Understanding Mental Health in Neurodevelopmental Conditions: A Hidden Talents Approach

Neurodevelopmental conditions (NDCs) such as Autism, ADHD and Developmental Coordination Disorder are lifelong conditions which affect around 10% of the population (Emerging Minds, 2021). They have high co-occurrence with various mental health difficulties (Emerging Minds 2021).Autism alone is more costly than cancer, stroke, and heart disease, combined (Buescher et al., JAMA), yet there is little research spending on NDCs relative to other conditions (for example £6.60 per autistic adult vs £295 per cancer patient (Autistica, 2014)). Such underfunding, including PhD training, has left two particular gaps in understanding NDCs, which will be addressed in this project.

First, research on NDCs is overly focussed on single conditions even though neurodevelopmental traits are overlapping and continuously distributed in the population (Thapar et al., Lancet Psychiatry). Research suggests that it is more common for individuals with NDCs to have more than one condition rather than a 'pure' disorder (Rutter, 2008). Consequently there are calls for researchers to develop transdiagnostic approaches when researching NDCs rather than focusing on discrete categories (Astle et al., 2021; Emerging Minds, 2021).

Second, it is assumed that NDC related symptoms and adversities (e.g., bullying) are predictive of poor cognition and mental health. However, previous research has neglected to consider how adaptive developmental processes sometimes enhance cognition and thereby could reduce mental illness. This has recently been formalised as the 'hidden talents' approach (Frankenhuis et al., 2020, TiCS).

Drawing on population-based data and the cognitively grounded hidden talents approach, this cross-disciplinary project will identify hidden talents in NDCs and thereby inform understanding of and interventions for improving mental health in NDCs.

Study 1-An online qualitative survey study to investigate the lived experience of adolescents and adults with NDCs focusing on their talents and coping. Themes and findings will inform variable selection and modelling in Studies 2-4.
Studies 2-4-Three studies drawing on genetic, neuroimaging, and cognitive data in the Adolescent Brain Cognitive Development cohort; abcdstudy.org. This is the largest population-based study of neurocognition and health in the US (N~12K), with several measures of overlapping NDCs and mental health. Analyses will focus on uncovering hidden talents, i.e., neural and cognitive markers positively associated with NDCs and related adversities. We will then test if these hidden talents moderate the association between NDCs, related adversities, and later mental health outcomes, using genetically sensitive longitudinal analyses.

In identifying hidden talents in NDCs, the findings will be able to inform understanding of and interventions for improving mental health in neurodevelopmental conditions. Most research on NDCs focuses on single conditions, and so this project will provide insight into overlaps between conditions. The results will be presented to clinicians and charity partners, thereby increasing the potential for the findings to inform clinical practice and national policy. This research is relevant to the GW4 BioMed MRC strategic research theme of 'population health'.