Kapil Sayal

Kapil Sayal
University of Nottingham | Notts · Division of Psychiatry and Applied Psychology

PhD

About

214
Publications
42,767
Reads
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6,740
Citations
Citations since 2017
76 Research Items
4178 Citations
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Publications

Publications (214)
Article
Full-text available
To understand whether the mental health of children and young people (CYP) with and without attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) were differentially affected by COVID-19. We analysed data (n = 6507) from the Co-Space study, a UK web-based longitudinal survey. CYP with ADHD (n = 160;2.5%), ASD (n = 46...
Article
Background: Randomised sham-controlled trials of cranial electrostimulation with the Alpha-Stim Anxiety Insomnia and Depression (AID) device have reported improved anxiety and depression symptoms; however, no adequately powered sham-controlled trials in major depression are available. We investigated whether active Alpha-Stim AID is superior to sh...
Article
Full-text available
The Covid-19 pandemic and mitigation approaches, including lockdowns and school closures, are thought to have negatively impacted children and young people’s (CYP) mental health. However, the impact for clinically referred CYP is less clear. We investigated differences in the mental health of CYP referred to specialist Child and Adolescent Mental H...
Article
Full-text available
Background Children referred for attention-deficit/hyperactivity disorder (ADHD) often present with a broader pattern of conduct problems including oppositionality and defiance. This combination can be extremely stressful to parents, lower parents’ self-esteem and negatively impact family life. The National Institute for Health and Care Excellence...
Preprint
Full-text available
Background Children referred for attention-deficit hyperactivity disorder (ADHD) often present with a broader pattern of conduct problems including oppositionality and defiance. This combination can be extremely stressful to parents, lower parents’ self-esteem, and negatively impact family life. The National Institute for Health and Care Excellence...
Article
Full-text available
This systematic review and meta-analysis explores the effectiveness of teacher interventions supporting children with externalizing behaviors based on teacher and child outcomes. A systematic search was conducted using 5 electronic databases. From 5714 papers, 31 papers that included interventions delivered directly to teachers and aimed to benefit...
Article
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Background There is a complex and inconsistent relationship between bullying involvement and self-harmful thoughts and behaviour (SHTB) in young people. This novel systematic review aims to establish key interacting, moderating and mediating variables associated with SHTB in young people involved in bullying. Methods The systematic review was regi...
Article
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Background Previous studies suggest an association between age within schoolyear and attention-deficit hyperactivity disorder (ADHD). Scotland and Wales have different school entry cut-off dates (six months apart) and policies on holding back children. We aim to investigate the association between relative age and treated attention deficit hyperact...
Article
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Introduction: Emotional disorders (such as anxiety and depression) are associated with considerable distress and impairment in day-to-day function for affected children and young people and for their families. Effective evidence-based interventions are available but require appropriate identification of difficulties to enable timely access to serv...
Article
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Background Major depression is the second leading cause of years lost to disability worldwide and is a leading contributor to suicide. However, first-line antidepressants are only fully effective for 33%, and only 40% of those offered psychological treatment attend for two sessions or more. Views gained from patients and primary care professionals...
Article
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Background: n the UK, children with high levels of hyperactivity, impulsivity and inattention referred to clinical services with possible attention-deficit/hyperactivity disorder (ADHD) often wait a long time for specialist diagnostic assessment. Parent training (PT) has the potential to support parents during this difficult period, especially rega...
Preprint
Full-text available
Background: In the UK, children with high levels of hyperactivity, impulsivity and inattention referred to clinical services with possible attention-deficit/hyperactivity disorder (ADHD) often wait a long time for specialist diagnostic assessment. Parent training (PT) has the potential to support parents during this difficult period, especially reg...
Article
Full-text available
Background: Although parent interventions are recommended as a frontline treatment approach for children with attention deficit hyperactivity disorder (ADHD), a number of practical and situational barriers can impact accessibility and availability. Self-help parent interventions offer a potential alternative to therapist-led interventions when bar...
Preprint
Full-text available
Importance COVID-19 public health mitigation measures are likely to have detrimental effects on emotional and behavioural problems in children. However, longitudinal studies with pre-pandemic data are scarce. Objective To explore trajectories of emotional and behavioural difficulties in children during the COVID-19 pandemic. Design and setting Data...
Article
Full-text available
Background Medication for attention deficit hyperactivity disorder (ADHD) should be closely monitored to ensure optimisation. There is growing interest in using computerised assessments of ADHD symptoms to support medication monitoring. The aim of this study was to assess the feasibility and acceptability of a randomised controlled trial (RCT) to e...
Article
Full-text available
Youth who self-harm report high levels of trait impulsivity and identify impulsive behaviour as a proximal factor directly preceding a self-harm act. Yet, impulsivity is a multidimensional construct and distinct impulsivity-related facets relate differentially to self-harm outcomes. Studies have yet to examine if and how a multidimensional account...
Article
Full-text available
Background: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting up to 5% of children and adults. Undiagnosed and untreated ADHD can result in adverse long-term health, educational, and social impacts for affected individuals. Therefore, it is important to identify this disorder as early as possible. General pr...
Article
Full-text available
Background Multimodal intervention incorporating psychosocial intervention and medication is recommended for school aged children with Attention‐Deficit/Hyperactivity Disorder (ADHD). This randomised controlled trial (RCT) investigates the adjunctive benefit of the self‐help version of the New Forest Parenting Programme (NFPP‐SH) when offered in a...
Article
Full-text available
Background Attention deficit hyperactivity disorder (ADHD) is underdiagnosed in the UK and the assessment and diagnosis pathway often involves a general practitioner (GP) referral to secondary care services. GPs’ levels of knowledge and understanding about ADHD is often a significant barrier in patients accessing care. The development of an online...
Article
Background Attention deficit hyperactivity disorder was previously seen as a childhood developmental disorder, so adult mental health services were not set up to support attention deficit hyperactivity disorder patients who became too old for child services. To our knowledge, this is the first in-depth study of the transition of attention deficit h...
Article
Full-text available
Digital health interventions (DHIs) have frequently been highlighted as one way to respond to increasing levels of mental health problems in children and young people. Whilst many are developed to address existing mental health problems, there is also potential for DHIs to address prevention and early intervention. However, there are currently limi...
Article
Full-text available
Background UK clinical guidelines recommend treatment of attention-deficit hyperactivity disorder (ADHD) in adults by suitably qualified clinical teams. However, young people with ADHD attempting the transition from children's to adults’ services experience considerable difficulties in accessing care. Aims To map the mental health services in the...
Preprint
Full-text available
BACKGROUND Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder affecting up to 5% of children and adults. Undiagnosed and untreated ADHD can result in adverse long term health, educational and social impacts for affected individuals. Identifying this disorder as early as possible is therefore important. General Practiti...
Article
Full-text available
Background Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting up to 5% of children and adults. Undiagnosed and untreated ADHD can result in adverse long-term health, educational, and social impacts for affected individuals. Therefore, it is important to identify this disorder as early as possible. General pra...
Article
Full-text available
Background Rates of self-harm in young adolescents are increasing and self-harm typically emerges at this developmental stage. Greater specificity of impulsivity as a multifaceted construct is enabling investigation of links between individual impulsivity facets and self-harm outcomes. However, studies have yet to adequately explore these associati...
Article
Background Self‐harm amongst young people is an increasing problem, with looked‐after young people at higher risk. Despite this, little research exists on what young people who self‐harm find helpful. Method One hundred and twenty‐six 11–21 year olds (53 who had experience of the care system and 73 who did not) were recruited from the community an...
Preprint
Full-text available
Background: Attention deficit hyperactivity disorder (ADHD) is underdiagnosed in the UK and the assessment and diagnosis pathway often involves a general practitioner (GP) referral to secondary care services. GPs’ levels of knowledge and understanding about ADHD is often a significant barrier in patients accessing care. The development of an online...
Preprint
Full-text available
Background: Attention deficit hyperactivity disorder (ADHD) is underdiagnosed in the UK and the assessment and diagnosis pathway often involves a general practitioner (GP) referral to secondary care services. GPs’ levels of knowledge and understanding about ADHD is often a significant barrier in patients accessing care. The development of an online...
Article
Full-text available
Background: Attention Deficit Hyperactivity Disorder (ADHD) is underdiagnosed in many European countries and the process of accessing care and diagnosis is complex and variable. In many countries, general practitioners (GPs) refer on to secondary care where individuals receive an assessment and, if appropriate, a diagnosis and access to care. It i...
Preprint
Full-text available
Background: Medication for attention deficit hyperactivity disorder (ADHD) should be closely monitored to ensure optimisation. There is growing interest in using computerised assessments of ADHD symptoms to support medication monitoring. The aim of this study was to assess the feasibility and acceptability of a randomised controlled trial (RCT) to...
Preprint
Full-text available
Background: Medication for attention deficit hyperactivity disorder (ADHD) should be closely monitored to ensure optimisation. There is growing interest in using computerised assessments of ADHD symptoms to support medication monitoring. The aim of this study was to assess the feasibility and acceptability of a randomised controlled trial (RCT) to...
Preprint
Full-text available
Background: Attention Deficit Hyperactivity Disorder (ADHD) is underdiagnosed in many European countries and the process of accessing care and diagnosis is complex and variable. In many countries, general practitioners (GPs) refer on to secondary care where individuals receive an assessment and, if appropriate, a diagnosis and access to care. It is...
Article
Full-text available
There is a growing international literature investigating the relationship between attention-deficit/hyperactivity disorder (ADHD) and younger relative age within the school year, but results have been mixed. There are no published systematic reviews on this topic. This study aimed to systematically review the published studies on the relative age...
Article
Full-text available
Methylphenidate (MPH), the most common medication for children with Attention Deficit/Hyperactivity Disorder (ADHD) in many countries, is often prescribed for long periods of time. Any long-term psychotropic treatment in childhood raises concerns about possible adverse neurological and psychiatric outcomes. We aimed to map current evidence regardin...
Preprint
Full-text available
Background Attention Deficit Hyperactivity Disorder (ADHD) is underdiagnosed in many European countries and the process of accessing care and diagnosis is complex and variable. In many countries, general practitioners (GPs) refer on to secondary care where individuals receive an assessment and, if appropriate, a diagnosis and access to care. It is...
Article
Full-text available
Attention deficit hyperactivity disorder (ADHD) is a developmental disorder affecting up to 5% of children and adults and is underdiagnosed in many European countries. The process of access to care for this disorder is complex and variable across countries. In general, those affected, or their caregiver, will seek help through their primary care pr...
Article
Full-text available
Objective: Although UK clinical guidelines make tentative recommendations for ‘harm minimisation’ strategies for repeated self-harm, this is in the absence of empirical evidence supporting their acceptability or effectiveness. We explore young people’s views of harm minimisation strategies (e.g. snapping elastic bands on skin, drawing on skin with...
Article
Full-text available
Background The Strengths and Difficulties Questionnaire (SDQ) is widely used to assess child and adolescent mental health problems. However, the factor structure of the SDQ is subject to debate and there is limited evidence investigating measurement equivalence invariance (ME/I) between treatment groups, informants, and across time. Method A rando...
Article
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Background: The study design and protocol that underpin a randomised controlled trial (RCT) are critical for the ultimate success of the trial. Although RCTs are considered the gold standard for research, there are multiple threats to their validity such as participant recruitment and retention, identifying a meaningful change, and non-adherence t...
Article
Full-text available
Background Optimal transition from child to adult services involves continuity, joint care, planning meetings and information transfer; commissioners and service providers therefore need data on how many people require that service. Although attention-deficit hyperactivity disorder (ADHD) frequently persists into adulthood, evidence is limited on t...
Article
The Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) is a widely used scale that measures the core symptoms of attention deficit hyperactivity disorder (ADHD). However, there are contradictory findings regarding factor structure. Factor structure and measurement equivalence/invariance analysis on parent and teacher SNAP-IV for children referred fo...
Article
Full-text available
Background Self-harm and depression are strong risk factors for repeat self-harm and suicide. We aimed to investigate the feasibility of a randomised controlled trial (RCT) of remotely delivered problem-solving cognitive behaviour therapy (PSCBT) plus treatment as usual (TAU) versus TAU in young people with repeat self-harm and depression. Methods...
Preprint
Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder affecting up to 5% of children and adults and is underdiagnosed in many European countries. The process of access to care for this disorder is complex and variable across countries. In general, those affected, or their caregiver, will seek help through their primary care pr...
Article
Rationale: Self-harm in young people is of significant clinical concern. Multiple psychological, social and clinical factors contribute to self-harm, but it remains a poorly understood phenomenon with limited effective treatment options. Objective: To explore young women's experience of self-harm in the context of interpersonal stressors and sup...
Article
Background: Globally, poisonings account for most medically-attended self-harm. Recent data on poisoning substances are lacking, but are needed to inform self-harm prevention. Aim: To assess poisoning substance patterns and trends among 10-24-year-olds across England DESIGN AND SETTING: Open cohort study of 1 736 527 young people, using linked C...
Article
Background Injuries commonly cause morbidity and mortality in children and young people (CYP). Attention‐deficit hyperactivity disorder (ADHD) is the commonest neurobehavioural disorder in CYP and is associated with increased injury risk. However, large, population‐based estimates of the risk of specific injuries are lacking. We aimed to provide es...
Article
Full-text available
Background Research about self-harm in adolescence is important given the high incidence in youth, and strong links to suicide and other poor outcomes. Clarifying the impact of involvement in school-based self-harm studies on young adolescents is an ethical priority given heightened risk at this developmental stage. Methods Here, 594 school-based...
Article
Background In England, there is a discrepancy between the prevalence of attention-deficit/hyperactivity disorder (ADHD) ascertained from medical records and community surveys. There is also a lack of data on variation in recorded prevalence by deprivation and geographical region; information that is important for service development and commissioni...
Article
Full-text available
Background Diagnosis of attention deficit hyperactivity disorder (ADHD) relies on subjective methods which can lead to diagnostic uncertainty and delay. This trial evaluated the impact of providing a computerised test of attention and activity (QbTest) report on the speed and accuracy of diagnostic decision‐making in children with suspected ADHD....
Article
Full-text available
Introduction: Attention-deficit hyperactivity disorder (ADHD) is characterised by symptoms of inattention, hyperactivity and impulsivity. To improve outcomes, the National Institute for Health and Care Excellence ADHD guidelines recommend regular monitoring of symptoms when children commence medication. However, research suggests that routine moni...
Article
Background: Findings are mixed on the relationship between attention-deficit hyperactivity disorder (ADHD) and younger relative age in the school year. We aimed to investigate whether relative age is associated with ADHD diagnosis in a country where prescribing rates are low and whether any such association has changed over time or relates to como...
Article
Importance: Patients with attention-deficit/hyperactivity disorder (ADHD) are at an increased risk of attempting suicide. Stimulants, such as methylphenidate hydrochloride, are the most common treatment for ADHD, but the association between their therapeutic use and suicide is unclear. Objective: To investigate the association between methylphen...
Article
Although emotional avoidance may be a critical factor in the pathway from psychological distress to self-injury and/or suicidality, little is known about the relative importance of differing functional coping dynamics and experiential avoidance between people with self-injury histories of differing intent (e.g., Non-Suicidal Self-Injury only vs. No...
Article
Objectives: Young people in the public care system ('looked-after' young people) have high levels of self-harm. Design: This paper reports the first detailed study of factors leading to self-harm over time in looked-after young people in England, using sequence analyses of the Card Sort Task for Self-harm (CaTS). Methods: Young people in care...
Article
Full-text available
Attention-Deficit/Hyperactivity Disorder (ADHD) is a common childhood behavioural disorder – systematic reviews indicate that the community prevalence of ADHD globally is between 2% to 7%, with an average of around 5%. In addition, a further 5% of children have significant difficulties with over-activity, inattention and impulsivity that are just s...
Article
Full-text available
Research supports an association between impulsivity and self-harm, yet inconsistencies in methodology across studies have complicated understanding of this relationship. This systematic review examines the association between impulsivity and self-harm in community-based adolescents aged 11-25 years and aims to integrate findings according to diffe...
Article
Full-text available
Background The diagnosis and monitoring of Attention deficit hyperactivity disorder (ADHD) typically relies on subjective reports and observations. Objective continuous performance tests (CPTs) have been incorporated into some services to support clinical decision making. However, the feasibility and acceptability of adding such a test into routine...