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Abstract Background Several protective factors have been identified for mental health (MH) resilience in adolescent offspring of depressed parents. However, it is unclear if these effects persist into adulthood. Methods Depressed parents and their offspring (N = 188) from the Early Prediction of Adolescent Depression study were assessed four times (mean offspring ages 12.39, 13.77, 14.82, and 23.41). Mental health resilience was examined using residual scores (better‐than‐expected mood‐, behaviour‐, or anxiety‐related MH at mean age 23 given risk exposure), and categorically as sustained good MH across adolescence and young adulthood. Results Only 9.2% of young adults demonstrated sustained good MH. Parents of resilient individuals showed lower comorbidity (anxiety, antisocial behaviour and harmful drinking) and higher depression remission. Considering adolescent protective factors, weak evidence was observed of associations of mood‐resilience with adolescent peer‐relationship quality (β = −0.20, 95%CI:−0.36, −0.04); friendship quality (β = −0.14, 95%CI:−0.31, 0.02); risk adjustment (β = −0.16, 95%CI:‐0.34, 0.03) and dysfunctional attitudes (β = 0.18, 95%CI:0.01, 0.35). There was weak evidence of behavioural‐resilience association with parent positive expressed emotion (β = −0.15, 95%CI:−0.31, 0.02) and offspring exercise (β = −0.37, 95%CI:−0.77, 0.03). No adolescent protective factors showed an association with anxiety‐resilience. For sustained good MH, there was weak evidence of an association with inhibitory control (OR = 0.39, 95%CI:0.14, 1.07). Strong evidence was observed for associations between young adult‐reported peer relationship quality and mood‐resilience (β = −0.35, 95%CI:−0.53, −0.17), behavioural‐resilience (β = −0.33, 95%CI:−0.51, −0.14) and anxiety‐resilience (β = −0.34, 95%CI:−0.53, −0.14), while weak evidence was observed of an association of social activities with anxiety‐resilience (β = −0.51, 95%CI:−0.97, −0.06). Conclusions We found limited evidence for the long‐lasting effects of adolescent protective factors on adult MH resilience. Social factors remained protective into young adulthood, while family factors did not. Early preventative intervention might not be sufficient to maintain good long‐term MH, and young people will likely require more prolonged support.

Abstract Background Structural differences exist in the brains of autistic individuals. To date only a few studies have explored the relationship between fetal brain growth and later infant autistic traits, and some have used fetal head circumference (HC) as a proxy for brain development. These findings have been inconsistent. Here we investigate whether fetal subregional brain measurements correlate with autistic traits in toddlers. Methods A total of 219 singleton pregnancies (104 males and 115 females) were recruited at the Rosie Hospital, Cambridge, UK. 2D ultrasound was performed at 12-, 20- and between 26 and 30 weeks of pregnancy, measuring head circumference (HC), ventricular atrium (VA) and transcerebellar diameter (TCD). A total of 179 infants were followed up at 18–20 months of age and completed the quantitative checklist for autism in toddlers (Q-CHAT) to measure autistic traits. Results Q-CHAT scores at 18–20 months of age were positively associated with TCD size at 20 weeks and with HC at 28 weeks, in univariate analyses, and in multiple regression models which controlled for sex, maternal age and birth weight. Limitations Due to the nature and location of the study, ascertainment bias could also have contributed to the recruitment of volunteer mothers with a higher than typical range of autistic traits and/or with a significant interest in the neurodevelopment of their children. Conclusion Prenatal brain growth is associated with toddler autistic traits and this can be ascertained via ultrasound starting at 20 weeks gestation.

Abstract Background Parental depression is associated with a range of mental health conditions and other difficulties in the offspring. Nevertheless, some offspring exposed to parental depression do not develop mental health problems, indicating the presence of protective factors that may buffer parental depression-related risk effects. However, evidence of protective factors that might explain good sustained mental health in offspring of depressed parents is limited and systematic synthesis of these factors is still needed. Therefore, as far as we are aware, this will be the first systematic review that will identify parent, family, child, social, and lifestyle factors associated with mental health resilience in offspring of depressed parents, examine evidence for sex-, developmental stage-, and outcome-specific factors and define mental health resilience in the parental depression context. Methods This protocol has been developed according to the PRISMA-P guidelines. Electronic searches will be performed for articles published up to 2022 in PsycINFO, Embase, MEDLINE, Web of Science Core Collection, and Cochrane Library. Two reviewers will independently screen titles/abstracts and full-texts against eligibility criteria, extract the data, and assess the overall quality of evidence. Both observational and RCT studies will be eligible for inclusion if they report offspring mental health resilience/outcome and depressive symptoms or depressive disorder in at least one of the parents/caregivers. Risk of bias will be assessed using The Joanna Briggs Institute (JBI) critical appraisal checklists and The Revised Cochrane risk of bias tool for randomised trials (RoB 2). It is expected that studies will be heterogeneous; therefore, meta-analysis will not be attempted. Studies will be systematically retrieved and collated using numerical, graphical, tabular, and narrative summaries and grouped by their design, scope, or overall quality. Further sub-group analyses will be performed to examine sex-, developmental stage-, and outcome-specific protective factors. Discussion The proposed systematic review will be the first to summarise and critically assess quality and strength of evidence of protective factors associated with mental health resilience in offspring of depressed parents. Directions and effect sizes of the protective factors will be discussed as well as differences between the studies, their limitations, and research gaps and future directions. Strengths and limitations of the proposed systematic review will be also discussed. The proposed systematic review findings are expected to help better understand mental health resilience and identify targets for evidence-based prevention and intervention strategies for those in need. Systematic review registration A previous version of this systematic review protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) database ( www.crd.york.ac.uk/PROSPERO , CRD42021229955).

Abstract The ratio of index to ring finger (2D:4D) has been hypothesised to indicate prenatal androgen exposure, yet evidence for its validity is lacking. We report the first pre-registered study to investigate mothers’ early pregnancy sex hormone concentrations in relation to their children’s digit ratios measured at 18–22-month follow-up. Although the testosterone (T) to estradiol (E) ratio correlated negatively with right hand digit ratio (R2D:4D) and directional asymmetry (right-minus-left) in digit ratio (D[R−L]), neither effect remained statistically significant once demographic and obstetric covariates were controlled for. Nevertheless, the multivariate level of analysis did reveal that T correlated positively with left hand digit ratio (L2D:4D) and negatively with D[R−L]. However, the first of these effects is in the opposite direction to that predicted by theory. Taken together, the results of our study suggest research with larger samples is required to determine whether digit ratios are valid proxies for maternal sex hormone exposure.