Developmental trajectories of psychosis in population-based samples: interplay between early adversity and familial risk

Lead Research Organisation: King's College London
Department Name: Inst of Psychiatry School Offices

Abstract

Mental health problems such as psychosis (e.g., schizophrenia) can be extremely disabling and result in massive costs for the individual, NHS services and society in general. Greater understanding of what factors are involved in development and persistence of such disorders would assist attempts to prevent and treat them. One of the major factors thought to cause psychosis is an individual‘s genetic make-up but environmental factors are also thought to play a role, possibly in combination with genes. Therefore, I propose to investigate whether individuals who have been exposed to potentially distressing experiences in childhood (severely beaten by or separated from their parents) and have a genetic risk (positive family history) are more likely to experience psychotic symptoms (such as hearing voices) over a long period of time and require treatment for psychosis during the life-course than individuals with only one or neither of these factors. To test this proposition I will analyse data from four different longitudinal studies: three general population birth cohorts in adolescence and adulthood and a 10-year follow-up of clinically diagnosed psychosis patients on whom information is available about their family and childhood history and experience of psychotic symptoms and mental health treatment at different time points.

Technical Summary

Aim: To develop a greater understanding of how exposure to adverse childhood experiences and their interplay with family history of psychosis can influence the developmental course of psychosis throughout adolescence and adulthood.



Objectives:



1. Examine qualitative differences in the form and content of psychotic symptoms experienced by environmentally versus neurodevelopmentally vulnerable children and potential links to comorbidity.



2. Investigate how types of childhood adversity and familial liability steer individuals towards a pathway leading to psychosis rather than other psychiatric disorders.



3. Explore the role of early environmental adversity versus neurodevelopmental deficits together with familial liability in the persistence and longer-term outcomes of psychosis.



Design: Four longitudinal studies will be utilised: a UK population-based sample of twins aged 12 years and their mothers; a UK birth cohort aged 18 years; a New Zealand birth cohort aged 38 years; and a 10-year follow-up of epidemiologically sampled first-episode psychosis patients.



Methodology:



Study 1 - E-Risk: Thematic analysis will be conducted on twins‘ narrative description of psychotic symptoms at age 12, to explore differences in type and content of symptoms according to victimisation history, neurodevelopmental deficits, and comorbidity. Prevalence rates of different forms of childhood maltreatment and their interplay with familial risk will be compared in mothers with lifetime diagnoses of psychosis, depression, mania and no psychiatric disorder.



Study 2 - ALSPAC: Differences in prevalence rates of childhood victimisation and their interaction with familial liability to psychosis will be explored amongst the following prospectively obtained groups: no psychotic symptoms at 12 or 17 years, psychotic symptoms at both 12 and 17 years, symptoms only at 12 years, and new onsets at 17.



Study 3 - Dunedin: Comparison of dferent psychosis trajectories between 11 - 38 years and utilisation of services in terms of familial risk and prospectively assessed developmental risk factors (neurodevelopmental deficits, victimisation, and cannabis use).



Study 4 - AESOP: The course of psychotic disorder, service utilisation and psychosocial outcomes assessed prospectively over a 10-year period will be compared for first-episode patients with and without a retrospectively reported history of childhood adversity and parental psychiatric disorder.



Scientific and medical opportunities: Improved aetiological understanding of the course of psychosis has massive implications for prevention and treatment. Identification of malleable environmental mechanisms will enable clinicians to provide more effective interventions to reduce the risk of vulnerable children developing disabling and potentially life-long mental health problems and promote resilience. Ultimately, this project intends to improve well-being across the lifespan.

Publications

10 25 50
 
Description Report for DoH Panel on Clinical Performance Indicators for Psychosis
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
 
Description Centenary Award
Amount £15,000 (GBP)
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start 09/2012 
End 08/2013
 
Description ESRC Multidisciplinary 1+3 studentships (x3)
Amount £210,000 (GBP)
Organisation Economic and Social Research Council 
Sector Public
Country United Kingdom
Start 09/2013 
End 09/2017
 
Description ESRC project grant
Amount £21,530 (GBP)
Organisation Economic and Social Research Council 
Sector Public
Country United Kingdom
Start 11/2014 
End 11/2016
 
Description ESRC training bursary
Amount £900 (GBP)
Organisation Economic and Social Research Council 
Sector Public
Country United Kingdom
Start 02/2012 
End 03/2012
 
Description Health Technology Assessment programme grant
Amount £1,801 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 11/2012 
End 12/2014
 
Description ICOSR Young Investigator Award
Amount $800 (USD)
Organisation International Congress on Schizophrenia Research 
Sector Academic/University
Country United States
Start 04/2013 
End 05/2013
 
Description IEPA Young Investigator in Early Psychosis Award
Amount $1,800 (USD)
Organisation International Early Psychosis Association 
Sector Academic/University
Country Global
Start 09/2012 
End 10/2012
 
Description MQ Fellowship
Amount £225,000 (GBP)
Organisation MQ Transforming Mental Health 
Sector Charity/Non Profit
Country United Kingdom
Start 12/2014 
End 11/2017
 
Description MRC Centre PhD studentship
Amount £90,000 (GBP)
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start 09/2014 
End 09/2018
 
Description Margaret Temple (schizophrenia)
Amount £30,781 (GBP)
Organisation British Medical Association (BMA) 
Sector Learned Society
Country United Kingdom
Start 03/2013 
End 02/2016
 
Description Sackler Travel Award
Amount £800 (GBP)
Organisation National Academy of Sciences 
Sector Charity/Non Profit
Country United States
Start 09/2011 
End 10/2011
 
Description Society and Science workshop grant
Amount £4,000 (GBP)
Organisation Economic and Social Research Council 
Sector Public
Country United Kingdom
Start 06/2014 
End 07/2014
 
Description Waterloo Foundation project grant
Amount £1,000 (GBP)
Organisation The Waterloo Foundation 
Sector Charity/Non Profit
Country United Kingdom
Start 03/2013 
End 02/2014
 
Description AESOP study 
Organisation Medical Research Council (MRC)
Country United Kingdom 
Sector Academic/University 
PI Contribution I have been involved in training staff, collecting data, analysing data and writing up results for publication.
Collaborator Contribution Providing training, access to data and substantial intellectual input into my research.
Impact Several papers have been produced as part of this collaboration: PMID: 22353995, PMID: 22048144 , PMID: 21601792, PMID: 20855184, PMID: 20529412, PMID: 20178679, PMID: 19776204, PMID: 19336782, PMID: 19053965 and PMID: 24399191. I have given over 10 international conference presentations on this data.
Start Year 2006
 
Description ALSPAC study 
Organisation University of Bristol
Department Avon Longitudinal Study of Parents and Children (ALSPAC)
Country United Kingdom 
Sector Academic/University 
PI Contribution I analysed data from their cohort and wrote up the results for publication. I also provided statistical advice and research support during my fellowship placement at Warwick University.
Collaborator Contribution Access to the dataset and guidance over interpretation of the results of my analysis. Provided office space during a 3 month research placement at Warwick University.
Impact We have published four papers together PMID: 22941743, PMID: 23702450, PMID: 24587569 and PMID: 24342773, and have 1 more in press. I have presented this data at 4 international conferences. I also included further collaborations with this group in my successful MRC Population Health Scientist fellowship and MQ Fellowship.
Start Year 2010
 
Description ALSPAC study 
Organisation University of Warwick
Department Department of Psychology
Country United Kingdom 
Sector Academic/University 
PI Contribution I analysed data from their cohort and wrote up the results for publication. I also provided statistical advice and research support during my fellowship placement at Warwick University.
Collaborator Contribution Access to the dataset and guidance over interpretation of the results of my analysis. Provided office space during a 3 month research placement at Warwick University.
Impact We have published four papers together PMID: 22941743, PMID: 23702450, PMID: 24587569 and PMID: 24342773, and have 1 more in press. I have presented this data at 4 international conferences. I also included further collaborations with this group in my successful MRC Population Health Scientist fellowship and MQ Fellowship.
Start Year 2010
 
Description CHADS 
Organisation King's College London
Department Child Health and Development Study (CHADS)
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution I have written a grant application and provided assistance with two other applications.
Collaborator Contribution Agreed to allow me access to the cohort and also made an intellectual contribution to my research.
Impact We obtained a BMA project grant and also a Waterloo Foundation project grant. This collaboration has produced two papers to date: PMID: 24882153 and PMID: 24627296.
Start Year 2011
 
Description DeCC study 
Organisation King's College London
Department Depression Case Control Study (DeCC)
Country United Kingdom 
Sector Academic/University 
PI Contribution I have analysed data and written up the results for publication. I have also provided guidance to other researchers in relation to gene x environment interaction analysis. I am also involved in testing and running analysis for an international meta-analysis that includes DeCC data.
Collaborator Contribution Provided access to the data and made an intellectual contribution to my work.
Impact We have published two papers together with myself as first author: PMID: 22840631 and PMID: 21982504 and two other papers: PMID: 23618376 and PMID: 24219410. This collaboration has also resulted in me becoming involved in an international collaborative meta-analysis and the Psychiatric Genetics Consortium.
Start Year 2009
 
Description Dunedin study 
Organisation Duke University
Department Department of Psychology and Neuroscience
Country United States 
Sector Academic/University 
PI Contribution I have analysed data and written up the results for publication.
Collaborator Contribution They have provided access to their data and substantial intellectual input into my research. They also hosted me for a few days in Dunedin (New Zealand) to observe data collection as well as for 6 weeks at Duke University (USA) to develop deeper collaborative relationships.
Impact We have two papers together: PMID: 24030246 and PMID: 23302254. I have also spent 6 weeks with the research team at Duke University and visited the data collection in Dunedin. The collaboration involves psychologists, psychiatrists, biologists, geneticists, biostatisticians and public health researchers.
Start Year 2011
 
Description Dunedin study 
Organisation University of Otago
Department Dunedin Multidisciplinary Health & Development Research Unit
Country New Zealand 
Sector Academic/University 
PI Contribution I have analysed data and written up the results for publication.
Collaborator Contribution They have provided access to their data and substantial intellectual input into my research. They also hosted me for a few days in Dunedin (New Zealand) to observe data collection as well as for 6 weeks at Duke University (USA) to develop deeper collaborative relationships.
Impact We have two papers together: PMID: 24030246 and PMID: 23302254. I have also spent 6 weeks with the research team at Duke University and visited the data collection in Dunedin. The collaboration involves psychologists, psychiatrists, biologists, geneticists, biostatisticians and public health researchers.
Start Year 2011
 
Description E-Risk study 
Organisation King's College London
Department Environmental Risk (E-Risk) Longitudinal Twin Study
Country United Kingdom 
Sector Academic/University 
PI Contribution I have conducted analysis of their dataset and written up the results for publication. I am also involved in the steering committee for the current wave of data collection and responsible for monitoring the quality of the data collected on mental health and violence exposure. I also supervised an undergraduate placement student on this study and currently supervise two PhD students who are using data from this study. Additionally I have provided funding for further epigenetic analysis to be conducted on this cohort.
Collaborator Contribution Provided access to the twin dataset and significant intellectual contribution to my research.
Impact We have published a paper in the BMJ together (with me as first author): PMID: 22539176, and also two with me as a co-author: PMID: 20952460 and PMID: 24059939. They have also made me a co-investigator of the E-Risk phase 18 study. The collaboration involves psychologists, epidemiologists, geneticists, biologists and psychiatrists. I have also obtained an MRC Centenary Award and an MQ Fellowship to conduct further research on this cohort.
Start Year 2011
 
Description EU-GEI/CAPsy 
Organisation European Commission
Department European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI)
Country European Union (EU) 
Sector Public 
PI Contribution I was involved in the development of the social assessment measures for this multi-site project as well as for training researchers. I also made a substantial contribution to the design and writing of the successful Wellcome grant application. Additionally, I also conduct indepth interviews with the psychosis patients.
Collaborator Contribution None at present but hopefully they will provide access to their data in the future.
Impact One paper to date: PMID: 23671196.
Start Year 2010
 
Description EU-GEI/CAPsy 
Organisation King's College London
Department Childhood Adversity and Psychosis (CAPsy) Study
Country United Kingdom 
Sector Academic/University 
PI Contribution I was involved in the development of the social assessment measures for this multi-site project as well as for training researchers. I also made a substantial contribution to the design and writing of the successful Wellcome grant application. Additionally, I also conduct indepth interviews with the psychosis patients.
Collaborator Contribution None at present but hopefully they will provide access to their data in the future.
Impact One paper to date: PMID: 23671196.
Start Year 2010
 
Description English Romanian adoption study 
Organisation University of Southampton
Country United Kingdom 
Sector Academic/University 
PI Contribution I provide training and ongoing advice regarding the assessment of psychotic symptoms in this sample of adopted adults.
Collaborator Contribution Hopefully in time I will be given access to this data.
Impact I have provided a training session to all of the researchers.
Start Year 2012
 
Description Forbow 
Organisation Dalhousie University
Country Canada 
Sector Academic/University 
PI Contribution Provided feedback on grant application and advice on measures to use. Scored psychosis measures as part of inter-rater reliability exercise. Went to Halifax in 2014 to train the team on the childhood abuse and victimisation measures.
Collaborator Contribution Involved me in a grant application for this project.
Impact No papers to date but 1 under review. One grant application on which I am a named collaborator to the Canadian Government. A range of disciplines are involved - psychology, psychiatry, biologists, sociologists, nurses, geneticists.
Start Year 2013
 
Description GAP study 
Organisation King's College London
Department Institute of Psychiatry, Psychology & Neuroscience
Country United Kingdom 
Sector Academic/University 
PI Contribution I have been involved in training staff, collecting data, analysing data, supervising students and writing up results for publication.
Collaborator Contribution Access to data and allocation of a PhD student.
Impact The following papers have been published: PMID: 23764407, PMID: 23891482, PMID: 20529412, PMID: 19751968 and PMID: 25101008.
Start Year 2006
 
Description HTA grant 
Organisation National Society for the Prevention of Cruelty to Children
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Provided input into grant application process, search for appropriate literature, comment on report drafts and facilitated stakeholder focus groups.
Collaborator Contribution Involvement in the grant application and reviewing process.
Impact We have an HTA grant together to systematically review literature on interventions for childhood maltreatment. No other outputs at present.
Start Year 2011
 
Description HTA grant 
Organisation Queen's University Belfast
Country United Kingdom 
Sector Academic/University 
PI Contribution Provided input into grant application process, search for appropriate literature, comment on report drafts and facilitated stakeholder focus groups.
Collaborator Contribution Involvement in the grant application and reviewing process.
Impact We have an HTA grant together to systematically review literature on interventions for childhood maltreatment. No other outputs at present.
Start Year 2011
 
Description HTA grant 
Organisation University of Bristol
Country United Kingdom 
Sector Academic/University 
PI Contribution Provided input into grant application process, search for appropriate literature, comment on report drafts and facilitated stakeholder focus groups.
Collaborator Contribution Involvement in the grant application and reviewing process.
Impact We have an HTA grant together to systematically review literature on interventions for childhood maltreatment. No other outputs at present.
Start Year 2011
 
Description Hamburg 
Organisation University Medical Center Hamburg-Eppendorf
Country Germany 
Sector Hospitals 
PI Contribution I provided supervision to a research psychiatrist from this centre and subsequently we have analysed and written papers together.
Collaborator Contribution Provided a research psychiatrist for a 2 month placement. Since then he has written papers with me.
Impact We have published several papers together: PMID: 22048144, PMID: 22033827, PMID: 21897251, PMID: 21741038, PMID: 23168909. I was also invited to give a seminar in Hamburg for a conference they were hosting.
Start Year 2010
 
Description Lifespan 
Organisation Kingston University London
Country United Kingdom 
Sector Academic/University 
PI Contribution I provided analysis skills, interpretation of the data and writing of papers. Additionally developed ideas for them for future grant applications. I am a co-investigator on a new project grant with this group.
Collaborator Contribution Provided access to invaluable archive of lifetime adversity data originally funded by MRC and also provided extensive training on adversity and attachment measures.
Impact A joint article has been published in Child Abuse and Neglect journal: PMID: 21354622. I gave a lecture on this work at an archive seminar hosted by Lifespan. Two more journal papers are currently being jointly prepared. We jointly wrote a successful application for an ESRC project grant which started on 01/11/13.
Start Year 2009
 
Description Lifespan 
Organisation Middlesex University
Department Department of Psychology
Country United Kingdom 
Sector Academic/University 
PI Contribution I provided analysis skills, interpretation of the data and writing of papers. Additionally developed ideas for them for future grant applications. I am a co-investigator on a new project grant with this group.
Collaborator Contribution Provided access to invaluable archive of lifetime adversity data originally funded by MRC and also provided extensive training on adversity and attachment measures.
Impact A joint article has been published in Child Abuse and Neglect journal: PMID: 21354622. I gave a lecture on this work at an archive seminar hosted by Lifespan. Two more journal papers are currently being jointly prepared. We jointly wrote a successful application for an ESRC project grant which started on 01/11/13.
Start Year 2009
 
Description Lifespan 
Organisation Royal Holloway, University of London
Department Department of Health & Social Care
Country United Kingdom 
Sector Academic/University 
PI Contribution I provided analysis skills, interpretation of the data and writing of papers. Additionally developed ideas for them for future grant applications. I am a co-investigator on a new project grant with this group.
Collaborator Contribution Provided access to invaluable archive of lifetime adversity data originally funded by MRC and also provided extensive training on adversity and attachment measures.
Impact A joint article has been published in Child Abuse and Neglect journal: PMID: 21354622. I gave a lecture on this work at an archive seminar hosted by Lifespan. Two more journal papers are currently being jointly prepared. We jointly wrote a successful application for an ESRC project grant which started on 01/11/13.
Start Year 2009
 
Description MiData 
Organisation Camden and Islington NHS Foundation Trust
Country United Kingdom 
Sector Public 
PI Contribution Involved in the development of the MiData audit tool for evaluating Early Intervention in Psychosis Services across London. Provide training for clinical teams, merge anonymised data, and provide supervision for MSc students who are using the data.
Collaborator Contribution Access to clinical data across London.
Impact We have published several papers: PMID: 24025696, PMID: 23701858, PMID: 22955006, PMID: 18560782, PMID: 25214411, and PMID: 25054369. There are 2 other papers under review. I have given over 10 presentations at international conferences on this project. Eight MSc thesis have been successfully submitted on this data. I have also provided over 50 half-day training sessions for clinicians on using this tool. Additionally, using data from this study, I provided a report for the Department of Health which they are using to assist their decisions around the new Payment by Results performance indicators for psychosis services in England.
Start Year 2006
 
Description MiData 
Organisation Central and North West London NHS Foundation Trust
Country United Kingdom 
Sector Public 
PI Contribution Involved in the development of the MiData audit tool for evaluating Early Intervention in Psychosis Services across London. Provide training for clinical teams, merge anonymised data, and provide supervision for MSc students who are using the data.
Collaborator Contribution Access to clinical data across London.
Impact We have published several papers: PMID: 24025696, PMID: 23701858, PMID: 22955006, PMID: 18560782, PMID: 25214411, and PMID: 25054369. There are 2 other papers under review. I have given over 10 presentations at international conferences on this project. Eight MSc thesis have been successfully submitted on this data. I have also provided over 50 half-day training sessions for clinicians on using this tool. Additionally, using data from this study, I provided a report for the Department of Health which they are using to assist their decisions around the new Payment by Results performance indicators for psychosis services in England.
Start Year 2006
 
Description MiData 
Organisation Chelsea and Westminster Hospital NHS Foundation Trust
Country United Kingdom 
Sector Public 
PI Contribution Involved in the development of the MiData audit tool for evaluating Early Intervention in Psychosis Services across London. Provide training for clinical teams, merge anonymised data, and provide supervision for MSc students who are using the data.
Collaborator Contribution Access to clinical data across London.
Impact We have published several papers: PMID: 24025696, PMID: 23701858, PMID: 22955006, PMID: 18560782, PMID: 25214411, and PMID: 25054369. There are 2 other papers under review. I have given over 10 presentations at international conferences on this project. Eight MSc thesis have been successfully submitted on this data. I have also provided over 50 half-day training sessions for clinicians on using this tool. Additionally, using data from this study, I provided a report for the Department of Health which they are using to assist their decisions around the new Payment by Results performance indicators for psychosis services in England.
Start Year 2006
 
Description MiData 
Organisation East London NHS Foundation Trust
Country United Kingdom 
Sector Public 
PI Contribution Involved in the development of the MiData audit tool for evaluating Early Intervention in Psychosis Services across London. Provide training for clinical teams, merge anonymised data, and provide supervision for MSc students who are using the data.
Collaborator Contribution Access to clinical data across London.
Impact We have published several papers: PMID: 24025696, PMID: 23701858, PMID: 22955006, PMID: 18560782, PMID: 25214411, and PMID: 25054369. There are 2 other papers under review. I have given over 10 presentations at international conferences on this project. Eight MSc thesis have been successfully submitted on this data. I have also provided over 50 half-day training sessions for clinicians on using this tool. Additionally, using data from this study, I provided a report for the Department of Health which they are using to assist their decisions around the new Payment by Results performance indicators for psychosis services in England.
Start Year 2006
 
Description MiData 
Organisation Imperial College London
Country United Kingdom 
Sector Academic/University 
PI Contribution Involved in the development of the MiData audit tool for evaluating Early Intervention in Psychosis Services across London. Provide training for clinical teams, merge anonymised data, and provide supervision for MSc students who are using the data.
Collaborator Contribution Access to clinical data across London.
Impact We have published several papers: PMID: 24025696, PMID: 23701858, PMID: 22955006, PMID: 18560782, PMID: 25214411, and PMID: 25054369. There are 2 other papers under review. I have given over 10 presentations at international conferences on this project. Eight MSc thesis have been successfully submitted on this data. I have also provided over 50 half-day training sessions for clinicians on using this tool. Additionally, using data from this study, I provided a report for the Department of Health which they are using to assist their decisions around the new Payment by Results performance indicators for psychosis services in England.
Start Year 2006
 
Description MiData 
Organisation South London and Maudsley (SLAM) NHS Foundation Trust
Country United Kingdom 
Sector Public 
PI Contribution Involved in the development of the MiData audit tool for evaluating Early Intervention in Psychosis Services across London. Provide training for clinical teams, merge anonymised data, and provide supervision for MSc students who are using the data.
Collaborator Contribution Access to clinical data across London.
Impact We have published several papers: PMID: 24025696, PMID: 23701858, PMID: 22955006, PMID: 18560782, PMID: 25214411, and PMID: 25054369. There are 2 other papers under review. I have given over 10 presentations at international conferences on this project. Eight MSc thesis have been successfully submitted on this data. I have also provided over 50 half-day training sessions for clinicians on using this tool. Additionally, using data from this study, I provided a report for the Department of Health which they are using to assist their decisions around the new Payment by Results performance indicators for psychosis services in England.
Start Year 2006
 
Description MiData 
Organisation South West London and St George's Mental Health NHS Trust
Country United Kingdom 
Sector Public 
PI Contribution Involved in the development of the MiData audit tool for evaluating Early Intervention in Psychosis Services across London. Provide training for clinical teams, merge anonymised data, and provide supervision for MSc students who are using the data.
Collaborator Contribution Access to clinical data across London.
Impact We have published several papers: PMID: 24025696, PMID: 23701858, PMID: 22955006, PMID: 18560782, PMID: 25214411, and PMID: 25054369. There are 2 other papers under review. I have given over 10 presentations at international conferences on this project. Eight MSc thesis have been successfully submitted on this data. I have also provided over 50 half-day training sessions for clinicians on using this tool. Additionally, using data from this study, I provided a report for the Department of Health which they are using to assist their decisions around the new Payment by Results performance indicators for psychosis services in England.
Start Year 2006
 
Description MiData 
Organisation St George's University of London
Country United Kingdom 
Sector Academic/University 
PI Contribution Involved in the development of the MiData audit tool for evaluating Early Intervention in Psychosis Services across London. Provide training for clinical teams, merge anonymised data, and provide supervision for MSc students who are using the data.
Collaborator Contribution Access to clinical data across London.
Impact We have published several papers: PMID: 24025696, PMID: 23701858, PMID: 22955006, PMID: 18560782, PMID: 25214411, and PMID: 25054369. There are 2 other papers under review. I have given over 10 presentations at international conferences on this project. Eight MSc thesis have been successfully submitted on this data. I have also provided over 50 half-day training sessions for clinicians on using this tool. Additionally, using data from this study, I provided a report for the Department of Health which they are using to assist their decisions around the new Payment by Results performance indicators for psychosis services in England.
Start Year 2006
 
Description MiData 
Organisation University College London
Country United Kingdom 
Sector Academic/University 
PI Contribution Involved in the development of the MiData audit tool for evaluating Early Intervention in Psychosis Services across London. Provide training for clinical teams, merge anonymised data, and provide supervision for MSc students who are using the data.
Collaborator Contribution Access to clinical data across London.
Impact We have published several papers: PMID: 24025696, PMID: 23701858, PMID: 22955006, PMID: 18560782, PMID: 25214411, and PMID: 25054369. There are 2 other papers under review. I have given over 10 presentations at international conferences on this project. Eight MSc thesis have been successfully submitted on this data. I have also provided over 50 half-day training sessions for clinicians on using this tool. Additionally, using data from this study, I provided a report for the Department of Health which they are using to assist their decisions around the new Payment by Results performance indicators for psychosis services in England.
Start Year 2006
 
Description NSPCC 
Organisation National Society for the Prevention of Cruelty to Children
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution I analysed a portion of the data related to mental health outcomes of maltreatment and wrote parts of the NSPCC report. I have subsequently provided additional assistance with analysis of child maltreatment data and conducted statistical workshops for their staff.
Collaborator Contribution Provided access to large national datset of children and adolescents and gave me experience of working in a charitable organisation.
Impact We jointly wrote an extensive report on the study for the NSPCC that has been published and circulated to government officials, media and relevant stakeholders. This has also been published in part as a journal article: PMID: 23522961. We have two further papers under review. Additionally, I provided a lecture on child abuse and psychosis to an NSPCC seminar series for social workers along with statistical methods' workshops.
Start Year 2010
 
Description International article 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact EU-related organisation Research Media commissioned an article to showcase my work in their publication: International Innovations. This is currently in the process of being distributed to 51000 stakeholders world-wide at every level of the government, policy, research and the health community.

Not known as yet.
Year(s) Of Engagement Activity 2012
 
Description Lecture to Community Paediatricians 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Health professionals
Results and Impact 150 paediatricians attended my lecture on bullying and self-harm and discussed how to implement my research into their clinical practice. This lecture has been repeated twice.

Unknown. Hopefully it has made these clinicians consider asking children they see about bullying and point them in the direction of relevant services.
Year(s) Of Engagement Activity 2012,2013
 
Description MRC Centenary Science Museum Game of Life 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? Yes
Type Of Presentation Workshop Facilitator
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Over 200 children and adults attended the MRC Centenary event at the Science Museum. I was involved in developing an epigenetics activity and running the interactive stall for the MRC SGDP Centre as part of this event.

Not known. Hopefully this event sparked a greater understanding in people from different generations about how experiences you have in life get underneath your skin and influence your health and well-being. certainly that was the impression I got from the people I spoke to on the day.
Year(s) Of Engagement Activity 2013
URL http://www.centenary.mrc.ac.uk/
 
Description MRC SGDP Centre Open Day 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? Yes
Type Of Presentation Workshop Facilitator
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Over 150 children from local schools and adults from the local community visited the MRC SGDP Centre Science open day. They participated in activities such as building a brain, creating DNA from pipecleaners, and extracting DNA from strawberries. I was involved in running a stall based on the Dunedin Study where people could try out aging activities such as scratch and sniff, balance, grip strength and hand-eye coordination tests.

Several local schools have requested that we run this open day event every year!
Year(s) Of Engagement Activity 2013
URL http://www.kcl.ac.uk/iop/depts/mrc/events/MRC-Centenary-Events-at-the-SGDP/index.aspx
 
Description Radio interview (Sky News) 
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 Invited to be interviewed on the radio for Sky news to discuss my BMJ paper on bullying and self harm. This broadcast was sent to over 100 radio stations in the UK.

Unknown.
Year(s) Of Engagement Activity 2012