Risk And Resilience Following Childhood Maltreatment: A Longitudinal Investigation

Lead Research Organisation: University College London
Department Name: Division of PALS

Abstract

Childhood maltreatment continues to represent a major societal problem in the UK. The NSPCC have shown that almost one in five adolescents report experiencing severe maltreatment. Of these, around 70% experienced maltreatment from their parent or guardian. We know from previous research that familial maltreatment - including physical, sexual, emotional abuse and neglect - can have a profound impact on a child's development. In particular, we know that exposure to maltreatment significantly increases a child's risk of later mental health problems, including anxiety and depression.

Over the last decade neuroscience has begun to shed light on why early adversity is associated with future problems. We and others have identified structural differences in specific parts of the brain that characterise children with maltreatment. However, there has been relatively little research using functional magnetic resonance imaging (fMRI), which investigates brain function. In the first fMRI study investigating the impact of physical abuse and domestic violence on children, we found that exposure to such adverse experiences were associated with greater activation in threat regions of the brain, including the amygdala, suggesting that these children may have become 'hypervigilant' to threat cues in their environment.

But there are many important questions we still need to answer. Do the 'neural markers' associated with maltreatment go away over time or do they persist? Are these neural markers associated with future symptoms of anxiety or depression? Do brain changes differ across boys and girls? And what do we know about resilience? We plan to answer these questions by carrying out the first longitudinal fMRI study comparing children exposed to maltreatment with their non-maltreated peers. We will verify that children have been exposed to maltreatment from social services records. All children will be seen when they are 12-14 years old and undergo psychological tests and a brain scan. We will then follow up the same children two years later when they are 14-16 years old, and repeat our set of measures and carry out a second scan. By following up the same children over time we can learn about how their brain function and structure changes, but we will also have the chance to see if brain differences early on predict future problems. This does not mean that we would use brain scans to test all children in the future; rather, identifying brain differences associated with maltreatment may help us understand why maltreated children are often vulnerable to psychological problems.

Our study will also use novel tasks to broaden our understanding of the impact of maltreatment. Future vulnerability to mental health problems may be associated with greater brain reactivity to threat in maltreated children. However, we know that poor memory of past personal events is also common in maltreated children and this may be another factor that contributes to their vulnerability to mental health problems. A key function of memory for past events for all of us is to help better solve problems in the future. We will therefore investigate whether behavioural and neural measures of personal memory are associated with future mental health. Finally, we know that maltreatment affects boys and girls differently, with girls more likely to develop symptoms of anxiety and depression. Why? Using brain imaging we will investigate the brain basis of these different patterns of vulnerability.

We hope that our research will contribute to a better understanding of the impact of maltreatment on children and help inform more effective forms of prevention and treatment.

Planned Impact

We plan to build on our already successful impact strategy developed for our previous ESRC grant (see end of grant report; RES-061-25-0189). We will continue to work closely with a broad range of potential beneficiaries including:

Clinicians and practitioners including social workers, health visitors, psychiatrists, clinical psychologists and psychotherapists. In the short to medium term our research will help inform a clinical model of how maltreatment influences emotional brain systems and its link to increased vulnerability to psychological and behavioural problems. The PI and Co-I recently organised a conference attended by over 250 clinicians (October 2011 "Childhood Disorders: Neuroscience and Intervention") that paired presentations from both leading academics and expert practitioners. We will also organize a new conference "Maltreatment: Neuroscience and Intervention" aimed at practitioners to disseminate the project findings at the end of the project.

In the longer-term we hope that gains from this project will contribute to improved clinical assessment of emotional disturbance, better clinical guidelines in meeting the needs of children experiencing maltreatment (including systemic intervention), and more effective individual interventions with those children most at risk for long term psychiatric and antisocial problems following maltreatment. Short briefing downloadable documents will be created for clinicians and practitioners that will be uploaded onto our UCL Unit website (www.drru-research.org).

Children's charities including organisations such as the NSPCC and Anna Freud Centre. The PI works for NSPCC and has strong links with the Anna Freud Centre. We propose to establish a formal advisory board with a representative from children's charities chaired by the PI in order to consider how the findings of the proposed study are relevant to their work. This will include:

i. Continuing to support their case for intervention: many of these charities lobby government to increase provision for children in need, particular those who experience abuse.
ii. Providing additional evidence of the impact of maltreatment relevant to increasing public and media awareness of this societal problem
iii. Informing new policy initiatives
iv. Convening workshops and seminars within each organisation for frontline practitioners

Policy makers including the Department of Children, Schools and Families, The Department of Health, and the Department of Justice will have a direct interest in the focus of the current research. Findings from the study will be well placed to inform policy and government priorities in relation to interventions for children who have experienced or are at risk from maltreatment. We will organise a national policy day towards the end of the grant period specifically aimed at policy makers and influencers to leverage the policy implications of the findings.

Carers often find it a challenging experience to understand and manage their child's emotional and behavioural problems. A fuller understanding of the links between adversity and emotional development may help contextualise some of these difficulties, making them easier to manage. Previously the PI has collaborated in the production of a series of recorded CD materials for prospective adopted parents to help them understand the possible impact of adversity and trauma on psychological and neural development. ("Everything you always wanted to know about adoption but were afraid to ask"; www.adoptionuk.org). We will continue to contribute to new materials in this way to help parents and carers of children who have experienced maltreatment.

Publications

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Hoffmann F (2018) Risk-taking, peer-influence and child maltreatment: a neurocognitive investigation. in Social cognitive and affective neuroscience

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Kelly PA (2016) The sexually dimorphic impact of maltreatment on cortical thickness, surface area and gyrification. in Journal of neural transmission (Vienna, Austria : 1996)

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McCrory EJ (2017) Autobiographical memory: a candidate latent vulnerability mechanism for psychiatric disorder following childhood maltreatment. in The British journal of psychiatry : the journal of mental science

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Puetz VB (2016) Altered neural response to rejection-related words in children exposed to maltreatment. in Journal of child psychology and psychiatry, and allied disciplines

 
Description There are currently four main outcomes of this longitudinal research project to highlight.

First, we have developed a new theory - the theory of latent vulnerability - which helps explain how early adversity gets 'under the skin' in ways that may increase risk of future mental health problems. Abuse and neglect can have a negative impact on children's mental health - even many years after the event. Our research shows that children appear adapt to early chaotic, unpredictable or violent homes in ways that may help them survive and cope. However, the biological and psychological changes associated with these adaptations come at a high price. Some children adapt to 'fit' atypical and disturbed environments in ways that are not helpful when they go out into the world to make friends, learn and develop as adults. Children who have experienced maltreatment may not immediately appear to have a mental health problem, but have an underlying vulnerability that increases the risk of anxiety, depression and other disorders later in life. Potential markers of 'latent vulnerability', both in relation to brain structure and function, have been identified in this project.

Second, we have advanced our understanding of how autobiographical memory is altered in children who experience maltreatment and how this might link to mental health vulnerability. A pattern of 'overgeneral' autobiographical memory is seen in individuals with PTSD and Depression. We have replicated previous findings that show that children who experience maltreatment have a similar recall pattern, even in the absence of a presenting mental health problem. In addition, using fMRI we have shown that the same children recall positive and negative memories differently. Relative to peers, they show reduced activation in the right hippocampus during positive memory recall, and significantly heightened amygdala activation during negative memory recall. These findings are consistent with those from studies of adults presenting with depression and PTSD. Our preliminary analyses of the follow-up data (unpublished) indicate that these alterations are associated with future functioning and may represent a marker of latent vulnerability to psychopathology. In particular we believe that overgeneral autobiographical memory may lead to poorer social problem solving, compromising the ability of maltreated children to effectively negotiate future stressors and build protective social networks.

Third, we have shown that maltreatment experience is associated with common patterns of altered brain structure in males and females. Specifically, we found reduced volume and cortical thickness in areas involved in emotional and behavioural regulation. This suggests that males and females are impacted in a similar way at the level of brain structure, following abuse. In addition, our ongoing analyses (unpublished) suggest that these changes may be associated with future functioning.

Finally, we have established that maltreatment alters how children process social threat cues. Our data indicate threat can elicit a pattern avoidance - not simply hypervigilance - and that such a response may be associated with an avoidant processing style that may increase risk of anxiety-related difficulties in the future.
Exploitation Route These findings suggest that maltreatment is associated with a range of neuro-cognitive adaptations even in children who present with no diagnosable mental health problems. Finding a way to identify and operationalise these markers of latent vulnerability is an important task for future research as it would open the potential of being able to screen those children at most high risk. Such work can also shed light on what might represent preventative interventions that could be delivered by teachers, social workers and mental health professionals.
Sectors Healthcare

URL http://www.ucl.ac.uk/pals/people/profiles/academic-staff/eamon-mccrory
 
Description See outputs from the committees detailed in the Policy and Practice section.
First Year Of Impact 2017
Sector Healthcare,Other
Impact Types Policy & public services

 
Description Care pathways for looked-after children with mental health and wellbeing difficulties
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
URL https://www.scie.org.uk/children/care/mental-health/findings/call-evidence-findings
 
Description Department of Education Report: Missed opportunities: Indicators of neglect - what is ignored, why, and what can be done?
Geographic Reach National 
Policy Influence Type Participation in a national consultation
URL https://www.gov.uk/government/publications/indicators-of-neglect-missed-opportunities
 
Description Department of Health Development of a 10 Year Mental Health Strategy
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
URL https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/665576/A_framework_for_men...
 
Description Early Intervention Foundation Science Series
Geographic Reach National 
Policy Influence Type Membership of a guidance committee
URL http://www.eif.org.uk/eif-launches-scienceseries/
 
Description Member of Dept Education Expert Panel on Neglect
Geographic Reach National 
Policy Influence Type Participation in advisory committee
 
Description Member of Early Intervention Foundation Advisory Panel
Geographic Reach National 
Policy Influence Type Membership of a guidance committee
URL http://www.eif.org.uk/our-work/
 
Description Member of NSPCC Research Advisory Panel
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
 
Description NSPCC Expert Symposium
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description AFA Cymru Medical Group Conference Cardiff - 23rd March 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact This was a conference for medical practitioners (primarily paediatricians) as well as social work staff in Wales providing an overview of the current evidence regarding maltreatment and early adversity and latest findings from the current grant. There were over 100+ in attendance and a lively debate followed the presentation regarding implications for practice and in particular prevention.
Year(s) Of Engagement Activity 2017
 
Description Anna Freud National Centre for Children and Families Annual Colloquium 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This colloquium is a longstanding international meeting of leading therapists and psychoanalysts in the field of child mental health. I provided the Key Note talk, which focussed on the impact of early adversity and how this may impact on adolescent development in particular. I presented preliminary data from our project and outlined the theory of latent vulnerability.
Year(s) Of Engagement Activity 2016
URL http://www.annafreud.org/training-research/training-and-conferences-overview/conferences-and-seminar...
 
Description BBC News: The PTSD brains of children and soldiers 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact BBC News on Maltreatment Research. Presented information on new research comparing brains of PTSD soldiers and maltreated children.
Year(s) Of Engagement Activity 2016
URL http://www.bbc.co.uk/news/health-35595086
 
Description BBC Radio 4: Brain activity and trauma 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Radio broadcast on research by Professor Eamon McCrory that has found that children exposed to trauma show the same pattern of activity in their brains as soldiers exposed to combat.
Year(s) Of Engagement Activity 2016
URL http://www.bbc.co.uk/programmes/b070fft9
 
Description BPS Children and Young People Annual Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Productive discussion following talk.

Increased interest in evidence based practice and use of neuroscience / genetic research to inform psychological models of development and psychopathology.
Year(s) Of Engagement Activity 2014
 
Description Changing Lives Workshop: Oxford 10th July 2017 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Third sector organisations
Results and Impact This was a day long workshop to explore what enables children growing up in adversity to thrive in modern Britain, with a focus on the impact of early adversity and poverty.
Year(s) Of Engagement Activity 2017
URL http://torch.ox.ac.uk/themes/changing-lives-understanding-what-enables-children-growing-adversity-th...
 
Description Child Centre for Mental Health London 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Keynote talk - engaged audience in debate and thinking about neuroscience and genetics of early adversity.

Increased interest in evidence based practice and use of research to inform decision making.
Year(s) Of Engagement Activity 2012,2014
 
Description Clinical and Research Conference on maltreatment - organised by the PI 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This conference was organised to provide clinicians and researchers a unique overview of recent advances in research and practice in the field of childhood maltreatment.
The speakers - experts in psychological treatment, social care, neuroscience and policy - reviewed the emerging evidence and considered:
- how the emerging evidence advances our understanding of the impact of maltreatment, and
- the implications for prevention, care and treatment of children who have been affected.

Details of the conference were used by the Anna Freud National Centre for Children and Families in their 'Spotlight on Childhood Adversity Series. See website below.
Year(s) Of Engagement Activity 2016
URL http://www.annafreud.org/about-us/anna-freud-learning-network/childhood-adversity-and-trauma/
 
Description Conference presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This was a presentation to the annual conference of the American Academy of Child and Adolescent Psychiatry in Washington D.C. This event brings together child psychiatrists from across North America. The talk was well received and created discussion as to the application of the theory of latent vulnerability to clinical practice and prevention.
Year(s) Of Engagement Activity 2017
 
Description Huffington Post: Every Child Deserves a Chance to Enter Adulthood With Ambition, Hope and an Opportunity to Flourish 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Entry on The Huffington Post Blog - Young Mind Matter series, designed to lead the conversation with children about mental health, launched with Her Royal Highness, The Duchess of Cambridge as guest editor.
Year(s) Of Engagement Activity 2016
URL http://www.huffingtonpost.co.uk/eamon-mccrory/childrens-mental-health-research_b_9236686.html
 
Description Interview on BBC Radio 4 Woman's Hour 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact This interview focussed on the impact of early neglect and emotional abuse - particularly in relation to fathers, and how such an impact may affect development, increasing risk of later mental health problems.
Year(s) Of Engagement Activity 2016
URL http://www.bbc.co.uk/programmes/b07w5y66#playt=0h17m20s
 
Description Key note at the EIF Science Series 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Active discussion at this meeting in relation to impact of adversity in the early years, the role of neuroscience in epigenetics in informing policy and implications for practice.

Ongoing debate within the Science Series.
Year(s) Of Engagement Activity 2014
URL http://www.eif.org.uk/eif-launches-scienceseries/
 
Description Keynote at BPS Neuropsychology Conference Winchester 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Discussion of impact of neuroscience evidence on practice.

n/a
Year(s) Of Engagement Activity 2014
 
Description Loebel Lecture Series Oxford 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact The Oxford Loebel Lectures and Research Programme (OLLRP) form an interdisciplinary scientific and philosophical project dedicated to exploring and explicating the causal and conceptual links between the biological, psychological, and social factors that contribute to mental processes, mental health, and in particular mental illness. Its aim is to lay the ground work for a unified theory that can form the basis for clinical work in psychiatry. The first two of the three Annual Lectures planned were presented by Professors Kenneth Kendler and Stephen Hyman respectively. I was involved in the 2016 Lectures, co-ordinated by Prof Essi Viding, a Co-I on the ESRC grant.

The field of psychiatry uncomfortably spans biological and psycho-social views of mind and behaviour. As a branch of medicine, psychiatry has long been under pressure to conform to the sort of reductive, biological model that has traditionally defined medicine. According to this biomedical model, diseases are characterized primarily in biological terms (e.g. genetic influence, molecular changes in the body's organs, abnormalities detectable via blood tests, MRI scans, etc.) As well as being a branch of medicine, however, psychiatry draws heavily on the psychodynamic tradition. This makes no reference to the biological underpinnings of mental life, concerning itself instead with psycho-social elements. Patients' mental distress, on this approach, is explained with reference to life experience and treated by reflecting on past experience and current feelings in psychotherapeutic treatment.

Our talks explored the impact of early adversity on development and how this may impact neurocognitive systems in ways that may increase latent vulnerability to future mental health problems. There was extensive discussion and debate and all talks are being prepared as podcasts that will be publicly available.
Year(s) Of Engagement Activity 2016
URL http://www.loebelprogramme.ox.ac.uk
 
Description NSPCC research event - 27March 2017 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Third sector organisations
Results and Impact This event involved showcasing future research plans in the context of the findings of the current research programme. There were over 100+ individuals in attendance from a wide range of backgrounds.
Year(s) Of Engagement Activity 2017
 
Description New York Times Article 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact New York Times article in relation to how neuroscience research in the field of maltreatment can be understood.

Full article available here:

http://op-talk.blogs.nytimes.com/2014/11/24/can-brain-science-be-dangerous/?_r=0
Year(s) Of Engagement Activity 2014
URL http://op-talk.blogs.nytimes.com/2014/11/24/can-brain-science-be-dangerous/?_r=0
 
Description Practitioner training event - Winchester 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact This was an all day training for a group of mixed professionals - including social workers, psychologists, educational psychologists and mental health practitioners working in residential care. The format was highly interactive and include formal talks, small group tasks and workshops. The audience indicated a keen interest in the impact of abuse and neglect on brain and behaviour and were motivated to develop their practice theory links.
Year(s) Of Engagement Activity 2016
 
Description Presentation / Training for the Minerva-Gentner-Symposium 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact This event is a workshop based event designed to support and train the best postgraduate students from Germany, Israel and other countries to advance research in child development. This was an opportunity to present the work of the current study and engage in discussion as to the possible interpretation of the emerging surface based findings from the study, as well as increase the profile of neurobiological research in the field of maltreatment.
Year(s) Of Engagement Activity 2015
 
Description Presentation to Great Ormond Street Hospital 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Health professionals
Results and Impact Useful discussion with range of practitioners about the evidence base on epigenetics, neuroscience and childhood adversity.

Increased interest in role of neuroscience in informing practice.
Year(s) Of Engagement Activity 2014
 
Description Presentation to the ICCAP Conference (10th International Conference on Child and Adolescent Psychopathology) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Helpful discussion regarding emerging evidence in neuroscience field.
Year(s) Of Engagement Activity 2015
 
Description Presentation to the New England Psychoanalytic Society 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Keynote delivered to a broad range of child and adult practitioners. Focus on the impact of abuse and neglect and the association with mental health problems in a developmental context. Study aims and findings presented within the context of the theory of latent vulnerability.
Year(s) Of Engagement Activity 2016
 
Description Presentation to the Place2Be Conference 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact This event was attended by over 250 head teachers, government ministers and the Duchess of Cambridge. It allowed a full presentation of the research related to the current grant, with a particular emphasis on the impact for schools. A discussion session following my talks allowed for these issues to be explored in detail.
Year(s) Of Engagement Activity 2015
 
Description Presentation to the Psychology Department, Trinity College Dublin 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact To outline the current state of the evidence and overview the research objectives of the current grand. There was a useful discussion regarding the need but also challenges of longitudinal study of this population.
Year(s) Of Engagement Activity 2015
 
Description Quality Network for Inpatient CAMHS Annual Forum - 15th June 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact There were over 150 practitioners from inpatient child and adolescent services at this event which focussed on the implications of current research to practice and policy.
Year(s) Of Engagement Activity 2017
 
Description SafeLives Conference on Domestic Violence 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact This event focussed on the impact of domestic violence. My talk focussed on our emerging and past research findings indicating the impact of domestic violence on brain development and the need for early and prompt intervention.
Year(s) Of Engagement Activity 2015
 
Description Talk to Wellcome Dept Functional Imaging Queen Square 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Extended discussion regarding emerging evidence in neuroscience field.

Increased interest in application of neuroscience to the study of adversity.
Year(s) Of Engagement Activity 2013
 
Description Training Camden Social Work teams 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Helpful workshop for frontline practitioners.

Increased interest in evidence based practice and use of research to inform decision making.
Year(s) Of Engagement Activity 2014
 
Description Training for a large group of social work practitioners in Scotland 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact This was a two day event ("Changing the Narrative" Glasgow, November 27th & 28th) to train a group of social work practitioners in relation to advances in research in the field of maltreatment and consider the implications for practice - and indeed developing a new framework for looked after children in Scotland.
Year(s) Of Engagement Activity 2017
 
Description Trauma Network Northern Ireland workshop 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact A presentation and discussion of research that considered childhood maltreatment experience in the context of trauma for both child and adult practitioners.
Year(s) Of Engagement Activity 2018
 
Description UCL Lunchtime Lecture - for the General Public 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact This talk allowed the research themes and initial findings to be disseminated to a large audience. There were several questions following the talk and an chance to consider the implications of the research.
Year(s) Of Engagement Activity 2016
URL https://www.youtube.com/watch?v=7hApgHngibQ
 
Description Workshop for Child Psychotherapists in Northern Italy - 27th May 2017 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact An event was convened to provide practicing therapists with the background around the latest findings in neurobiological research and early adversity. There was a particular focus on latent vulnerability as a construct and how it could inform practice. There was TV media coverage including interview and a panel discussion.
Year(s) Of Engagement Activity 2017