Laura Havers’s research while affiliated with University of London and other places

Bipolar disorder (BD) is characterised by episodes of mania and hypomania (the less severe presentation of mania). (Hypo)manic symptoms include elevated/irritable mood, increased energy, and goal-directed behaviour. Subclinical hypomania is common in non-clinical community populations, particularly among adolescents. Evidence indicates that experiencing these symptoms in youth is linked to the development of BD. However, questions remain around whether subclinical hypomania lies on the same continuum as BD phenotypically and aetiologically and, thus, represents a valid target for its study. This critical review synthesises some of the research surrounding the predictive and construct validity of youth subclinical hypomania as a quantitative trait of BD. The findings presented show that youth subclinical hypomania I) is associated with the later development of BD, and II) shares similarities with BD, including risk factors (high heritability, childhood maltreatment/adversity, substance use), and co-occurring symptoms (depression, psychosis, sleep problems, personality traits) and conditions (substance use, anxiety, personality disorders, attention-deficit/hyperactivity disorder, autism). Despite the sparsity of research and limitations of the literature, these associations are similar to those observed in other well-documented continuums (e.g., autistic traits–autism, psychotic-like experiences–adult psychopathology) and are suggestive of the predictive and construct validity of the youth subclinical hypomania–BD continuum. BD is a multisymptomatic illness that may be best understood as the intersection of various quantitative traits, but youth subclinical hypomania appears to represent one important target for its study. Given its adverse impact and association with other mental illnesses, youth subclinical hypomania warrants investigation in its own right.

Background Adolescents exposed to adversity show higher levels of depression and anxiety, with the strongest links seen in socially/societally disadvantaged individuals (e.g., females, low socioeconomic status [SES]), as well as neurodivergent individuals. The intersection of these characteristics may be important for the differential distribution of adversity and mental health problems, though limited findings pertain to the extent to which intersectional effects moderate this association. Methods Combined depression/anxiety symptoms were measured using the emotional problems subscale of the Strengths and Difficulties Questionnaire in 13–14‐year‐olds in Cornwall, United Kingdom in 2017‐2019. In a cross‐sectional design (N = 11,707), multiple group structural equation modeling was used to estimate the effects of youth adversity on depression/anxiety symptoms across eight intersectionality profiles (based on gender [female/male], SES [lower/higher], and traits of hyperactivity/inattention [high/low]). Moderation effects of these characteristics and their intersections were estimated. Results Youth adversity was associated with higher levels of depression/anxiety (compared to an absence of youth adversity), across intersectional profiles. This effect was moderated by gender (stronger in males; β = 0.22 [0.11, 0.36]), and SES (stronger in higher SES; β = 0.26 [0.14,0.40]); with indications of moderation attributable to the intersection between gender and hyperactivity/inattention (β = 0.21 [−0.02,0.44]). Conclusions Youth adversity is associated with heightened depression/anxiety across intersectional profiles in 13–14‐year‐olds. The stronger effects observed for males, and for higher SES, may be interpreted in terms of structural privilege. Preliminary findings suggest that vulnerability and resilience to the effects of youth adversity may partially depend on specific intersectional effects. Importantly, the current results invite further investigation in this emerging line of inquiry.

Background Youth adversity is associated with persistence of depression and anxiety symptoms. This association may be greater for disadvantaged societal groups (such as females) compared with advantaged groups (e.g. males). Given that persistent symptoms are observed across a range of disadvantaged, minoritized, and neurodivergent groups (e.g. low compared with high socio-economic status [SES]), the intersection of individual characteristics may be an important moderator of inequality. Methods Data from HeadStart Cornwall ( N = 4441) was used to assess the effect of youth adversity on combined symptoms of depression and anxiety (Strengths and Difficulties Questionnaire emotional problems subscale) measured at three time-points in 11–14-year-olds. Latent trajectories and regressions were estimated for eight intersectionality profiles (based on gender, SES, and hyperactivity/inattention), and moderating effects of the individual characteristics and their intersections were estimated. Results Youth adversity was associated with higher average depression/anxiety symptoms at baseline (11–12-years) across all intersectionality profiles. The magnitude of effects differed across profiles, with suggestive evidence for a moderating effect of youth adversity on change over time in depression/anxiety symptoms attributable to the intersection between (i) gender and SES; and (ii) gender, SES, and hyperactivity/inattention. Conclusions The detrimental effects of youth adversity pervade across intersectionality profiles. The extent to which these effects are moderated by intersectionality is discussed in terms of operational factors. The current results provide a platform for further research, which is needed to determine the importance of intersectionality as a moderator of youth adversity on the development of depression and anxiety symptoms in adolescence.

Background: Adolescents exposed to adversity show higher levels of depression and anxiety, with the strongest links seen in disadvantaged (e.g., females, low socioeconomic status [SES]), as well as neurodivergent, groups. The intersection of these characteristics may moderate the impact of youth adversity on adolescent mental health.Aims: To investigate the moderating influence of intersectionality on the relation between youth adversity and depression and anxiety symptoms in adolescence.Methods: Depression and anxiety symptoms were measured in 13-14-year-olds in the HeadStart Cornwall cohort (N=12,067) using the emotional problems subscale of the Strengths and Difficulties Questionnaire. Multiple group structural equation modelling was used to estimate the effects of youth adversity on combined depression and anxiety symptoms across eight intersectionality profiles. Group assignment was based on gender (female/male), SES (lower/higher), and hyperactivity/inattention (high/low). Moderation effects attributable to these characteristics and their intersections were estimated.Results: Youth adversity was associated with higher levels of depression and anxiety (compared to an absence of youth adversity), across intersectional profiles. This association was moderated by gender (stronger in males than females (β=0.22 [0.11,0.36])), and SES (stronger in higher compared to lower SES (β=0.26 [0.14,0.40])); with indications of moderation attributable to the intersection of gender and hyperactivity/inattention (β=0.21 [-0.02,0.44]).Conclusions: Youth adversity detrimentally impacts the mental health of 13-14-year-olds, across intersectional profiles. Preliminary findings suggest that vulnerability and resilience to the negative impacts of youth adversity may partially depend on the intersection of individual characteristics. These results invite further investigation in this emerging field of research.

Background: Youth adversity is associated with persistence of depression and anxiety symptoms over time. Evidence suggests that this association may be greater for disadvantaged societal groups (such as females) compared with advantaged groups (e.g., males). However, given that persistent symptoms are observed across a range of disadvantaged groups (e.g., low compared with high socio-economic status [SES]), the intersection of individual characteristics may be an important moderator of inequality. Methods: Data from HeadStart Cornwall (N=5,336) was used to assess the effect of youth adversity on symptoms of depression and anxiety, measured using the Strengths and Difficulties Questionnaire emotional problems subscale, at three time-points in 11-14-year-olds. Latent trajectories and regression coefficients were estimated for eight intersectionality profiles (based on gender, SES, and hyperactivity/inattention) within a multiple group structural equation model. Compound parameters were specified to estimate the moderating effects of the individual characteristics and their intersections. Results: Youth adversity, compared with an absence of such, was associated with higher average depression and anxiety symptoms at baseline (11-12-years), across all intersectionality profiles. The magnitude of the effect of youth adversity differed across profiles, and there was weak evidence to suggest that the effect of youth adversity on the average rate of change in depression and anxiety symptoms was moderated by the intersection of, i) gender and SES, and ii) gender, SES, and hyperactivity/inattention. Conclusions: Youth adversity has detrimental effects on the development of depression and anxiety symptoms that pervade across intersectionality profiles: The extent to which these effects are moderated by intersectionality are discussed in terms of operational factors and sample size. The current results provide a platform for further research, which is needed to determine whether intersectionality is important in moderating the effect of youth adversity on the development of depression and anxiety symptoms in adolescence.

Background Youth adversity (e.g., abuse and bullying victimisation) is robust risk factor for later mental health problems (e.g., depression and anxiety). Research shows the prevalence of youth adversity and rates of mental health problems vary by individual characteristics, identity or social groups (e.g., gender and ethnicity). However, little is known about whether the impact of youth adversity on mental health problems differ across the intersections of these characteristics (e.g., white females). This paper reports on a component of the ATTUNE research programme (work package 2) which aims to investigate the impact and mechanisms of youth adversity on depressive and anxiety symptoms in young people by intersectionality profiles. Methods The data are from 4 UK adolescent cohorts: HeadStart Cornwall, Oxwell, REACH, and DASH. These cohorts were assembled for adolescents living in distinct geographical locations representing coastal, suburban and urban places in the UK. Youth adversity was assessed using a series of self-report questionnaires and official records. Validated self-report instruments measured depressive and anxiety symptoms. A range of different variables were classified as possible social and cognitive mechanisms. Results and analysis Structural equation modelling (e.g., multiple group models, latent growth models) and multilevel modelling will be used, with adaptation of methods to suit the specific available data, in accord with statistical and epidemiological conventions. Discussion The results from this research programme will broaden our understanding of the association between youth adversity and mental health, including new information about intersectionality and related mechanisms in young people in the UK. The findings will inform future research, clinical guidance, and policy to protect and promote the mental health of those most vulnerable to the negative consequences of youth adversity.

Background: Youth adversity (e.g., abuse and bullying victimisation) is robust risk factor for later mental health problems (e.g., depression and anxiety). Research shows the prevalence of youth adversity and rates of mental health problems vary by individual characteristics, identity or social groups (e.g., gender and ethnicity). However, little is known about whether the impact of youth adversity on mental health problems differ across the intersections of these characteristics (e.g., white female). This paper reports on a component of the ATTUNE research programme (work package 2) which aims to investigate the impact and mechanisms of youth adversity on depressive and anxiety symptoms in young people by intersectionality profiles. Methods: The data are from 4 UK adolescent cohorts: HeadStart Cornwall, Oxwell, REACH, and DASH. These cohorts were assembled for adolescents living in distinct geographical locations representing coastal, suburban and urban places in the UK. Youth adversity was assessed using a series of self-report questionnaires and official records. Validated self-report instruments measured depressive and anxiety symptoms. A range of different variables were classified as possible social and cognitive mechanisms. Results and analysis: Structural equation modelling (e.g., multiple group models, latent growth models) and multilevel modelling will be used, with adaptation of methods to suit the specific available data, in accord with statistical and epidemiological conventions. Discussion: The results from this research programme will broaden our understanding of the association between youth adversity and mental health, including new information about intersectionality and related mechanisms in young people in the UK. The findings will inform future research, clinical guidance, and policy to protect and promote the mental health of those most vulnerable to the negative consequences of youth adversity.

Background Psychotic experiences and negative symptoms (PENS) are common in non-clinical populations. PENS are associated with adverse outcomes, particularly when they persist. Little is known about the trajectories of PENS dimensions in young people, nor about the precursory factors associated with these trajectories. Methods We conducted growth mixture modelling of paranoia, hallucinations, and negative symptoms across ages 16, 17, and 22 in a community sample ( N = 12 049–12 652). We then described the emergent trajectory classes through their associations with genome-wide polygenic scores (GPS) for psychiatric and educational phenotypes, and earlier childhood characteristics. Results Three trajectory classes emerged for paranoia, two for hallucinations, and two for negative symptoms. Across PENS, GPS for clinical help-seeking, major depressive disorder, and attention deficit hyperactivity disorder were associated with increased odds of being in the most elevated trajectory class (OR 1.07–1.23). Lower education GPS was associated with the most elevated trajectory class for hallucinations and negative symptoms (OR 0.77–0.91). Conversely for paranoia, higher education GPS was associated with the most elevated trajectory class (OR 1.25). Trajectory class associations were not significant for schizophrenia, obsessive-compulsive disorder, bipolar disorder, or anorexia GPS. Emotional/behaviour problems and life events in childhood were associated with increased odds of being in the most elevated trajectory class across PENS. Conclusions Our results suggest latent heterogeneity in the development of paranoia, hallucinations, and negative symptoms in young people that is associated with specific polygenic scores and childhood characteristics.

We conducted growth mixture modelling of paranoia, hallucinations, and negative symptoms across ages 16, 17, and 22 in a community sample (N = 12,049-12,652). We then described the emergent trajectory classes through their associations with polygenic scores for psychiatric and educational phenotypes, and earlier childhood characteristics. Our results suggest systematic heterogeneity in the development of paranoia, hallucinations, and negative symptoms in young people that is associated with specific polygenic scores and childhood characteristics.