Regulating Emotions - Strengthening Adolescent Resilience (RE-STAR)

Lead Research Organisation: King's College London
Department Name: Child and Adolescent Psychiatry

Abstract

Many people experience adolescent depression. If we can find out who will do this and understand the reasons why, then we will be in a better position to find ways to support them to become more resilient and help them stop developing depression. This is our goal in Regulating Emotions - Strengthening Adolescent Resilience (RE-STAR). To achieve this, we will work with groups of people known already to be likely to develop depression during adolescence - those with high levels of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD); both those with diagnoses and those with high levels of these characteristics with no diagnoses - referred to overall as young people with neuroatypicalities (YPN). In RE-STAR, we will be especially interested in whether YPN who develop depression by late adolescence already show differences in how they react emotionally to challenges they experience in their day-to-day lives in early adolescence. We chose this focus because we know that YPN often have difficulties controlling their emotions when facing challenges and because emotional problems in early adolescence can lead to adolescent depression in other groups.

In RE-STAR, different experts will work together in a team including scientists, artists, teachers and doctors. They will work with YPN themselves who will be part of our Youth Researcher Panel. RE-STAR will place YPN's views, based on their day-to-day experiences, at the heart of its work to make sure it has an authentic view of the emotional challenges YPN face. We will learn about these experiences by listening to YPN discuss them but also through their performance in plays, dance and creative writing. This will then guide our search for the underlying reasons why YPN have difficulties controlling their emotions and how these change during adolescence and if - and how - they become linked to depression. RE-STAR will focus on YPN's experiences at school. This is because YPN face some of their most significant emotional challenges there. At the same time, school offers a great place to work with YPN to help them to deal with these challenges more effectively. Crucially, YPN will be involved in RE-STAR throughout. Our Youth Researcher Panel members will be actively engaged in shaping the research questions, designing the studies, collecting data and interpreting findings in the light of their experiences. They will also fully contribute to the co-development of our new approach to helping YPN handle emotional challenges better to stop them developing depression.

RE-STAR will have 6 work packages (WPs). In WP1 we will work with YPN to develop a new way of measuring emotion regulation difficulties - the Emotion Regulation in Neurodiversity Index (ERNI) - based on YPN's own accounts of their experiences. In WP2, based on this new understanding, we will conduct experiments to explore how YPN's difficulties in emotion regulation are linked to differences in their minds, brains and bodies. This will be followed in WP3 by a study of the way emotion regulation abilities change during adolescence and how this becomes linked to the experience of depression - especially when individuals are faced with daily hassles and stressors. In WP4 we will use creative performance-based practices to delve deeper into YPN's understanding of their experiences and how this impacts, and is impacted by, emotion regulation and mental health. WP5 will focus on the school as a context for YPN's emotion regulation challenges to build a platform for effective intervention. Finally, in WP6 the key findings from the prior WPs will be brought together to shape the new school-based strategy to improve YPN's ability to handle emotional challenges and provide them with skills to help them reduce depression. Throughout RE-STAR we will ask how people with ADHD and ASD are similar and/or different from one another and whether they need different sorts of support with emotion regulation.

Technical Summary

RE-STAR's goal is to find ways to reduce the risk of depression in young people with neuroatypicalities (YPN) associated with ADHD and ASD traits: a group at especially high risk for this. It will integrate developmental science and co-intentional research to develop a multi-faceted understanding of the role of YPN's emotion regulation difficulties as drivers of depression. Then, working with YPN, it will adapt and integrate a number of existing generic approaches into a comprehensive school-based intervention strategy, tailored to the specific needs of those with ADHD and ASD traits; the aim being to pre-emptively strengthen emotion regulation in early adolescence to reduce depression later on. Through its Youth Researcher Panel, RE-STAR will embody a co-creation philosophy: YPN's understanding of emotion regulation will be at the heart of RE-STAR: YPN will shape study design and undertake data collection. This will begin with the co-development of a new youth-report emotion regulation scale in WP1. Using this scale, and working across the full spectrum of atypicality, WP2 will study the cognitive/neurophysiological underpinnings of emotional regulation in YPN, while WP3 will longitudinally characterise YPN's adolescent pathways to depression and if these are moderated by daily stressors and hassles. WP4 will use co-creative performance-based practices to delve deeper into YPN's understanding of their experiences and how this impacts, and is impacted by, emotion regulation and mental health. WP5 will focus on school as both a context for YPN's emotion regulation challenges and a potential platform for effective intervention. In all WPs, characteristics shared between ADHD and ASD traits will be distinguished from those unique to each. Finally, in WP6, the key findings from the prior WPs will be brought together to create and feasibility test a new school-based RE-STAR strategy which will be co-developed by YPN and other educational and mental health stakeholders.

Publications

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Sonuga-Barke E (2021) The neurodiversity concept: is it helpful for clinicians and scientists? in The lancet. Psychiatry

 
Description Autistica and ADHD Foundation Social Media Post for RE-STAR 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact Recruitment advert hosted by two collaborating charities: Autistica and ADHD Foundation (both non-academic partners on the study) via their social media channels. This was viewed by thousands of UK families. This provided families with information about study and directed them to how to find out more. And resulted in over 250 enquiries (within 3 days) from interested families.
Year(s) Of Engagement Activity 2022
 
Description King's College London Press Release for RE-STAR 
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 Media (as a channel to the public)
Results and Impact Press release, hosted by King's College London 2 July 2021, to announce two King's projects (of which RE-STAR is one) to form part of new UKRI £24m investment into adolescent mental health. This was viewed by thousands of current academics, students, practitioners, schools, policymakers, university alumni, NGO reps, media partners and members of the general public interested in research and the study at King's College London.
Year(s) Of Engagement Activity 2021
URL https://www.kcl.ac.uk/news/kings-projects-to-form-part-of-new-24m-investment-into-adolescent-mental-...
 
Description Podcast hosted by BBC - Prof Edmund Sonuga-Barke on RE-STAR 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Professor Sonuga-Barke was invited to introduce RE-STAR on the BBC series "New Thinking: Mental Health Research", part of the BBC's "Arts & Ideas" podcast. Here, he introduced RE-STARS vision and aims, and also discussed how the programme will draw on expertise from across the arts and science disciplines. The podcast aired on 18/02/22 and has received ~10,000 listens.
Year(s) Of Engagement Activity 2022
URL https://www.bbc.co.uk/programmes/p0bhybj6
 
Description Podcast hosted by Extraordinary Brains - Prof Edmund Sonuga-Barke on living with and researching neurodiversity 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Prof Sonuga-Barke was invited for an interview on Extraordinary Brains, a podcast hosted by neurodivergent paediatrician, Max Davie. Here, he talked about his experiences living with and researching neurodiversity such as ADHD, and his thoughts on directions for future research. The session was aired on 23/10/2022 and has since been downloaded 217 times.
Year(s) Of Engagement Activity 2021
URL https://www.extraordinarybrainspod.com/e/episode-13-with-edmund-sonuga-barke/
 
Description Seminar at London ADHD Research Forum, hosted by King's College London - Dr Georgia Pavlopoulou and Dr Sylvan Baker invited as speakers on RE-STAR 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact We were invited to introduce the study's vision for co-intentional research at the London ADHD Research Forum. This forum is jointly hosted by UCL and King's College London and is made up of academic researchers working in the field of child and adolescent psychiatry with a particular interest in ADHD. The seminar took place online on 22/02/22 and was attended by 26 academic researchers who participated in a lively discussion on how to do co-intentional research in this area. Title of talk: "The Concept of Co-intentional Research"
Year(s) Of Engagement Activity 2022
 
Description Seminar at London ADHD Research Forum, hosted by King's College London - Prof Edmund Sonuga-Barke, Dr Steve Lukito, Dr Myrofora Kakiloudou invited as speakers on RE-STAR 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact We were invited to introduce the study to the London ADHD Research Forum. This forum is jointly hosted by UCL and King's College London and is made up of academic researchers working in the field of child and adolescent psychiatry with a particular interest in ADHD. The seminar took place online on 22/02/22 and was attended by 26 academic researchers who provided useful feedback on our early plans for for the study, particularly with regard to the methodology. Title of talk: "Introducing RE-STAR (Regulating Emotions - Strengthening Adolescent Resilience").
Year(s) Of Engagement Activity 2022
 
Description Talk hosted by Royal Central School of Speech and Drama - Dr Sylvan Baker invited as speaker on RE-STAR 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Our co-investigator at Royal Central School of Speech and Drama was invited to present the vision for co-intentional research within RE-STAR at a faculty meeting on 16th February 2022. This was attended by university staff and students who engaged in a useful discussion on co-intentional research, as well as discussing the merits and challenges of combing methodologies from the arts and sciences. Title of talk: "Co-intentional Research: RE-STAR".
Year(s) Of Engagement Activity 2022