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Report

Teaser, summary, work performed and final results

Periodic Reporting for period 1 - iHEAR (Investigating the meanings and mechanisms of psychotic experiences in young people: a novel, mixed-methods approach)

Teaser

Summary

At the heart of this study is a wish to better understand experiences of hallucinations and delusions in young people. Hallucinations are sensory and perceptual experiences that involve hearing, seeing, smelling or feeling things that arenâ€™t there and delusions refer thoughts and beliefs that arenâ€™t true, so much so that someone who has them canâ€™t be convinced that they arenâ€™t true. Over the past twenty years, research with children and adolescents in the general population (i.e. recruited from schools and communities and not from mental health services) has revealed that up to 1 in 5 young people may experience some form of hallucination or delusions during their childhood or adolescent years. For most young people, these experiences stop of their own accord and, for many, they are not an indication of any underlying mental health issues or a cause of concern. However, for others, they do seem to be related to their emotional and mental health and they put some young people at risk for developing a range of mental health issues when they are adults, including experiencing depression, feeling suicidal or making a suicide attempt and, for a small minority, developing a psychotic illness.

A number of researchers have been looking at the relationship between hallucination and delusions and experiences of early life stress and traumatic childhood experiences. That research has shown that young people who experience early life stress or trauma - for example, growing up in poverty, experiencing childhood abuse, being bullied in childhood - are at greater risk of experiencing hallucinations and delusions. This project wants to advance our understanding of how and why it is that this relationship exists by looking at multiple aspects of a young person\'s experience (their subjective views about themselves, their lives and their experiences of hallucinations and delusions, their mental health, their neurocognitive abilities, their stress response and the structure of their brains). It is hope that, by looking at the interplay between early life stress and hallucinations and delusions in this multi-dimensional way, this project will reveal new insights and generate new knowledge about how and why some young people who experience hallucinations and delusions are at higher risk for poorer outcomes in their early adult years.

Findings from this studies are so important for society because they might help, not only to identify those children and adolescents who are at high risk for poor outcomes later in life, but to identify targets for meaningful early intervention to reduce and minimise that risk.

Work performed

QUALITATIVE WORK:
1. Completion of qualitative data collection
2. Phase 1 qualitative data analysis
3. Presentation of phase 1 qualitative study findings at the IEPA Early Intervention in Psychiatry Conference, Boston, USA, October 2018
4. Submission of phase 1 qualitative study findings for publication

EPIDEMIOLOGICAL WORK
1. Securing of access to full Growing Up in Ireland (GUI) data set for epidemiological analysis
2. Systematic review and meta-analysis of existing studies on psychotic-like experiences and mental disorders completed and submitted for publication (accepted, subject to revisions)
3. Analysis of relationship between self-concept and psychotic-like experiences. Paper written and accepted for publication in the Journal of Child Psychology and Psychiatry (in press)
4. Analysis of relationship between psychotic-like experiences and psychopathology. Paper written and published in Early Intervention in Psychiatry (https://doi.org/10.1111/eip.12762)
5. Analysis of relationship between psychotic-like experiences and functioning. Paper written and published in Psychiatrica Scandinavia (https://doi.org/10.1111/acps.12907)
6. Presentation of findings at the Royal College of Surgeons in Ireland Research Day, 7th March 2019

NEUROBIOLOGICAL WORK
1. Development of full assessment protocol for follow-up phase of the Adolescent Brain Development (ABD) Study
2. Recruitment of sample of 100+ individuals from the original ABD study cohort for follow-up
3. Completion of clinical interview and neurocognitive assessments for ABD study follow-up
4. Ongoing MRI brain scanning being conducted with ABD study sample participants
5. Data entry for ABD follow-up complete
6. Analysis of relationship between psychotic-like experiences and fine motor skills. Paper written and published in Schizophrenia Research (https://doi.org/10.1016/j.schres.2018.08.014)
7. Neurocognitive findings presented at the Schizophrenia International Research Society (SIRS) Conference, Florence, April 2018
8. Neurocognitive findings presenting at the Royal College of Surgeons in Ireland Research Day, 7th March 2019

Final results

The study is already revealing some new and encouraging findings about the experience of hallucinations and delusions in young people.
Our qualitative findings have confirmed that not all young people who experience hallucinations and delusions will have endured traumatic life experiences and, those that have are more likely to continue having these experiences over time. However, even among those who continue to have these experiences into young adulthood, we are identifying clear qualitative differences in the types and meanings of those experiences for different young people. This is enabling us to consider patterns or permutations of experience and of mental health issues that seem to be either more or less associated with these experiences persisting over time. A key finding from our qualitative work has been the central role of early attachment relationships in the lives of young people who report hallucinations and delusions, whether or not they experience traumatic life events. Specifically, we have found evidence that secure attachment relationships buffer young people against the ill-effects of stress and adversity and are protective against the persistence of hallucinations and delusions over time. We also found that opportunities to engage in meaningful activities - be that volunteering or sport or music - can promote enhanced mental health, self-esteem and social relationships in adolescents, even where there is a previous history of poor mental health, low self-esteem and hallucinations and delusions. These findings are complemented by findings from the epidemiological arm of our research, which has revealed that positive self-concept is protective against persistent hallucinations and delusions during the adolescent years. These complementary findings highlight the value of the cross-disciplinary, multi-method approach to this study, with the potential to generate a more holistic and integrated understanding of the interrelationships between early life experiences, sense of self, mental health and experiences of hallucinations and delusions between childhood and early adulthood.