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 EJS (2023) Annual Research Review: Perspectives on progress in ADHD science - from characterization to cause. in Journal of child psychology and psychiatry, and allied disciplines

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

 
Title My Emotions and Me - Verbatim Performance. Delivered as part of the Being Human Festival, at Science Gallery London on 18th November 2022 
Description Verbatim recordings of transcripts from the RE-STAR qualitative interviews were performed by actors at a public engagement event at the Science Gallery London. The transcripts included neurodivergent young people's accounts of how they manage their emotions in the face of everyday stressors and hassles, what helps and what doesn't. These performances were used to stimulate discussion between the research team and the audience (general public) about schools etc could better accommodate the needs of neurodivergent young people to promote their emotional wellbeing. 
Type Of Art Performance (Music, Dance, Drama, etc) 
Year Produced 2022 
Impact This led to a productive discussion around what helps and what doesn't help neurodivergent young people manage their emotions. 
 
Title My Emotions and Me - Visual Installation displayed at Science Gallery London as part of Being Human Festival, 18th November 2022 
Description Images of the creative materials (artwork, models, poems) generated as part of the RE-STAR qualitative interview process were projected onto the walls of the Science Gallery London during the RE-STAR public engagement event: My Emotions and Me: A Journey Behind the Mask. This was part of the annual Being Human Festival. 
Type Of Art Artefact (including digital) 
Year Produced 2022 
Impact The visual installation provided a stimulus for discussion about the emotional lives of neurodivergent young people. 
URL https://www.beinghumanfestival.org/events/my-emotions-and-me-a-journey-behind-mask-fully-booked
 
Title My Emotions and Me - auditory installation. Presented at Science Gallery London as part of the Being Human Festival on 18th November 2022. 
Description Verbatim recordings of the transcripts from the RE-STAR qualitative interviews were shared with an audience at a public engagement event via a 'silent disco' format; this involved the audience listening through headphones, whilst walking around the gallery space. The auditory installation was part of a public engagement event, My Emotions and Me: the Journey Behind the Mask at the Science Gallery London, delivered on 18th November 2022. 
Type Of Art Artefact (including digital) 
Year Produced 2022 
Impact The auditory installation provided a stimulus for discussion around the topic of emotion regulation in neurodivergent young people. 
URL https://www.beinghumanfestival.org/events/my-emotions-and-me-a-journey-behind-mask-fully-booked
 
Description Being Human Festival
Amount £1,700 (GBP)
Organisation Being Human Festival 
Sector Charity/Non Profit
Start 01/2023 
End 02/2023
 
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 Invited talk - Annual Salvesen Lecture 2022 - by Professor Edmund Sonuga-Barke, Dr Susie Chandler, Dr Sylvan Baker. With Dr Georgia Pavlopoulou and Y-RP as discussants. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact The team delivered a live-screening of a pre-recorded lecture, followed by a live discussion on "The Neurodiversity Concept: Foundation for a New Science of Neurodevelopment?". 750 people signed up to watch online, with 450 joining the live broadcast, and >50 people joining in-person. The lecture has since had 1K views on Youtube.
Year(s) Of Engagement Activity 2023
URL https://www.youtube.com/watch?v=Q6i1VBZWRc0
 
Description Invited talk at EUNETHYDIS by Professor Edmund Sonuga-Barke, Dr Sylvan Baker, Dr Georgia Pavlopoulou and the Youth Researcher Panel. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The RE-STAR team gave an invited talk titled "RE-STAR: from neurodiversity to co-intentionality" at the annual meeting of the European Network of Hyperkinetic Disorders on 28/09/22. This sparked questions and discussions around how to involve neurodivergent people in research about neurodivergence, and how this can improve the real-world impact of translational science.
Year(s) Of Engagement Activity 2022
URL https://eunethydis.eu/wp-content/uploads/2022/09/Eunethydis-Annual-Meeting-Programme_forWEB.pdf
 
Description Keynote talk by Dr Georgia Pavlopoulou at British Psychological Society Educational and Child Psychology Section. Title: Learning from autistic people and their families- Re-writing the narrative 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Dr Georgia Pavlopoulou delivered this keynote talk to around 300 educational psychologists on 13th January 2023. The title of of the talk was Learning from autistic people and their families: re-writing the narrative, and included a discussion of the work in RE-STAR as an example. This stimulated discussion around what we can learn from the direct accounts of autistic people and their families.
Year(s) Of Engagement Activity 2023
 
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 Lecture by Dr Georgia Pavlopoulou to masters students at Institute of Education, UCL. Title: Creative participatory research - if so, how? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact Dr Pavlopoulou gave a talk to masters students on 22/11/22 at the Institute of Education, UCL as part of their module on Research Methods and Analysis in Psychology. The talk focused on creative ways of doing participatory research, using RE-STAR as an example. This led to discussions about how to do inclusive participatory mental health research.
Year(s) Of Engagement Activity 2022
 
Description Oral presentation at ITAKOM conference by Dr Georgia Pavlopoulou and members of the Youth Researcher Panel. Title: The feasibility of Shared Experience Interviewing as an inclusive framework for mental health research in neurodivergent young people 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact The RE-STAR team (including members of the Youth Researcher Panel; Y-RP) reported on a feasibility study in which Y-RP members co-interviewed neurodivergent young people, alongside academic researchers. They presented feedback from the young people, the Y-RP members and the academic researchers on the process which led to discussions about how to be more inclusive in the way we do mental health research. The talk took place on 14/03/2023.
Year(s) Of Engagement Activity 2023
URL https://itakom.org/wp-content/uploads/2023/01/SMR6382_ITAKOM_Abstract_Book_s1.pdf
 
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 Podcast hosted by changingstatesofmind.com, with Dr Georgia Pavolopoulou, Dr Sylvan Baker and members of our Youth Researcher Panel. Series title: Psychology in the Classroom. Episode title: Being Heard in Research. 546 downloads as of 08/03/23. 
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 Schools
Results and Impact The podcast series, 'Psychology in the Classroom' aims to bring current psychological research into the classroom. The RE-STAR podcasts aim to provide the audience with an insight into the running of a large-scale study such as RE-STAR. In this epidode (aired 27/06/22) our investigators and Youth Researchers spoke about how RE-STAR is involving young people in the planning and delivery of the research. It has been downloaded 546 times and sparked lively conversations among parents, researchers, participants, school staff etc who have listened to it.
Year(s) Of Engagement Activity 2022
URL https://changingstatesofmind.libsyn.com/re-star-being-heard-in-research
 
Description Podcast hosted by changingstatesofmind.com, with Professor Edmund Sonuga-Barke and Professor Emily Simonoff. Series title: Psychology in the Classroom. Episode title: Autism, ADHD and Depression. 599 downloads as of 08/03/23. 
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 Schools
Results and Impact In this podcast, Professor Sonuga-Barke and Professor Simonoff discussed the presentation of depression in autistic young people and those with ADHD, with a particular focus on the school context (how anxiety/depression might present in school, and what can be helpful). This episode aired on 11/01/23, and has already been downloaded 599 times. Listeners have commented on how helpful they found the practical tips for supporting ADHD and autistic young people in school.
Year(s) Of Engagement Activity 2023
URL https://changingstatesofmind.libsyn.com/autism-adhd-and-depression
 
Description Podcast hosted by changingstatesofmind.com, with Professor Edmund Sonuga-Barke. Series title: Psychology in the Classroom. Episode title: Introduction to RE-STAR. 520 downloads as of 08/03/23. 
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 Schools
Results and Impact This podcast series is aimed at school staff, and aims to bring current psychology research into the classroom. This podcast has now been downloaded 520 times and has sparked conversations between school staff, parents, students and young people that we have since come into contact with.
Year(s) Of Engagement Activity 2022
URL https://changingstatesofmind.libsyn.com/restar-regulating-emotions-strengthening-adolescent-resilien...
 
Description Podcast hosted by changingstatesofmind.com, with RE-STAR's Youth Researcher Panel. Series title: Psychology in the Classroom. Episode title: It's Time to Start Listening! 549 downloads as of 08/03/23. 
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 Schools
Results and Impact In this podcast (which aired 5/07/22), members of RE-STAR's Youth Researcher Panel, discussed how they have been involved in the programme so far, why they think youth involvement is important, what they feel they've contributed and what they feel they've gained from the experience. This has since sparked lively conversations with those (teachers, research participants, researchers, practitioners) who have listened to the episode.
Year(s) Of Engagement Activity 2022
URL https://changingstatesofmind.libsyn.com/re-star-its-time-to-start-listening
 
Description Public engagement event as part of the Being Human Festival, in collaboration with Science Gallery London. Event title: My Emotions and Me - A Journey Behind the Mask 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact RE-STAR's Youth Researcher Panel co-hosted a public engagement event in collaboration with the Science Gallery London, to share preliminary findings from the first part of the research programme and engage the public in the research. The event took place on 18/11/22 and involved a series of visual and audio installations, followed by a performance and discussion panel. ~50 attended the event in-person with another 49 joining the live-stream. This sparked questions and discussions around how neurodivergent young people manage their emotions in the face of everyday stresses and hassles, and what can be done to support this.
Year(s) Of Engagement Activity 2022
URL https://www.beinghumanfestival.org/events/my-emotions-and-me-a-journey-behind-mask-fully-booked
 
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 Kakoulidou 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 by Dr Sylvan Baker for McPin Foundation. Title: Multidisciplinary Mental Health Research - how to do it (better). 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Dr Sylvan Baker gave an online talk on 10th October 2022, on Multi-disciplinary Mental Health Research: how to do it (better). He discussed the work of RE-STAR as an example, and this led to discussion around how we can involve 'experts by experience' in our research.
Year(s) Of Engagement Activity 2022
 
Description Talk by Professor Edmund Sonuga-Barke, Dr Steve Lukito, Dr Myrofora Kakoulidou and Dr Angus Roberts for Child and Adolescent Psychiatry Department at IoPPN. Title: Regulating Emotions - Strengthening Adolescent Resilience: Work Package 1. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact The RE-STAR team presented the preliminary findings from the first RE-STAR work package, and outlined plans for further analyses. The audience gave some helpful feedback and suggestions for future work. Date of talk 06/03/23.
Year(s) Of Engagement Activity 2023
 
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
 
Description Video for IoPPN's social media channels by Dr Myrofora Kakoulidou and the members of the Youth Researcher Panel 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact The RE-STAR team (including members of the Youth Researcher Panel) were invited by King's IoPPN media team to create a video in which they talk about some of the challenges that neurodivergent young people might face and some of the things that help in the holiday season. The video was shared on Sat 17th Dec 2022 via King's social media channels (twitter, LinkedIn, Instagram). It was the most viewed instagram reel of the quarter, and one of the most popular of the year with 1K+ views on each of the channels.
Year(s) Of Engagement Activity 2022
URL https://www.instagram.com/p/CmRYlpatocM/