal factors are only partly known due to a scarcity of prospective, longitudinal studies which enable one to delineate the time ordering of antecedents, and allow for tentative causal inferences. This thesis explored the developmental precursors of BPD symptoms at 11 years, using a British cohort sample, with assessments pertaining to the study child from pregnancy to 11 years of age. Three studies were conducted. Firstly, the predictive relationship between exposure to maladaptive parenting and subsequent BPD symptoms was explored within a child population, using a clinically relevant assessment of BPD symptoms. This association has been previously shown in a range of retrospective studies. Secondly, the role of peer victimisation in the development of BPD was considered. This study was designed to extend current aetiological models, which focus on parental rather than peer relationships. It was based on the recognition of a strong interpersonal core in the BPD symptom constellation, and the role of trauma experiences in the development of BPD. Finally, the third study was designed to consider how these two experiential factors (maladaptive parenting and peer victimisation) might magnify a predisposition towards dysregulation, eventually culminating in BPD symptoms. Data was obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC), which studied 6,050 children (43.1% of the total sample population), using questionnaire and interview assessments. Results revealed that, firstly, family adversity during pregnancy and suboptimal parenting, during early to middle childhood was predictive of BPD symptoms at 11 years. Secondly, peer victimisation during early to late childhood was predictive of BPD symptoms at 11 years. There was an especially strong dose response effect for severe, combined or chronic victimisation. Finally, those evincing stable dysregulated trait behaviour from 4 to 8 years were more likely to develop BPD symptoms, and this effect was especially strong for high levels of dysregulation. Consistent with the biosocial developmental model of BPD, the association was fully mediated by psychosocial risk factors (peer victimisation). Those with high levels of dysregulation were more likely to be victimised and, in turn, develop BPD symptoms. Further, the indirect associations were significantly stronger for BPD, compared to psychotic or depression outcomes. The strengths and weaknesses, along with practical and theoretical implications, and future directions are discussed in the final chapter

Using min-sum loopy belief propagation for decentralised supply chain formation

Modern business trends such as agile manufacturing and virtual corporations require high levels of flexibility and responsiveness to consumer demand, and require the ability to quickly and efficiently select trading partners. Automated computational techniques for supply chain formation have the potential to provide significant advantages in terms of speed and efficiency over the traditional manual approach to partner selection. Automated supply chain formation is the process of determining the participants within a supply chain and the terms of the exchanges made between these participants. In this thesis we present an automated technique for supply chain formation based upon the min-sum loopy belief propagation algorithm (LBP). LBP is a decentralised and distributed message-passing algorithm which allows participants to share their beliefs about the optimal structure of the supply chain based upon their costs, capabilities and requirements. We propose a novel framework for the application of LBP to the existing state-of-the-art case of the decentralised supply chain formation problem, and extend this framework to allow for application to further novel and established problem cases. Specifically, the contributions made by this thesis are: • A novel framework to allow for the application of LBP to the decentralised supply chain formation scenario investigated using the current state-of-the-art approach. Our experimental analysis indicates that LBP is able to match or outperform this approach for the vast majority of problem instances tested. • A new solution goal for supply chain formation in which economically motivated producers aim to maximise their profits by intelligently altering their profit margins. We propose a rational pricing strategy that allows producers to earn significantly greater profits than a comparable LBP-based profitmaking approach. • An LBP-based framework which allows the algorithm to be used to solve supply chain formation problems in which goods are exchanged in multiple units, a first for a fully decentralised technique. As well as multiple-unit exchanges, we also model in this scenario realistic constraints such as factory capacities and input-to-output ratios. LBP continues to be able to match or outperform an extended version of the existing state-of-the-art approach in this scenario. • Introduction of a dynamic supply chain formation scenario in which participants are able to alter their properties or to enter or leave the process at any time. Our results suggest that LBP is able to deal easily with individual occurences of these alterations and that performance degrades gracefully when they occur in larger numbers

Metal binding to transferrin and immune reactions in Parkinson's disease

The binding of iron (59Fe) and gallium (67Ga) to the plasma protein transferrin (Tf) was investigated by G75 gel filtration chromatography in control patients and treated and untreated patients with Parkinson's disease (PD). Fe-Tf binding was 100% in all controls and PD patients suggesting that a defect in Fe-Tf binding was not involved in the aetiology of PD. Ga-Tf binding was significantly reduced in both untreated and treated PD patients compared to controls. In addition, treated PD patients had significantly higher Ga-Tf binding than untreated patients. A reduction in metal binding to Tf could result in the increase of a low molecular weight species which may more readily enter the CNS. Alternatively, it could lead to a decrease in the transport of essential metals into the brain via the Tf receptor system. A significant elevation in neopterin was demonstrated within the plasma of untreated PD patients compared to controls suggesting the activation of a cellular immune response. Furthermore, plasma neopterin was lower in treated compared to untreated PD patients, although the difference was not significant. There was no evidence for the activation of the humoral immune response in untreated or treated PD patients as measured by circulating immune complex (CIC) levels within the plasma. An inverse relationship between Ga-Tf binding and neopterin was observed in untreated PD patients. The addition of oxidants in the form of potassium permanganate and activated manganese dioxide reduced Ga-Tf binding in control plasma. However, relatively little response was observed using monocyte preparations. The results suggest that oxidants produced by activation of the cellular immune system could damage the Tf molecule thereby reducing its ability to bind metals