Eirini Flouri

Eirini Flouri
University College London | UCL · Department of Psychology and Human Development

PhD in Psychology

About

187
Publications
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Introduction
My broader research agenda is to seek to understand how contextual and biological risks impact on child psychopathology, so as to be able to suggest how resilience in children can be promoted.

Publications

Publications (187)
Article
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Objectives We examined whether decision-making at age 11 and 14 is associated with prodromal eating pathology at age 14 and whether it would persist across adolescence and also be present at age 17. Design This prospective, observational, population-based cohort study used a longitudinal design. Setting Data from the Millennium Cohort Study (MCS)...
Article
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Purpose School-level characteristics are known to be associated with pupils’ academic and cognitive ability but also their socioemotional development. This study examines, for the first time, whether primary school characteristics are associated with pupils’ affective decision-making too. Methods The sample included 3,141 children participating in...
Article
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Objective Deficits in social cognition are associated with internalising (emotional and peer problems) and externalising (conduct problems and hyperactivity/inattention) symptoms in youth. It has been suggested that stress may be one of the mechanisms underlying these associations. However, no empirical studies have investigated if physiological st...
Article
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The research exploring the association between the built environment and children's mental health and cognitive abilities has produced mixed results. This may be due to the inconsistency in the approach taken to describe the built environment. This study, using data from the Millennium Cohort Study (MCS), a large general-population birth cohort, co...
Article
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We investigated the role of physical characteristics of kindergartens’ outdoor play areas in teacher-rated physical aggression (PAgg) among 423 children followed annually from ages two to four years. We used data from the Behaviour Outlook Norwegian Developmental Study which follows children from southeast Norway, a country where almost all two- to...
Article
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Objective: Differences in decision-making under conditions of risk have been observed cross-sectionally in clinical groups of people with eating disorders but have never been studied longitudinally or in large cohorts. We investigated whether responses on the Cambridge Gambling Task (CGT), measured in the Millennium Cohort Study in childhood, woul...
Article
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Psychiatric disorders like eating disorders (EDs) might be underpinned by differences in decision making. However, little previous research has investigated this potential relationship using longitudinal data. This study aimed to understand how components of decision making (delay aversion, risk adjustment, risk taking, quality of decision making a...
Article
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Background The emergence of eating problems during childhood increases the risk for eating disorders (EDs) during young adulthood. Previous studies highlight a relationship between poor self-regulation and onset of eating pathology. In this study, we investigated whether this association is mediated by decision-making difficulties. Methods To test...
Article
We explored the role of long-term greenspace deprivation in how children evaluate potential rewards and punishments and use this information to make decisions. We used data from the Millennium Cohort Study (MCS), a large population-based longitudinal birth cohort in the UK. Reward and punishment sensitivity was measured at the age 11 data wave with...
Article
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Background: Autism can be diagnosed from 2 years of age, although most autistic people receive their diagnosis later than this after they have started education. Research is required to understand why some autistic children are diagnosed late, and the level and nature of unmet need prior to diagnosis for late-diagnosed children. Methods: We exam...
Article
Background The paucity of research investigating the role of the physical environment in the developmental progression of conduct problems and the potential moderating effects of intellectual disability (ID) is surprising, given the clinical relevance of elucidating environmental determinants of disruptive behaviours. Aims To use data from a large...
Article
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According to Life History Theory, environments with abundant and reliable resources encourage ‘slow’ (deliberative) strategies that are low-risk and focused on long-term outcomes. Arguably, greener neighbourhoods may approximate such environments, especially in urban settings. This study used the UK’s Millennium Cohort Study to investigate the role...
Article
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Research shows that paternal psychological distress is associated with child emotional and behavioural difficulties. However, little is known about the direction of this association including whether it is bidirectional. The aim of this study was to explore the reciprocal relationships between paternal psychological distress and child emotional and...
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Mental health and well-being in adolescence are associated with many short- and long-term outcomes. The evidence suggests that greenspace may play a role in adolescents' mental well-being, but we do not know much about the specifics of this link. In this paper, we investigated the role of other factors in the association. In a cross-sectional study...
Preprint
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Background: The paucity of research investigating the role of the physical environment in the developmental progression of conduct problems and the potential moderating effects of intellectual disability (ID) is surprising, given the clinical relevance of elucidating environmental determinants of disruptive behaviours. Aims: To use data from a larg...
Article
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This study examined the development of decision-making and its association with psychological wellbeing and risky behaviours in adolescents with and without autism. Participants included 270 autistic and 9,713 typically developing adolescents. In both samples, those with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) were excluded....
Article
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Ability‐grouping has been studied extensively in relation to children's academic, but not emotional and behavioral outcomes. The sample comprised 7259 U.K. children (50% male) with data on between‐class and within‐class ability‐grouping at age 7. Peer, emotional, hyperactivity, and conduct problems were measured at ages 7, 11, and 14 years. Childre...
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Experience of bullying may be a significant risk factor for non-suicidal self-injury (NSSI). This study had three aims: to systematically investigate the association between bullying and NSSI, analyze the possible mechanisms underlying the two phenomena, and evaluate any differences between bullying victimization and bullying perpetration with resp...
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Objective Children with attention-deficit/hyperactivity disorder (ADHD) show hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis. Whether the association between hyperactivity/inattention symptoms with HPA axis dysfunction holds in the general child population too is not clear. Method We assessed associations between longitudinal traject...
Article
Importance People with anorexia nervosa often experience difficulties regulating their emotions. There is no longitudinal evidence as to whether these differences are already present in childhood or when they begin to emerge. Objective To investigate the association between emotion regulation trajectories from 3 to 7 years of age and symptoms of a...
Article
Background Psychopathology in childhood and adolescence, commonly indexed by co-occurring internalizing and externalizing problem behaviors, has been found to predict psychotic-like experiences (PLEs) in adults. However, studies to date have rarely examined internalizing and externalizing problem behaviors simultaneously or identified in which deve...
Article
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Adolescents who perceive their neighbourhoods as unsafe are more likely to display emotional and behavioural problems. But, little is known about whether perceptions of safety and problem behaviour influence each other. This study explored the reciprocal relationships between perceptions of neighbourhood safety and emotional and behavioural problem...
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This study explored if adolescents’ style of decision-making is related to the sex composition of their friendship groups. Using data on 13,413 members of the Millennium Cohort Study at ages 11 and 14 years, we explored reciprocal associations between decision-making, measured with the Cambridge Gambling Task, and own-sex and other- or mixed-sex co...
Article
Introduction Experience of bullying may be a significant risk factor for non-suicidal self-injury (NSSI). Objectives This study had three aims: to systematically investigate the association between bullying and NSSI, to analyze the possible mechanisms underlying the two phenomena, and to evaluate any differences between bullying victimization and...
Article
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Background Temperament is associated with circulating inflammatory biomarkers, such as C-reactive protein (CRP), which has been associated with various health conditions, including depression. This study aims to investigate whether genetic disposition for increased circulating CRP concentration may influence temperament over the life-course. Metho...
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Background Cognitive mechanisms that characterize or precede depressive symptoms are poorly understood. We investigated cross-sectional and longitudinal associations between risk taking to obtain reward and adolescent depressive symptoms in a large prospective cohort, using the Cambridge Gambling Task (CGT). We also explored sex differences. Metho...
Article
This systematic review examines the evidence on the association between social cognition and cortisol in the general population. Literature was searched in six databases. Of the 401 studies identified, meta‐analyses were conducted on 46 effect sizes (Pearson's correlation coefficients) from 19 studies, supplemented by a narrative review. Pooled est...
Article
Background: In children, internalizing and externalizing problems impact on learning. However, there is limited research on the specific impact of such problems on spatial working memory (SWM), strongly related to cognitive ability and children's learning. Aims: We explored distinct trajectories of internalizing problems and externalizing proble...
Article
Psychotic-like experiences (PLEs) are part of a continuum of psychosis. Previous longitudinal studies highlighted a relationship between peripheral inflammation during childhood and onset of PLEs in adulthood. In this study, we tested if this association is mediated by internalising and externalising symptoms experienced during childhood and adoles...
Article
Background Family financial difficulties have been directly linked to poorer executive functioning in childhood. However, recent studies suggest that difficulties in affording basic items and other necessities may also indirectly affect children’s executive functions through several psychological but also physiological paths. One of the latter may...
Article
Self-regulation is an important marker of both cognitive and socio-emotional competency. This exploratory study examined the role of the indoor home environment in children’s trajectories of two components of self-regulation: emotional dysregulation and independence. We used growth curve modelling to explore the trajectories of self-regulation amon...
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Background Despite the growing interest in the involvement of decision-making under conditions of risk in the onset of eating disorders in adolescence, no studies have investigated how the development of decision-making across that period may influence such a risk. Using data from the Millennium Cohort Study this study explored whether changes in p...
Preprint
Author NotesThis manuscript has been submitted for publication and is likely to be edited as part of the peer-review process. Correspondence regarding this paper should be addressed to Keri Ka-Yee Wong, keri.wong@ucl.ac.uk.AbstractBackground Psychopathology in childhood and adolescence, commonly indexed by co-occurring internalizing and externalizi...
Article
Self-regulation in childhood is associated with multiple short- and long-term outcomes, including academic achievement, and physical and mental health. The literature to date suggests several individual and family factors that can influence children's development of self-regulation. However, the role of the wider context, particularly the wider phy...
Article
Background High or increasing trajectories of internalising and externalising symptoms in childhood are mutually re-enforcing and associated with poor emotional and behavioural outcomes in adolescence. This study sought to identify classes of children with similar trajectories of internalising and externalising symptoms after adjusting one domain's...
Article
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Background The prevalence of childhood psychopathology fluctuates across the lifespan, yet studies often adopt linear growth curve models (LGM) of estimation that assumes constant linear growth and do not account for the comorbidity between internalizing and externalizing behaviors in predicting later psychosis. This study tests whether internalizi...
Article
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This study aimed to identify determinants of a late autism spectrum disorder diagnosis, including diagnoses made ‘very late’ (i.e., in adolescence), using the Millennium Cohort Study, a nationally representative population-based cohort in the United Kingdom. Children diagnosed with autism spectrum disorder by age 14 (N = 581) were included and grou...
Article
Background Elevations in inflammatory marker levels have been shown to precede internalising and externalising problems in the general child population. One study has found the reverse, that elevations in inflammatory marker levels in childhood follow internalising and externalising problems. However, the authors did not explore the role of the cou...
Article
Background: Stressful life events experienced during childhood and early prenatal development have been associated with inflammation during childhood. However, no study has considered these two exposures jointly, or has investigated the effect of their interaction. Methods: In the Avon Longitudinal Study of Parents and Children, a general-popula...
Article
Children living in deprived areas tend to show greater problem behaviour relative to children in more advantaged areas. We explored the effect of different forms of area deprivation (such as income, education and health) on the development of child problem behaviour (emotional and behavioural problems) from early childhood to middle adolescence. Us...
Article
Background: Children from families of low socioeconomic status (SES) are more likely to be exposed to upsetting situations and stressors. Such exposures have, in turn, been linked to inflammation in some studies. In this study we explore if low SES is related to inflammation in children via such stressful life events. Methods: Data on 4,525 chil...
Article
Cognitive ability, externalizing symptoms, and internalizing symptoms are correlated in children. However, it is not known why they combine in the general child population over time. To address this, we used data on 17,318 children participating in the UK Millennium Cohort Study and followed-up five times between ages 3 and 14 years. We fitted thre...
Article
Background: No study has investigated the role of inflammation in explaining the association between early exposures to adverse life events and depressive symptoms in adolescence. Method: Using data from the Avon Longitudinal Study of Parents and Children, we tested if inflammatory markers [serum C-reactive protein (CRP) and interleukin 6 (IL-6)...
Article
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There is little research on the role of school and its composition in explaining individual children’s psychological outcomes. This study examined for the first time the role of several primary-school compositional characteristics, and their interactions with individual level characteristics, in the development of two such outcomes, internalising a...
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Purpose Low neighbourhood cohesion and increased levels of inflammation are independent predictors of psychological distress. In this study we explored if they also interact to predict it. Methods Our sample was 9,393 adult participants of the UK Household Longitudinal Study (UKHLS), a large longitudinal household panel study in the UK. Inflammati...
Article
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The article “Main and interactive effects of inflammation and perceived neighbourhood cohesion on psychological distress: results from a population-based study in the UK”, written by “Efstathios Papachristou, Eirini Flouri, Theodora Kokosi and Marta Francesconi”, was originally published electronically on the publisher’s Internet portal (currently...
Article
Psychotic-like experiences (PLEs) are part of a continuum of psychosis. Previous longitudinal studies highlighted a relationship between peripheral inflammation during childhood and onset of PLEs in adulthood. In this study, we tested if this association is mediated by internalising and externalising symptoms experienced during childhood and adoles...
Article
Inflammation has been proposed as a pathway from adverse physical environments to poor physical and mental health. We estimated longitudinal associations of neighbourhood-level air pollution and greenspace with individual-level inflammation (measured with C-reactive protein and fibrinogen), using data from over 8000 adults living in England and Wal...
Article
The existing literature suggests an association between the physical environment and mental health but also complex relationships between the social and the physical environment as well as between objective and subjective measures of the environment. In this study, we attempted to explore the role of the residential neighbourhood's physical environ...
Preprint
Full-text available
Background: Large population-based studies of neuropsychological factors that characterize or precede depressive symptoms are rare and we know little about gender differences in these associations. Methods: The Millennium Cohort is a representative UK birth cohort of children born between 2000 and 2002. The Cambridge Gambling Task (CGT) was complet...
Article
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Background This study explored the role of outdoor air pollution [nitrogen dioxide (NO2) and sulphur dioxide (SO2)] and indoor air quality (measured with damp or condensation and secondhand smoke exposures) at age 9 months in emotional, conduct and hyperactivity problems at age 3 years. Method Data from 11,625 Millennium Cohort Study children livi...
Article
We investigated, using a cross‐lagged design, the longitudinal association of bullying involvement and peer problems with affective decision‐making in adolescence (ages 11 and 14 years) in 13,888 participants of the Millennium Cohort Study. Affective decision‐making (risk‐taking, quality of decision‐making, risk adjustment, deliberation time, and d...
Article
Background: Cognitive ability and problem behaviour (externalising and internalising problems) are variable and inter-related in children. However, it is not known if they mutually influence one another, if difficulties in one cause difficulties in the other, or if they are related only because they share causes. Methods: Random-intercept cross-...
Article
Objective: To explore whether paternal psychological distress is related to the longitudinal course of child problem behavior after accounting for maternal psychological distress. Method: We used data from the Millennium Cohort Study (MCS), a large general-population birth cohort in the United Kingdom. Maternal and paternal psychological distres...
Article
Objective: To test the hypothesis that higher plasma levels of inflammatory markers due to exposure to adverse life events may lead to internalising and externalising symptoms in children. Method: Using data from the Avon Longitudinal Study of Parents and Children, a general population birth cohort, we explored if inflammatory markers [serum C-r...
Article
Full-text available
General cognitive ability (IQ) and problem behavior (externalizing and internalizing problems) are variable and inter-related in children. However, it is unknown how they co-develop in the general child population and how their patterns of co-development may be related to later outcomes. We carried out this study to explore this. Using data from 16...
Article
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Background Exposure to nature may be particularly beneficial for the brain regions that support spatial working memory, a strong correlate of academic achievement. Aims To explore whether children living in greener neighbourhoods (wards) have better spatial working memory. Sample Drawn from the UK's Millennium Cohort Study, the sample was 4,758 1...
Article
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Background: There is a well-established association between literacy difficulties and emotional and behavior disorders (EBD). However, the scarcity of experimental studies means directions of causality are not clear. Aims: This study investigates causal relationships between literacy and EBD, and implications of co-morbidity for intervention. Sampl...
Article
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This study investigated the role of intelligence and its development across childhood in decision‐making in adolescence (age 11 years). The sample was 12,514 children from the UK's Millennium Cohort Study, followed at ages 3, 5, 7, and 11 years. Decision‐making (risk‐taking, quality of decision‐making, risk adjustment, deliberation time, and delay...
Article
Research has shown that inflammation is implicated in the pathogenesis of mental health disorders, but not all individuals with such disorders have raised inflammatory markers. This study examined whether general intelligence may be a protective factor for 9666 adults aged 18–97 with elevated inflammation, measured with C-reactive protein (CRP), us...
Article
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Longitudinal patterns of maternal depressive symptoms have yet to be linked to risky behaviours, such as substance use or violence, in early adolescence, when such behaviours may be particularly detrimental. This study was carried out to do this. Using data from the UK’s Millennium Cohort Study, it modelled the effect of trajectories of maternal de...
Article
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Background: Parents of young children generally report more depressive symptoms than parents of adult children or people without children, mainly because the presence of young children increases exposure to significant stressors (such as stressful life events). However, most studies on the depressogenic role of stressful life events in parents of...
Technical Report
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This report reviews assessments for children under 6 in the UK for language literacy, numeracy and social emotional development. It also includes information about tools for assessing the home and early years environment
Article
We completed a systematic search of measures to assess language, literacy, numeracy, and socialemotional development for children up to the age of six. These included individual assessments of children’s competencies in these areas and assessments of the children’s home and early years environment. A review of the relevant competencies for these fo...
Article
Background The beneficial effect of physical activity (PA) on mental health in adults is well established, but less is known about this relationship in children. We examine associations between objectively measured sedentary time, PA and mental health in 11-year-olds from the UK Millennium Cohort Study (MCS). Methods Longitudinal data from MCS swe...
Article
Background: This study examined outdoor and indoor air quality at ages 9 months and 3 years and their association with cognitive ability at age 3 in England and Wales. Method: Data from 8198 Millennium Cohort Study children were analysed using multilevel regression. Outdoor air quality was assessed with mean annual estimates of nitrogen dioxide...
Article
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Strong spatial skills are associated with success in science, technology, engineering, and mathematics (STEM) domains. Although there is convincing evidence that spatial skills are a reliable predictor of mathematical achievement in preschool children and in university students, there is a lack of research exploring associations between spatial and...
Article
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Background: Incidence of depression increases markedly around age 13 years, and nearly three-quarters of adults report that their mental health problems started in adolescence. Although maternal depression is a risk factor for adolescent depression, evidence about the association between paternal and adolescent depression is inconclusive, and many...
Article
Full-text available
Introduction Childhood maltreatment (CM) has been associated with an increased risk of non-suicidal self-injury (NSSI) and suicidal behaviors. However, the exact nature of the association between CM and NSSI is currently unclear. The present review aimed to systematically investigate the association between CM and NSSI in adolescence and early adul...
Article
Full-text available
Previous research shows that, compared to children without ADHD, children with ADHD have worse socio-emotional outcomes and more experience of socio-economic disadvantage. In this study, we explored if and how the increased emotional and behavioural difficulties faced by children with ADHD may be accounted for by their more disadvantaged socio-econ...