Paul Wilkinson

University of Cambridge | Cam · Department of Psychiatry

OBJECTIVE Non-suicidal self-injury (NSSI) appears to be more common among women than men, though the underlying reasons for this remain unclear. In a community sample of young adults (N = 996, aged 18-33) assessed during the COVID-19 pandemic, we investigated alternative explanation for the NSSI prevalence gap: are women more likely to experience t...

Adults with major depressive disorder (MDD) with psychotic features (delusions and/or hallucinations) have more severe symptoms and a worse prognosis. Subclinical psychotic symptoms are more common in adolescents than adults. However, the effects of psychotic symptoms on outcome of depressive symptoms have not been well studied in adolescents. Depr...

Introduction NSSI (non-suicidal self-injury) is an important public health issue, with high prevalence and associations with future mental illness and suicide. To date, no large single study has tested age and gender effects on NSSI and their interplay with psychological distress. Method NSSI and psychological distress were ascertained by question...

Background Early adversity (EA) can contribute to the onset, manifestation, and course of various mental disorders. Measuring EA is still conceptually and psychometrically challenging due to issues such as content coverage, item-wording, scaling methods, and validation procedures. Further, despite research demonstrating the importance of the severi...

Background: Medical graduates from the universities of Oxford and Cambridge have a lower intention to become general practitioners compared to other UK medical graduates. It is not clear to what extent this difference is present on admission to medical school. Aim: To compare the career intention and influencing factors of students on admission...

Many refugees have been exposed to potentially traumatic events and report elevated levels of psychological distress. However, refugees vary greatly in the severity of mental health problems. Intra- and interpersonal factors help some refugees to cope effectively. To shed light on these factors, we scrutinized how potentially traumatic events, resi...

Background Knowledge of mental distress and resilience factors over the time span from before to after a stressor is important to be able to leverage the most promising resilience factors and promote mental health at the right time. To shed light on this topic, we designed the RESIST (Resilience Study) study, in which we assessed medical students b...

OBJECTIVE Non-suicidal self-injury (NSSI) appears to be more common among women than men, though the underlying reasons for this remain unclear. In a community sample of young adults (n=996, aged 18-30) assessed during the COVID-19 pandemic, we investigated gendered patterns in NSSI etiology. METHODS Mediation and moderation analyses considered ass...

Life, Animated (2016), directed by Roger Ross Williams is a documentary that centres around the life of Owen Suskind; an autistic person. In recent decades, the media has become a powerful tool that has been used to typify and inform public opinion surrounding autism. This article analyses the portrayal of autism in Life, Animated and draws out imp...

Background: Nonsuicidal self-injury (NSSI) is prevalent among adolescents and research is needed to clarify the mechanisms which contribute to the behavior. Here, the authors relate behavioral neurocognitive measures of impulsivity and compulsivity to repetitive and sporadic NSSI in a community sample of adolescents. Methods: Computerized labora...

Background: Early adversity (EA) can contribute to the onset, manifestation, and course of various mental disorders. Measuring EA is still conceptually and psychometrically challenging due to issues such as content coverage, wording of items, scaling methods, and validation procedures. Method: To this end, we have developed a 13-item measure of EA...

Purpose We examined the association between the school policy, social and physical environment and change in adolescent physical activity (PA) and explored how sex and socioeconomic status modified potential associations. Methods Data from the GoActive study were used for these analyses. Participants were adolescents (n = 1765, mean age±SD 13.2±0....

Background Adolescent physical activity levels are low and are associated with rising disease risk and social disadvantage. The Get Others Active (GoActive) intervention was co-designed with adolescents and teachers to increase physical activity in adolescents. Objective To assess the effectiveness and cost-effectiveness of the school-based GoActi...

Objective: Self-harm is an important public health issue in the UK. Young people who frequently self-harm feel misunderstood, and unable to access help. Improving understanding is key to informing the development and delivery of effective treatments and services. Methods: In this qualitative study, we interviewed nine adolescent girls (13–17 years...

Background Cortisol hypersecretion in depressed adolescents and adults is associated with more persistent illness and may signal a lower response to psychological therapies. A meta-analysis of small and heterogenous studies demonstrated that higher pre-treatment basal cortisol levels were associated with poorer response specifically to psychologica...

Screening tools developed for Western populations have produced heterogeneous prevalence estimates for depression and anxiety disorders among refugees. The use of these instruments assumes that psychopathological symptoms are manifested similarly across different cultural groups. Here, we scrutinized whether depressive and anxiety symptoms are mani...

Many refugees experience a wide range of mental health problems, but typically use mental health services less often than settled residents. Practical constraints like limited access to mental health care and language barriers largely account for this discrepancy. However, little is known about the psychological aspects explaining this difference i...

Background Depression is a common health problem during adolescence and is associated with adverse academic, social and health outcomes. To meet the demand for treatment for adolescent depression, there is a need for evidence-based interventions suitable for delivery outside of specialist Child and Adolescent Mental Health Services (CAMHS). Interpe...

School-based multi-component physical activity (PA) promotion is advocated; however, research has indicated that a multi-component approach may not always be effective at increasing adolescent PA. Evaluation of the GoActive 12-week multi-component school-based intervention showed no effect on adolescent PA. A mixed-methods process evaluation was em...

Objective Few studies have investigated the neurological underpinnings of social-emotional processing among individuals with non-suicidal self-injury (NSSI), despite the range of interpersonal impairments associated with the behavior. This study aims to identify NSSI-specific patterns of resting state functional connectivity (RSFC) and neural activ...

Introduction: Impulsivity and compulsivity are important constructs, relevant to understanding behaviour in the general population, as well as in particular mental disorders (e.g. attention deficit hyperactivity disorder, obsessive-compulsive disorder). The current paper provides a narrative review of self-report impulsivity and compulsivity scales...

Objective: More than one in three people worldwide are exposed to some form of childhood adversity (CA). CA is strongly associated with an increased risk for the development of mental health problems. Resilience factors (RFs), such as self-esteem, are known to reduce such vulnerability to mental health problems. Here we examine besides direct RF ef...

Non-suicidal self-injury (NSSI) is a common behavior, particularly among adolescents and young adults. Impulsivity has been implicated as an important factor associated with NSSI, however prospective longitudinal research is lacking. Moreover, the relationship between impulsivity and other risk factors for NSSI is unclear. By examining longitudinal...

Background: Depression is a common health problem during adolescence and is associated with adverse academic, social and health outcomes. To meet demand for treatment for adolescent depression, there is a need for evidence-based interventions suitable for delivery outside of specialist Child and Adolescent Mental Health Services (CAMHS). Interperso...

Background: Depression is a common health problem during adolescence and is associated with adverse academic, social and health outcomes. To meet demand for treatment for adolescent depression, there is a need for evidence-based interventions suitable for delivery outside of specialist Child and Adolescent Mental Health Services (CAMHS). Interperso...

One-in-two people suffering from mental health problems develop such distress before or during adolescence. Research has shown that distress can predict itself well over time. Yet, little is known about how well resilience factors (RFs), i.e. those factors that decrease mental health problems, predict subsequent distress. Therefore, we investigated...

Background Less than 20% of adolescents globally meet recommended levels of physical activity, and not meeting these recommended levels is associated with social disadvantage and rising disease risk. The determinants of physical activity in adolescents are multilevel and poorly understood, but the school’s social environment likely plays an importa...

Background: Resilience factors, such as self-esteem or social support, are known to reduce mental distress in the face of stress or adversity exposure. So far, knowledge on the promotive value of resilience factors over the time span from before to during and after the stress or adversity exposure is concerningly scarce. Such knowledge seems howeve...

BACKGROUND Knowledge of mental distress and resilience factors over the time span from before to after a stressor is important to be able to leverage the most promising resilience factors and promote mental health at the right time. To shed light on this topic, we designed the RESIST (Resilience Study) study, in which we assessed medical students b...

Objectives To inform suicide prevention policies and responses to youths at risk by investigating whether suicide risk is predicted by a summary measure of common mental distress (CMD (the p factor)) as well as by conventional psychopathological domains; to define the distribution of suicide risks over the population range of CMD; to test whether s...

Objectives: To inform suicide prevention policies and responses to youths at risk by investigating whether suicide risk is predicted by a summary measure of common mental distress (CMD, (the p-factor)) as well as by conventional psychopathological domains; to define the distribution of suicide risks over the population range of CMD; to test whether...

Background: Whether the differences in brain structure and function, characteristic of adult major depressive disorder (MDD1), are present in adolescent MDD is still unclear, but it has been shown that cognitive behavioral therapy (CBT2) affects resting-state functional connectivity in both adult and adolescent MDD patients, with the claim that CB...

Background: The longitudinal course of multiple symptom domains in adolescents treated for major depression is not known. Revealing the temporal course of general and specific psychopathology factors, including potential differences between psychotherapies, may aid therapeutic decision-making. Methods: Participants were adolescents with major de...

We assessed which intervention components were associated with change in moderate-to-vigorous physical activity (MVPA) and wellbeing through proposed psychosocial mediators. Eight schools (n = 1319; 13–14 years) ran GoActive, where older mentors and in-class-peer-leaders encouraged classes to conduct two new activities/week; students gained points...

One-in-two people suffering from mental health problems develop such distress before or during adolescence. Resilience factors (RFs) decrease mental health problems. However, little is known about which RFs are the best indicators for subsequent distress, and with what accuracy RFs predict subsequent distress. We examined ten RFs and distress in 11...

Background: Childhood adversity (CA) is strongly associated with mental health problems. Resilience factors (RFs) reduce mental health problems following CA. Yet, knowledge on the nature of RFs is scarce. Therefore, we examined RF mean levels, RF interrelations, RF-distress pathways, and their changes between early (age 14) and later adolescence (...

Background Adolescent physical activity levels are low and are associated with rising disease risk and social disadvantage at increasingly early ages. We aimed to assess the effectiveness of a school-based programme (GoActive) to increase moderate-to-vigorous physical activity (MVPA) in adolescents. Methods In this cluster randomised controlled tr...

Objective: To classify a cohort of depressed adolescents recruited to the UK IMPACT trial, according to trajectories of symptom change. We examined for predictors and compared the data-driven categories of patients with a priori operational definitions of treatment response. Method: Secondary data analysis using growth mixture modelling (GMM). M...

Purpose: To examine adolescent experiences and perspectives of the GoActive intervention (ISRCTN31583496) using mixed methods process evaluation to determine satisfaction with intervention components and interpret adolescents' experiences of the intervention process in order to provide insights for future intervention design. Methods: Participan...

Childhood adversity (CA) increases the risk of subsequent mental health problems. Adolescent social support (from family and/or friends) reduces the risk of mental health problems after CA. However, the mechanisms of this effect remain unclear, and we speculate that they are manifested on neurodevelopmental levels. Therefore, we investigated whethe...

Background: Childhood adversity (CA), such as trauma or long-lasting stress, is strongly associated with mental health problems. Resilience factors (RFs) reduce the liability for mental health problems subsequent to CA. As mental health levels change over time, RFs may also change. Yet, knowledge on the latter is scarce. Therefore, we examined whet...

Objective:: Identify the core 'interaction structures' between therapists and depressed adolescents within and across two common forms of psychotherapy. Method:: A total of 70 audio-recorded psychotherapy sessions representing short-term psychoanalytic psychotherapy (STPP) and cognitive behavioural therapy (CBT) with youth aged 12-18 years old w...

Resilience factors (RFs) help prevent mental health problems after childhood adversity (CA). RFs are known to be related, but it is currently unknown how their interrelations facilitate mental health. Here, we used network analysis to examine the interrelations between ten RFs in 14-year-old adolescents exposed ('CA'; n = 638) and not exposed to CA...

Background The majority of young people receive treatment for depressive symptoms in the UK from staff with minimal specialist mental health/therapeutic training. There is no evidence to guide them as to what treatments are likely to be effective. Interpersonal counselling (IPC) is a reduced form of interpersonal psychotherapy and may be an appropr...

Major depressive disorder in adolescents is an important public health concern. It is common, a risk factor for suicide and is associated with adverse psychosocial consequences. The UK National Institute for Health and Care Excellence guidelines recommend that children and young people with moderate-to-severe depression should be seen within Child...

Objective: Non-suicidal self-injury (NSSI) often occurs before age 15, yet the majority of research on risk factors for this dangerous behavior has focused on older samples. Insecure attachment has been previously identified as a risk factor for both NSSI and behavioral problems, and behavioral problems appear to be particularly associated with NSS...

Background Over the past two decades new and key randomized controlled trials have reported the efficacy, clinical and cost effectiveness of psychological and pharmacological treatments for adolescents with major depression. Methods The literature was searched through pubmed, psychinfo, scopus and web of science for randomized controlled trials of...

Self-harm is a highly common behavior in adolescents, which is associated with future attempted suicide, completed suicide, and onset of mental illness.¹ It is associated with significant distress (both as a cause and as an outcome) and social impairment.² It is therefore essential that we provide effective treatment. Self-harm is a hazardous behav...

‘A Monster Calls’ is a children's fantasy novel written by Patrick Ness, based on an original idea by Siobhan David. Released to critical acclaim, the novel was lauded on its dealing of complex issues relating to bereavement and grief in a manner accessible to its younger readers. This article explores how ‘A Monster Calls’ presents a portrayal of...

Background: Up to half of Western children and adolescents experience at least one type of childhood adversity. Individuals with a history of childhood adversity have an increased risk of psychopathology. Resilience enhancing factors reduce the risk of psychopathology following childhood adversity. A comprehensive overview of empirically supported...

Background: Process evaluations are critical for interpreting and understanding outcome trial results. By understanding how interventions function across different settings, process evaluations have the capacity to inform future dissemination of interventions. The complexity of Get others Active (GoActive), a 12-week, school-based physical activit...

Psychiatric disorders are associated with aberrant brain development and/or aggressive behaviour, and are influenced by genetic factors; however, genes that affect brain aggression circuits remain elusive. Here we show that neuronal Src-homology-2 (SH2) B-adaptor protein-1 (Sh2b1) is indispensable for both brain growth and protection against aggres...

Childhood adversity (CA) increases the risk of subsequent mental health problems. Adolescent social support (from family and/or friends) reduces the risk of mental health problems after CA. However, the mechanisms of this effect remain unclear and we speculate that they are manifested on neurodevelopmental levels. Therefore, we investigated whether...

Background Non-suicidal self-injury (NSSI) is highly prevalent in adolescents and may be a behavioural marker for emergent mental illnesses. Aims To determine whether sporadic or recurrent NSSI up to the age of 14 years predicted increased risk of new onset of psychiatric disorder in the subsequent 3 years, independent of psychiatric symptoms and...

Resilience factors help prevent mental health problems after childhood adversity (CA). Resilience factors are known to be related, but it is currently unknown how their interrelations facilitate mental health. Here, we used network analysis to examine the interrelations between ten resilience factors in 14-year-old adolescents exposed (‘CA group’;...

Background Non-suicidal self-injury (NSSI) is highly prevalent in adolescents and may be a behavioural marker for emergent mental illnesses. Aims We sought to determine whether sporadic or recurrent NSSI up to the age of 14 years predicted increased risk of new onset of psychiatric disorder in the subsequent 3 years, independent of psychiatric symp...

In this paper, we summarise and critique a network meta-analysis (NMA) of antidepressant efficacy and tolerability for paediatric depression and an accompanying editorial. Although we agree that many of the extant studies are flawed, this meta-analysis showed clear efficacy of fluoxetine in the NMA, and for sertraline and escitalopram in pairwise a...

Background: Non-suicidal self-injury (NSSI) is a common harmful behavior during adolescence. Exposure to childhood family adversity (CFA) is associated with subsequent emergence of NSSI during adolescence. However, the pathways through which this early environmental risk may operate are not clear. Aims: We tested four alternative hypotheses to e...

Background: Non-suicidal self-injury (NSSI) is a common harmful behavior during adolescence. Exposure to childhood family adversity (CFA) is associated with subsequent emergence of NSSI during adolescence. However, the pathways through which this early environmental risk may operate are not clear. Aims: We tested four alternative hypotheses to expl...

Psychiatric disorders are associated with aberrant brain development and/or aggressive behavior and are influenced by genetic factors; however, genes that affect brain aggression circuits remain elusive. Here, we show that neuronal Src-homology-2 (SH2)B adaptor protein-1 (Sh2b1) is indispensable for both brain growth and protection against aggressi...

Objective: Therapy dropout is a common occurrence, especially in adolescence. This study investigated whether dropout could be predicted from a range of child, family, and treatment factors in a sample of adolescents receiving therapy for depression. Method: This study draws on data from 406 participants of the IMPACT study, a randomized controlled...

OBJECTIVE: Therapy dropout is a common occurrence, especially in adolescence. This study investigated whether dropout could be predicted from a range of child, family, and treatment factors in a sample of adolescents receiving therapy for depression. METHOD: This study draws on data from 406 participants of the IMPACT study, a randomized controlled...

INTRODUCTION: Adolescent physical activity promotion is rarely effective, despite adolescence being critical for preventing physical activity decline. Low adolescent physical activity is likely to last into adulthood, increasing health risks. The Get Others Active (GoActive) intervention is evidence-based and was developed iteratively with adolesce...

Introduction Adolescent physical activity promotion is rarely effective, despite adolescence being critical for preventing physical activity decline. Low adolescent physical activity is likely to last into adulthood, increasing health risks. The Get Others Active (GoActive) intervention is evidence-based and was developed iteratively with adolescen...

Background: Up to half of Western children and adolescents experience at least one type of childhood adversity. Individuals with a history of childhood adversity have an increased risk of psychopathology. Resilience enhancing factors reduce the risk of psychopathology following childhood adversity. A comprehensive overview of empirically supported...

This project is funded by the National Institute for Health Research Public Health Research (13/90/18). Intervention delivery costs will be borne by Essex and Cambridgeshire County Councils.