Publications: Mental Health & Wellbeing

  • Green, M. J., Tzoumakis, S., Laurens, K. R., Dean, K., Kariuki, M., Harris, F., Brinkman, S.A., Carr, V. J. (2018). Early developmental risk for subsequent childhood mental disorders in an Australian population cohort. Australian & New Zealand Journal of Psychiatry, 53(4), 304-315.

This paper examined associations between developmental vulnerability profiles determined at the age of 5 years, and subsequent childhood mental illness diagnosed between ages 6 and 13 years, in a population sample of 86,668 children from the New South Wales Child Development Study (NSW-CDS) cohort. Membership of putative risk classes in early childhood were delineated via latent class analysis of Australian Early Development Census subdomains, and children designated as those with established ‘special needs’ at school entry were examined as a separate group of interest. The results indicated that the crude odds of being diagnosed with any mental disorder between the ages of 6–13 years was increased approximately threefold in children showing ‘pervasive' risk or ‘misconduct' risk profiles according to their AEDC vulnerability patterns at age 5 years, relative to children showing no AEDC vulnerabilities. The odds of mental illness among children with special needs was increased approximately sevenfold, relative to children showing no AEDC vulnerabilities, before adjusting for other contributing factors (e.g., parental mental illness history, child protection records, socioeconomic status, child’s sex). These findings show that distinct patterns of early childhood developmental vulnerability are associated with subsequent onset of mental disorders, and that AEDC risk profiles have the potential to inform interventions to mitigate the risk for mental disorders in later childhood and adolescence.

  • Whitten, T., Stevens, R., Ructtinger, L., Tzoumakis, S., Green, M.J., Laurens, K.R., Holbrook, A., Carr, V.J.(2018). Connection to the Natural Environment and Well-Being in Middle Childhood. Ecopsychology 2018 10:4, 270-279.

This study examined connection to the natural environment in relation to well-being in childhood, in the context of other factors known to influence wellbeing such as social supports, attention, and empathic skills. We used a representative sample of 26,848 children from the NSW Child Development Study (NSW-CDS) who completed the Middle Childhood Survey (a self-report survey of mental health and well-being) that was undertaken when the children were aged approximately 11 years. The results indicated that connection to nature was positively, albeit weakly, associated with two indicators of well-being: self-satisfaction and prosocial behaviour, while other factors had stronger effects on wellbeing. For example, social supports had the strongest relationship with self-satisfaction, while empathy had the strongest relationship with prosocial behaviour. These findings suggest that developing a connection to nature can slightly improve well-being, and may augment education-based programs to improve wellbeing in childhood.

  • Bore, M.* / Laurens, K.R.*, Hobbs, M.J., Green, M.J., Tzoumakis, S., Harris, F., Carr, V.J. (2018). Item Response Theory analysis of the Big Five Questionnaire for Children Short-Form (BFC-SF): A self-report measure of personality in children aged 11-12 years. Journal of Personality Disorders, 32, 1-24. (*shared lead authorship)

Brief self-report questionnaire measures of the Big Five personality dimensions in children are needed for use in large population studies, for which longer instruments are not suited. The Big Five traits describe individual differences in personality within the population, with the expression of each trait in an individual varying along a dimension. These Big Five traits include: Agreeableness (generous, honest, modest vs. selfish, aggressive, arrogant), Conscientiousness (dependable, achievement-driven, constrained vs. disorderly, laid-back, unambitious), Neuroticism (worried, anxious, sad, vs. emotionally stable, calm), Extraversion (warm, outgoing, cheerful vs. introverted, reserved, solitary, sombre), and Openness to experience (curious, exploratory vs. rigid, practical, traditional). This study established the psychometric properties (reliability, validity) of a brief self-report measure of the Big Five personality dimensions in children, using data from 27,415 children in the NSW Child Development Study cohort. The psychometric properties were examined using Item Response Theory methods, exploratory and confirmatory factor analyses. The findings demonstrate the suitability of the brief, 20-item short-form measure of the Big Five personality dimensions in children for administration online in large population-based studies. The questionnaire could be useful in research examining how personality traits in childhood might act as risk or protective factors for later adolescent and adult health and well-being outcomes, and thereby inform public health policy and practices that promote mental health and prevent mental illness.

  • Green, M.J., Kariuki, M., Dean, K., Laurens, K.R., Tzoumakis, S., Harris, F., Carr, V.J. (2018). Childhood developmental vulnerabilities associated with early life exposure to infectious and noninfectious diseases and maternal mental illness. Journal of Child Psychology and Psychiatry, 59(7), 801-810; doi: 10.1111/jcpp.12856 (Published online 26 December 2017). 

 This study investigated the effects of in utero exposure to maternal infection and noninfectious diseases during pregnancy on offspring developmental vulnerabilities at age 5 years, in a population sample of 66,045 children drawn from the NSW Child Development Study (NSW-CDS) cohort. Maternal infectious diseases during pregnancy and early childhood infection conferred the largest associations with developmental vulnerabilities at age 5 years; maternal noninfectious illness during pregnancy also retained small but significant associations with developmental vulnerabilities even when adjusted for other physical and mental illness exposures and covariates known to be associated with early childhood development. Among all exposures examined, maternal mental illness first diagnosed prior to childbirth conferred the greatest odds of developmental vulnerability at age 5 years.  Prenatal exposure to infectious or noninfectious diseases appear to influence early childhood physical, social, emotional and cognitive developmental vulnerabilities that may represent intermediate phenotypes for subsequent mental disorders.

  • Dean , K., Green, M.J., Laurens, K.R., Kariuki, M., Tzoumakis, S., Sprague, T., Lenroot, R.,  and Carr, V.J. (2018). The impact of parental mental illness across the full diagnostic spectrum on externalising and internalising vulnerabilities in young offspring. Psychological Medicine, 48(13), 2257-2263; doi: 10.1017/S0033291717003786 (Published online 14 January 2018).

 This study examined patterns of association between externalising and internalising vulnerabilities in early childhood and parental mental disorder, in a population sample of 69,116 children drawn from the NSW Child Development Study (NSW-CDS) cohort. Measures of externalising and internalising vulnerability, obtained via the Australian Early Development Census, were linked to administrative health datasets to determine parental psychiatric diagnostic status. Parental mental illness, across diagnostic categories, was associated with all child externalising and internalising domains of vulnerability. These findings have important implications for informing early identification and intervention strategies in high-risk offspring and for research into the causes of mental illness.

  • Green, M.J., Tzoumakis, S., Laurens, K.R., Dean, K., Kariuki, M., Harris, F., O’Reilly, N., Chilvers, M., Brinkman, S.A., Carr, V.J. (2018). Latent profiles of early developmental vulnerabilities in a NSW child population at age 5 years. Australian & New Zealand Journal of Psychiatry, 52(6), 530-541; doi: 10.1177/0004867417740208 (Published online 6 November 2017).

This study determined classes of children among the general population who may be at risk for later mental disorder on the basis of early patterns of developmental functioning, and the associations of each risk-class with exposure to childhood maltreatment, parental mental illness, parental offending, and perinatal adversities, and other demographic factors. Data from 16 subdomains of the Australian Early Development Census (AEDC) were used to determine classes of children with shared patterns of developmental vulnerabilities in a population sample of 67,353 children drawn from the New South Wales Child Development Study (NSW-CDS) cohort. Four classes were identified, reflecting putative risk states for mental disorders: (1) disrespectful and aggressive/hyperactive behaviour, labelled ‘misconduct risk’ (6.5%); (2) ‘pervasive risk’ (4.0%); (3) ‘mild generalised risk’ (11.6%); and (4) ‘no risk’ (77.9%). The odds of membership in putative risk groups (relative to the no risk group) were greater among children from backgrounds of child maltreatment, parental history of mental illness, parental history of criminal offending, socioeconomic disadvantage, and perinatal adversities. 

  • Kariuki, M., Raudino, A., Green, M.J., Laurens, K.R., Dean, K., Brinkman, S.A., Lenroot, R.K, Liu, E., Harris, F., Luo, L., Carr, V.J. (2016). Hospital admission for infection during early childhood influences developmental vulnerabilities at age 5 years. Journal of Paediatrics and Child Health, 52(9), 882-888. (Abstract)

This study examined the relationship between early childhood infections requiring hospitalisation and developmental vulnerability at age 5 years, as assessed using the Australian Early Development Census (AEDC). The AEDC provides an index of each child’s level of function on five domains, including Physical Health and Wellbeing, Social Competence, Emotional Maturity, Language and Cognitive Skills, Communication Skills and General Knowledge. Hospital admissions for infections were associated with vulnerability on all five developmental domains. This suggests that severe infections during early childhood may pose a risk to development by school-age.

  • Matheson, S.L., Kariuki, M., Harris, F., Green, M.J., Tarren-Sweeney, M., Dean, K., Tzoumakis, S., Brinkman, S., Chilvers, M., Sprague, T., Carr, V.J., Laurens, K.R. (2017). Effects of maltreatment and parental schizophrenia spectrum disorders on early childhood social-emotional functioning: a population record linkage study. Epidemiology and Psychiatric Sciences, 26(6), 612-623; doi: 10.1017/S204579601600055X (Published online: 4 August 2016)X

This study examined the associations between early childhood maltreatment (age 0-5 years) and childhood social and emotional functioning at approximately age 5 years. This was achieved by linking Family and Community Services Data, parental Mental Health Ambulatory and Admitted Patients Data and Australian Early Development Census Data.  Medium-sized associations were found between maltreatment and poor social competency, aggressive behaviour, and hyperactive/inattentive behaviour, and small associations were found between maltreatment and poor prosocial/helping and anxious/fearful behaviour. These associations overshadowed the impact of having a parent with schizophrenia spectrum disorders. The results suggest childhood maltreatment may adversely impact on early childhood social and emotional functioning to a greater extent than parental schizophrenia and related disorders.

  • Laurens, K.R., Luo, L., Matheson, S.L., Carr, V.J., Raudino, A., Harris, F., Green, M.J. (2015). Common or distinct pathways to psychosis? A systematic review of evidence from prospective studies for developmental risk factors and antecedents of the schizophrenia spectrum disorders and affective psychoses. BMC Psychiatry, 15:205; doi: 10.1186/s12888-015-0562-2.

This scientific review provides a summary of the available evidence relating to risk factors for the development of schizophrenia spectrum disorders (e.g., schizophrenia, schizoaffective disorder), and affective psychoses (e.g., bipolar disorder). A total of 127 papers were reviewed for the purpose of evaluating the evidence for various risk factors as potentially conferring risk for psychoses, and to highlight gaps in the evidence base.  Factors which conferred the greatest risk, or were observed most consistently to confer risk to both affective and non-affective (schizophrenia spectrum) psychoses, included: obstetric complications, maternal illness during pregnancy (especially infections), other maternal physical factors, negative family emotional environment, psychopathology and psychotic symptoms, and cognitive and motor dysfunctions.

  • Sara, G., Luo, L., Carr, V.J., Raudino, A., Green, M.J., Laurens, K.L., Dean, K., Cohen, M. Burgess, P., Morgan, V.A. (2014). Comparing algorithms for deriving psychosis diagnoses from longitudinal administrative clinical records. Social Psychiatry and Psychiatric Epidemiology, 49(11), 1729-37.

This study describes a method that we have tested to determine the performance of four different methods for assigning a single diagnosis (for a psychotic disorder) from health records in which multiple diagnoses can be recorded for a single individual over time. Administrative health records are valuable research tools but the methods to extract accurate mental health diagnoses can be challenging because of the number of admissions for any given individual. The methods tested in this report include testing the validity of using: ‘any’ diagnosis, ‘most recent’ diagnosis, ‘most frequent’ (modal) diagnosis or ‘hierarchy’ (where a diagnostic hierarchy was applied). Overall agreement between administrative and reference diagnoses was modest with different methods producing results of varying accuracy. This illustrates that the choice of methods used to summarise health records can impact the accuracy of diagnosis and hence is an important consideration for study methods.