Keri Wong is a developmental psychologist, currently the Betty Behrens Research Fellow at the Department of Psychology, University of Cambridge. Her research interests are in developmental psychopathology, schizophrenia-spectrum disorders and the causes of crime.
Research Items (13)
Background Research on paranoia in adults suggests a spectrum of severity, but this dimensional approach has yet to be applied to children or to groups from different countries. Aims To investigate the structure, prevalence and correlates of mistrust in children living in the UK and Hong Kong. Method Children aged 8-14 years from the UK (n = 1086) and Hong Kong (n = 1412) completed a newly developed mistrust questionnaire as well as standard questionnaire measures of anxiety, self-esteem, aggression and callous-unemotional traits. Results Confirmatory factor analysis of the UK data supported a three-factor model - mistrust at home, mistrust at school and general mistrust - with a clear positive skew in the data: just 3.4%, 8.5% and 4.1% of the children endorsed at least half of the mistrust items for home, school and general subscales respectively. These findings were replicated in Hong Kong. Moreover, compared with their peers, ‘mistrustful’ children (in both countries) reported elevated rates of anxiety, low self-esteem, aggression and callous-unemotional traits. Conclusions Mistrust may exist as a quantitative trait in children, which, as in adults, is associated with elevated risks of internalising and externalising problems.
Previous studies with preschoolers have reported "East-West" contrasts in children's executive function (East>West) and theory of mind (East<West). This cross-cultural study with two samples of older children from the United Kingdom and Hong Kong aimed to test competing accounts of these contrasts that focus on either global effects of culture or more specific effects of pedagogical experience. Both groups of children in Hong Kong outperformed the British children on executive function tasks. That is, with respect to executive function, general cultural influences appear to be salient. In contrast, compared with their U.K. counterparts, children attending local schools in Hong Kong (but not those attending British-based international schools in Hong Kong) performed poorly on age-appropriate tests of theory of mind. With respect to theory of mind, therefore, pedagogical experiences appear to be more salient than factors related to the broad contrast between individualist and collectivist cultures. Our findings also contribute to the debate surrounding the relationship between theory of mind and executive function; although scores on these two sets of tasks were robustly correlated within each country, the double dissociation between delayed theory of mind but superior executive function for children in local schools in Hong Kong compared with their U.K. peers suggests that variation in executive function may be necessary but is not sufficient to explain variation in theory of mind.
Purpose of the Review This review identifies the early developmental processes that contribute to schizotypy and suspiciousness in adolescence and adulthood. It includes the most recent literature on these phenomena in childhood. Recent Findings The early developmental processes that affect schizotypy and paranoia in later life are complex. In contrast to existing studies of psychiatric patients and clinical/nonclinical adult populations, the study of schizotypy and suspiciousness in young children and adolescents is possible due to new child-appropriate dimensional assessments. New assessments and the advancement of technology (e.g., virtual reality in mental health) as well as statistical modeling (e.g., mediation and latent-class analyses) in large data have helped identified the developmental aspects (e.g., psychosocial, neurocognitive and brain factors, nutrition, and childhood correlates) that predict schizotypy and suspiciousness in later life. Summary Prospective longitudinal designs in community youths can enhance our understanding of the etiology of schizophrenia-spectrum disorders and, in the future, the development of preventive interventions by extending adult theories and interventions to younger populations.
Background: We validated the Social Mistrust Scale (SMS) and utilized it to examine the structure, prevalence, and heritability of social mistrust in a large sample of Chinese children and adolescents. Methods: In Study 1, a large sample of healthy twins (N=2094) aged 8 to 14years (M=10.27years, SD=2) completed the SMS. Structural equation modeling (SEM) was conducted to assess the structure of the SMS and to estimate the heritability of social mistrust in a sub-sample of twins (n=756 pairs). In Study 2, 32 adolescents with childhood-onset schizophrenia were compared with 34 healthy controls on levels of suspiciousness and clinical symptoms to examine the associations between the SMS and the Positive and Negative Syndrome Scale (PANSS). Results: We found a three-factor structure for social mistrust (home, school, and general mistrust). Social mistrust was found to be moderately - heritable (19%-40%), with mistrust at home most strongly influenced by genetic factors. Compared with 11.76% of the healthy controls, 56.25% of the adolescents with early-onset schizophrenia exhibited very high levels of social mistrust on all three subscales of the SMS. The SMS exhibited good discriminant validity in distinguishing adolescents with childhood-onset schizophrenia from healthy controls and showed associations with a broad range of symptoms assessed by the PANSS. Conclusions: Social mistrust assessed by the SMS may be heritable. The SMS demonstrates good discriminant validity with clinical diagnoses of schizophrenia. However, it seems to be correlated with multiple aspects of psychopathology in the schizophrenia group, rather than being specific to delusional ideation/paranoia.
- Sep 2018
Objective: Negative home environments are associated with both schizophrenia-spectrum disorders and crime, but whether this is due to the social or cognitive sequelae of such environments is unclear. This study investigates the effect of early home environments on adult mental health. Method: Using data from the Mauritius Child Health Project, a multiple time-point prospective study where all children born in 1969 in two towns (Quatre Bornes and Vacaos) were recruited at age 3 years (N = 1794), a group of children left home alone at age 3 (n = 34) were compared to children cared for by siblings/relatives (n = 222), or by mothers (n = 1498) on antisocial behavior and schizotypal personality at ages 11, 17, and 23 years. Results: Home alone children showed higher scores on psychotic behavior and conduct disorder at age 17, and also schizotypal personality and crime at 23 years compared to the other groups. No negative behavioral or cognitive effects were observed at age 11. Findings were not accounted for by social adversity or ethnicity and appear to be 'sleeper effects' in that they do not emerge until later adolescence and into adulthood. Conclusions: Findings appear to be the first to show the negative effects of dual-parental daytime absence on adult schizotypy and crime, a finding that cannot be accounted for by verbal and spatial cognitive impairments. Results suggest an early common psychosocial denominator to the two comorbid conditions of antisocial behavior and schizotypy.
Project - Social Mistrust and Behavioural Understanding in UK and Hong Kong Children
First dimensional assessment of paranoia in children. FREE for research use. Please email author for permission and more information.
Background Paranoia exists on a continuum of severity in adult patient populations and more recently it has been found to exist in children and adolescents in the general population. Childhood paranoia, assessed by the Social Mistrust Scale (SMS), has been found to be related to both internalising and externalising problem behaviours (Wong, Freeman & Hughes, 2014); however, the nature of why children’s suspicions are related to psychosocial functioning remains unexamined. The current qualitative study addresses this gap by following up the original 2014 sample to examining the nature of children’s suspicions using thematic analysis. By giving voice to children and adolescents, I will discuss: 1) children’s definition of trust and mistrust more broadly 2) the common themes generated from interview questions about children’s suspicions in relation to baseline self-reported levels of suspiciousness on the Social Mistrust Scale (SMS) and 3) other developmental psychosocial factors contributing to childhood suspicions. This study is also the first study to address whether or not children’s suspicions are valid, or grounded in reality, using interviewer ratings and child self-report measures of mistrust. Methods 118 trusting and persistently mistrustful children from the UK (n=40) and Hong Kong (n=78) were matched and followed-up at 6 and 12 months based on their self-reported levels of suspiciousness on the Social Mistrust Scale. Correlations and kappas were conducted to assess the stability and convergent validity between assessments. Thematic analysis was conducted on 95 (80%) randomly selected semi-structured interviews about mistrust. The coding scheme generated from this analysis was further tested on the remaining transcripts for discriminant validity. Results Children’s definition of trust was consistent with existing developmental literature. Commonly discussed topics related to mistrust, particularly school mistrust, included (i) experiences of bullying, concerns with popularity and the consequences of being targeted, (ii) emotional worries, anxieties and feelings of hostility, spying, and teasing, and (iii) coping mechanisms that maintained children’s avoidant behaviours. Consistent with the threat anticipation cognitive model of delusions (Freeman et al., 2007), persistently mistrustful children reported frequent peer victimization and hostile attributional bias. Instances of unfounded paranoia were rare but not absent. There was moderate convergent validity between interviewer ratings and the SMS (k=.49, p<.001). The coding scheme discriminated trusting and mistrustful children accurately. Discussion Interviews with trusting and persistently mistrustful children are necessary in verifying unfounded childhood suspicions. Complementing self-report measures of suspiciousness, thematic codes from this study have the potential to screen for persistent and strongly held suspicions that may develop into delusions later in life.
Background Paranoia, or excessive suspiciousness of others, has been one of the core psychotic symptoms of schizophrenia. Recent studies have extended the study of psychotic symptoms in clinical groups to psychotic-like experiences in the general population. Few studies have systematically examined the prevalence of paranoid thinking or its attenuated form, social mistrust, in young children in the community. The present study examined the Social Mistrust Scale (SMS) and utilized it to examine the structure, prevalence, and heritability of social mistrust in a large sample of Chinese children and adolescents. Methods We administered the SMS to 1047 pairs of healthy twins aged 8 to 14 years and conducted structural equation modelling (SEM) to assess the structure of the SMS. Heritability of social mistrust was estimated in a sub-sample of twins (n=959 pairs). Finally, we examined administered the SMS to 32 adolescents with childhood-onset schizophrenia and 34 healthy controls to examine the convergent validity between the SMS and the Positive and Negative Syndrome Scale (PANSS). Results The SEM showed a three-factor structure for social mistrust (home, school, and general mistrust). Social mistrust was moderately heritable (39%, 95% CI [21%-59%]) with context-dependent sex differences. The SMS exhibited good discriminant validity in distinguishing adolescents with childhood-onset schizophrenia from healthy controls (AUC=0.80), and good convergent validity with the Positive and Negative Syndrome Scale (rs = 0.33–0.45). Discussion Taken together, the present findings showed a stable latent structure of the SMS in a large-scale non-clinical sample of children and adolescents. We found a moderate heritability estimate for social mistrust (39%) in a large healthy-twin sample. In addition, significant gender differences were found, where home mistrust was heritable for males (58%) but not for females, and school mistrust was heritable for females (54%) but not for males. Finally, we also demonstrated that the SMS possesses good discriminate validity in identifying adolescents with childhood-onset schizophrenia from healthy controls and convergent validity with standardized clinical measures of schizophrenia symptoms.
Background: We validated the Social Mistrust Scale (SMS) and utilized it to examine the structure, prevalence, and heritability of social mistrust in a large sample of Chinese children and adolescents. Methods: In Study 1, a large sample of healthy twins (N=2094) aged 8 to 14 years (M=10.27 years, SD=2) completed the SMS. Structural equation modelling (SEM) was conducted to assess the structure of the SMS and to estimate the heritability of social mistrust in a sub-sample of twins (n=756 pairs). In Study 2, 32 adolescents with childhood-onset schizophrenia were compared with 34 healthy controls on levels of suspiciousness and clinical symptoms to examine the associations between the SMS and the Positive and Negative Syndrome Scale (PANSS). Results: We found a three-factor structure for social mistrust (home, school, and general mistrust). Social mistrust was found to be moderately - heritable (19% -40%), with mistrust at home most strongly influenced by genetic factors. Compared with 11.76% of the healthy controls, 56.25% of the adolescents with early-onset schizophrenia exhibited very high levels of social mistrust on all three subscales on the SMS. The SMS exhibited good discriminant validity in distinguishing adolescents with childhood-onset schizophrenia from healthy controls, and showed associations with a broad range of symptoms assessed by the PANSS. Conclusions: Social mistrust assessed by the SMS may be heritable. The SMS demonstrates good discriminant validity with clinical diagnoses of schizophrenia. However, it seems to be correlated with multiple aspects of psychopathology in the schizophrenia group, rather than being specific to delusional ideation/paranoia.
Paranoia, or persecutory delusions, is a quintessential symptom of psychotic disorders such as schizophrenia. Individuals suffering from paranoid ideations become increasingly isolated, avoidant of social situations, and unhappy. These unfounded fixed suspicions that others are out to harm the individual exist on a continuum of severity across clinical and community populations, with 1–3% of nonclinical populations having delusions of clinical severity, a further 5–6% having a delusion but of less severity, and 10–15% reporting regular paranoid thoughts. This dimensional approach has recently been applied to children and to groups from different countries. Much progress has been made on the causes and treatments of paranoia, and these remain significant areas of research and clinical interest. Understanding paranoia and its correlates developmentally continues to be critical to our understanding of the etiology of schizophrenia-spectrum disorders.
- Mar 2015
Recent work has shown that paranoia - excessive suspiciousness of others - exists on a spectrum of severity in the adult general population. Yet little is known about either the nature of mistrust in children or whether studying paranoia in children could increase our understanding of the aetiology of adult paranoia and inform early prevention strategies. The current thesis, comprised of three main studies, adopted a hitherto lacking developmental perspective to examine social mistrust in middle childhood. The first goal was to assess the structure, prevalence, correlates and short-term stability of childhood mistrust in nonclinical samples drawn from two different countries (the UK and Hong Kong). Classroom-based surveys of 8- to 14-year-olds from the UK (N = 1,086) and Hong Kong (N = 1,470) were carried out between 2011 and 2014. A new measure developed for the study was administered: The Social Mistrust Scale. The second goal was to examine children’s definitions and reasons for social trust and mistrust. This was a large qualitative examination of interviews with children, in order to learn more about the phenomenon at this age and generate future research questions to test. The final main goal was to test the association with childhood mistrust and a number of potential causal factors identified from the adult literature. Cognitive processes (i.e., reasoning bias, theory of mind and executive function) and psychosocial risk factors (i.e., bullying, loneliness, peer-rated social status, and hostile attribution bias) were studied. Overall, this thesis presented evidence that: (i) Social mistrust is prevalent in a minority of children, and it is associated with both internalising and externalising problems; (ii) Qualitative interviews indicated that mistrust was often well-justified but that a minority of children may well be having excessive suspiciousness about being targeted; (iii) Mistrustful children (especially with mistrust about school) report persistent victimisation and hostile attribution bias but do not show biases in non-affective cognitive performance compared with trusting peers; and (iv) There is moderate agreement between self-report and interviewer assessments of paranoia, child and peer ratings of mistrust but not with parent ratings. This thesis began the task of researching a developmental perspective on childhood suspiciousness, extending the work in adults. Mistrust is present in children and associated with symptoms of mental health problems and adverse experiences. The extent to which the fears were unfounded (i.e. true paranoia was assessed) was not established in the thesis nor the causal direction of the associations found. Continued research on social mistrust in community children and beyond may provide promising avenues to earlier preventions and better treatments of paranoia.
Question - I am looking for aggressive behavior assessment tools for adults?
you might want to use the reactive - proactive aggression questionnaire (raine, 2006). It's short, widely replicated, and easy to understand.
The Test of Variables of Attention (TOVA) is a continuous performance test (CPT) that assesses attention, impulsivity, and processing speed. CPTs are used in the assessment of attention-deficit/hyperactivity disorder (ADHD) in children, but more young adults are being assessed for ADHD as well. The TOVA norms are based on a standardization sample that was tested early in the day, and any TOVA administered after 1:00 p.m. will be flagged as potentially invalid. Whereas the testing time recommendations make sense for pediatric samples, it is unclear whether they are appropriate for young adults in college, who typically show significant phase delay in their diurnal rhythms. In addition, many college students consume large amounts of caffeine, and it is unclear how caffeine consumption affects TOVA performance. The current study examined the impact of time of day, self-reported diurnal preference, and caffeine consumption on TOVA performance in a double-blind, placebo-controlled experiment with healthy college students. There was evidence of diurnal variation on average response time and impulsivity but not on overall ADHD score, with participants tested in the afternoon responding faster but making more commission errors than did participants tested in the morning. Caffeine consumption led to significantly faster response times, but only for participants who typically consumed relatively little caffeine. We conclude that the TOVA can be administered to young adults outside the recommended time constraints without compromising the validity of test score interpretation but that the caffeine consumption of participants should be closely monitored.
Adolescent developmental issues, such as mental health problems, substance abuse, and egocentric behavior, of university students are examined. This conceptual review generally shows that although there are related issues among university students deserving greater attention, there is a general lack of systematic prevention or positive youth development programs adopting the principle of universal prevention. In contrast to the abundance of universal adolescent prevention and positive youth development programs specifically designed for high school students, similar programs are grossly lacking in the university educational context. This paper highlights the factors contributing to such negligence in university education and the possible strategies that can be adopted to help university students develop in a holistic manner.