Search

Aim:To review research developments on childhood adversity in the Christchurch Health and Development Study (CHDS) since 2001. Method:Narrative overview of the published work of the CHDS since 2001 in the context of research methods. Results:The CHDS research has continued to evolve as the cohort has aged. A clear focus has remained on the measurement of outcomes associated with psychosocial risk factors over the life course. This focus has allowed the CHDS to examine the linkages between exposure to adversity in childhood and later mental health, psychosocial and occupational outcomes across the life span to middle adulthood. The CHDS has many strengths, including prospective measurement of a broad and deep set of constructs, the use of multiple informants for data, and a range of statistical approaches suited to repeated measures longitudinal data. The CHDS has pioneered new approaches to the study of human development over the lifespan, which has been instrumental in investigating childhood adversity. Conclusion:The CHDS continues to provide unique information from a population cohort that has been studied for more than four decades. Future research will include examination of factors that mitigate the effects of childhood adversity and enhance resilience.

Introduction: Pasifika young people of Aotearoa New Zealand are known to experience higher rates of mental health and addiction conditions (especially anxiety and depression), compared with young non-Māori/non-Pasifika (NMNP). However, there is little information about how well these issues are identified by mental health services. Aim: We compared rates of diagnosis of common mental health and substance use-related conditions between Pasifika and NMNP young people (aged 10-24 years) and examined how these diagnoses varied with deprivation. Method: This national, cross-sectional study was undertaken using 2017/18 fiscal year data from a national database known as the Integrated Data Infrastructure. Specialist mental health service use, hospitalisations and pharmaceutical dispensing for any mental health condition, emotional condition (depression and/or anxiety), substance use-related conditions, and self-harm were examined. Results: A total of 982,305 young people (12.4%, Pasifika and 63.9%, NMNP) were identified. Compared with NMNP, Pasifika young people were significantly less likely to be diagnosed by specialist mental health services with any mental health condition (adjusted Risk Ratio (aRR) = 0.77, 95% CI = 0.75 to 0.78); any emotional condition (aRR= 0.44, 95% Confidence Interval (CI) = 0.43 to 0.45); or to be hospitalised for self-harm (aRR = 0.88, 95% CI = 0.82 to 0.94). However, they were significantly more likely than NMNP to be diagnosed with substance use-related conditions (aRR = 1.68, 95% CI = 1.63 to 1.74). Although the overall rate of mental health issues remained relatively stable across deprivation levels, emotional conditions were much less frequently diagnosed in those with greater deprivation. Discussion: Discrepancies between expected and identified rates of diagnoses of common mental health and substance use-related conditions might indicate different patterns of service access by Pasifika young people, or they may reflect the bias of an inequitable and less than culturally appropriate health system.

The aetiology of internalising disorders remains poorly understood. Recently, a bottom-up network perspective has suggested mental disorders are best conceptualised as emergent systems, and may be explained by mapping systems of symptoms embedded within a complex biopsychosocial environment. Under this framework, the complex system in which internalising disorders are embedded remains poorly understood. The present research outlines a brief psychosocial system of internalising disorders as a basis for future research.A Mixed Graphical Model was fitted on 15 psychosocial variables (including depression and anxiety) collected during the Christchurch Health and Development Study, a representative population birth cohort of 1265 people born in 1977 in Christchurch, New Zealand.The model demonstrates that psychosocial risk factors for internalising disorders tend to be inter-related. The psychosocial system accounted for 19.9% of the variance in the diagnostic depression variable, and 5.0% of the variance in diagnostic anxiety. Most variables (10/13) were associated with depression and anxiety either directly or indirectly.First, the estimated model is undirected, so causal directions are unspecified except for longitudinal relationships. Second, binary diagnostic variables were used for depression and anxiety, meaning the model does include symptom-level complexity. Third, the model does not account for within-person effects.This exploratory model may serve as a basis for the mapping of greater (bio) psychosocial complexity around internalising disorders. The model concisely demonstrates the need for researchers to "embrace complexity", but also underscores the conceptual scope that is required to do so on a broader (bio) psychosocial level.

To examine specialist mental health service, hospital discharge, and pharmaceutical dispensing data for emotional conditions (anxiety, depression), substance use, and self-harm for Māori compared to non-Māori/non-Pasifika (NMNP) youth.A novel population-level case identification method using New Zealand's Integrated Data Infrastructure for 232,845 Māori and 627,891 NMNP aged 10-24 years. Descriptive statistics on mental health conditions were generated and stratified by Māori/NMNP. Unadjusted and adjusted risk ratios (RRs) of mental health conditions were generated using generalised linear regression.Māori were less likely to be identified for anxiety (ARR=0.88; 95% CI 0.85-0.90) or depression (ARR=0.92; 95% CI 0.90-0.95) than NMNP. They were more likely to be identified for substance problems (ARR)=2.66; 95% CI 2.60-2.71) and self-harm (ARR=1.56; 95% CI 1.50-1.63). Māori living in high deprivation areas were significantly more likely to be identified for substance problems, but less likely for emotional conditions, than Māori in least deprived areas.Despite known high levels of mental health concerns for rangatahi Māori, administrative data suggests significant under-reporting, assessment, and treatment of emotional conditions relative to NMNP. These differences were exacerbated by deprivation. Māori were more likely to be referred to services for externalised symptoms of distress (substance use and self-harm).

Background: Variation in liability to cannabis use disorder has a strong genetic component (estimated twin and family heritability about 50–70%) and is associated with negative outcomes, including increased risk of psychopathology. The aim of the study was to conduct a large genome-wide association study (GWAS) to identify novel genetic variants associated with cannabis use disorder. Methods: To conduct this GWAS meta-analysis of cannabis use disorder and identify associations with genetic loci, we used samples from the Psychiatric Genomics Consortium Substance Use Disorders working group, iPSYCH, and deCODE (20 916 case samples, 363 116 control samples in total), contrasting cannabis use disorder cases with controls. To examine the genetic overlap between cannabis use disorder and 22 traits of interest (chosen because of previously published phenotypic correlations [eg, psychiatric disorders] or hypothesised associations [eg, chronotype] with cannabis use disorder), we used linkage disequilibrium score regression to calculate genetic correlations. Findings: We identified two genome-wide significant loci: a novel chromosome 7 locus (FOXP2, lead single-nucleotide polymorphism [SNP] rs7783012; odds ratio [OR] 1·11, 95% CI 1·07–1·15, p=1·84 × 10 −9) and the previously identified chromosome 8 locus (near CHRNA2 and EPHX2, lead SNP rs4732724; OR 0·89, 95% CI 0·86–0·93, p=6·46 × 10 −9). Cannabis use disorder and cannabis use were genetically correlated (r g 0·50, p=1·50 × 10 −21), but they showed significantly different genetic correlations with 12 of the 22 traits we tested, suggesting at least partially different genetic underpinnings of cannabis use and cannabis use disorder. Cannabis use disorder was positively genetically correlated with other psychopathology, including ADHD, major depression, and schizophrenia. Interpretation: These findings support the theory that cannabis use disorder has shared genetic liability with other psychopathology, and there is a distinction between genetic liability to cannabis use and cannabis use disorder. Funding: National Institute of Mental Health; National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse; Center for Genomics and Personalized Medicine and the Centre for Integrative Sequencing; The European Commission, Horizon 2020; National Institute of Child Health and Human Development; Health Research Council of New Zealand; National Institute on Aging; Wellcome Trust Case Control Consortium; UK Research and Innovation Medical Research Council (UKRI MRC); The Brain & Behavior Research Foundation; National Institute on Deafness and Other Communication Disorders; Substance Abuse and Mental Health Services Administration (SAMHSA); National Institute of Biomedical Imaging and Bioengineering; National Health and Medical Research Council (NHMRC) Australia; Tobacco-Related Disease Research Program of the University of California; Families for Borderline Personality Disorder Research (Beth and Rob Elliott) 2018 NARSAD Young Investigator Grant; The National Child Health Research Foundation (Cure Kids); The Canterbury Medical Research Foundation; The New Zealand Lottery Grants Board; The University of Otago; The Carney Centre for Pharmacogenomics; The James Hume Bequest Fund; National Institutes of Health: Genes, Environment and Health Initiative; National Institutes of Health; National Cancer Institute; The William T Grant Foundation; Australian Research Council; The Virginia Tobacco Settlement Foundation; The VISN 1 and VISN 4 Mental Illness Research, Education, and Clinical Centers of the US Department of Veterans Affairs; The 5th Framework Programme (FP-5) GenomEUtwin Project; The Lundbeck Foundation; NIH-funded Shared Instrumentation Grant S10RR025141; Clinical Translational Sciences Award grants; National Institute of Neurological Disorders and Stroke; National Heart, Lung, and Blood Institute; National Institute of General Medical Sciences.

This study aimed to investigate whether childhood dental caries was associated with self-reported general health in midlife.We used data on childhood oral health (caries experience) and adult self-reported general health from two New Zealand longitudinal birth cohorts, the Dunedin Multidisciplinary Health and Development Study (n = 922 and n = 931 at ages 5 and 45 years, respectively), and the Christchurch Health and Development Study (n = 1048 and n = 904 at ages 5 and 40 years, respectively). We used generalized estimating equations to examine associations between age-5 dental caries and self-rated general health and the number of self-reported physical health conditions at ages 45/40 (diagnosed by a doctor or health professional, n = 14 conditions among both cohorts). Covariates included known risk factors for poor health (SES, IQ, perinatal complications), and personality style, which is known to affect subjective health ratings.Incidence rate ratios for 'Excellent' self-rated health were lower among those who had high experience of dental caries as children than those who had not in both, the Dunedin (IRR, 0.76; 95% CI, 0.50, 1.14) and Christchurch studies (IRR, 0.69; 95% CI, 0.47, 1.00). Childhood dental caries was not associated with the number of self-reported physical health conditions in midlife, in either cohort. Dunedin Study members who at age 5 were not caries-free or whose parents rated their own or their child's oral health as poor were less likely to report 'Excellent' self-rated general health at age 45 than those who were caries-free and whose parents did not give a 'poor' rating (IRR, 0.69; 95% CI, 0.49, 0.97).Five-year-olds with greater caries experience were more likely to have poorer self-rated general health by midlife. Beyond this longitudinal association, future research should examine whether childhood dental caries is associated with objective/biological markers of physical health and whether it may have utility as an early indicator for poor general health in adulthood.

This paper reports on the development and validation of the COVID Psychosocial Impacts Scale (CPIS), a self-report measure that comprehensively examines both positive and negative psychosocial impacts from the COVID-19 pandemic. This is the first part of the program of work in which the CPIS was administered and compared with a measure of psychological distress (Kessler Psychological Distress Scale, K-10) and wellbeing (World Health Organization Well-Being Index, WHO-5). The data were obtained online in 2020 and 2022 at two distinct time points to capture different exposures to the pandemic in the New Zealand population to a non-representative sample of 663 and 687 adults, respectively. Two hundred seventy-one participants took part in both surveys. Findings indicate a unidimensional structure within CPIS subscales and inter-relatedness among CPIS stress-related subscales. The scatter plots and correlation matrix indicate CPIS having a positive moderate correlation with K10 and a negative moderate correlation with WHO-5, indicative of construct validity. The paper outlines contextual factors surrounding CPIS development and makes suggestions for future iterations of CPIS. Further work will examine its psychometric properties across cultures.

Objective:To report on post-traumatic growth and post-traumatic stress following the Canterbury earthquakes and to quantify the relationships between exposure to the earthquakes, post-traumatic growth and post-traumatic stress.Method:The Christchurch Health and Development Study is a longitudinal birth cohort study of New Zealanders aged 40 years at the time of latest assessment in 2017. A total of 455 participants were exposed to the Canterbury earthquakes and assessed in 2012 and 2017. Post-traumatic growth was measured in 2017 using the Post-traumatic Growth Inventory. Earthquake-related post-traumatic stress was measured in 2012 using post-traumatic stress disorder items from the Diagnostic Interview Schedule. Post-traumatic growth and post-traumatic stress were modelled using measures of earthquake impact and subjective measures of earthquake consequences (peri-traumatic stress and disruption distress).Results:There was an indirect relationship between earthquake impact and post-traumatic growth. This was mediated via disruption distress. There was also an indirect relationship between earthquake impact and post-traumatic stress. This was mediated via peri-traumatic stress and disruption distress. Post-traumatic growth and post-traumatic stress were not significantly related.Conclusions:Measurement of post-traumatic growth and post-traumatic stress is required for a holistic understanding of disaster consequences. Subjective assessment of distress following disasters is required to predict their psychological effects.

Background Studies involving clinically recruited samples show that genetic liability to schizophrenia overlaps with that for several psychiatric disorders including bipolar disorder, major depression and, in a population study, anxiety disorder and negative symptoms in adolescence. Aims We examined whether, at a population level, association between schizophrenia liability and anxiety disorders continues into adulthood, for specific anxiety disorders and as a group. We explored in an epidemiologically based cohort the nature of adult psychopathology sharing liability to schizophrenia. Method Schizophrenia polygenic risk scores (PRSs) were calculated for 590 European-descent individuals from the Christchurch Health and Development Study. Logistic regression was used to examine associations between schizophrenia PRS and four anxiety disorders (social phobia, specific phobia, panic disorder and generalised anxiety disorder), schizophrenia/schizophreniform disorder, manic/hypomanic episode, alcohol dependence, major depression, and – using linear regression – total number of anxiety disorders. A novel population-level association with hypomania was tested in a UK birth cohort (Avon Longitudinal Study of Parents and Children). Results Schizophrenia PRS was associated with total number of anxiety disorders and with generalised anxiety disorder and panic disorder. We show a novel population-level association between schizophrenia PRS and manic/hypomanic episode. Conclusions The relationship between schizophrenia liability and anxiety disorders is not restricted to psychopathology in adolescence but is present in adulthood and specifically linked to generalised anxiety disorder and panic disorder. We suggest that the association between schizophrenia liability and hypomanic/manic episodes found in clinical samples may not be due to bias. Declarations of interest None.

To systematically assess the service satisfaction of consumers, their families and referrers with crisis resolution (CR).Consecutive consumers discharged after receiving CR over a five-week period were potentially eligible for participation, together with their family and referrer (broadly defined). Structured telephone interviews were conducted and involved forced-choice questions assessing global satisfaction and satisfaction with specific aspects of care, plus two open-ended questions.Participants were 75 consumers, 22 family and 16 referrers. High levels of satisfaction were seen for all participants for both global (86-96%) and most specific aspects of care (75%). If consumers were dissatisfied with their overall care, they were significantly more likely to be aged 25-34 years of age. High levels of agreement among raters were found for global satisfaction (85%) and most specific aspects of care (70%), which provides some level of reassurance for staff. Open-ended questions showed that having effective treatment of sufficient duration and staff manner were most important to participants.High levels of satisfaction and agreement were found among consumers, family and referrers with CR. Open-ended questions identified which issues matter the most to key stakeholders, which may have implications for service evaluation tools.

This study aimed to examine the association between novelty seeking (NS) and antisocial behaviours (age 18-35).A New Zealand general population birth cohort was studied from 1977 to 2012. Sample sizes ranged from n = 962 (age 35) to n = 1025 (age 18). NS was measured at age 16 using the Tridimensional Personality Questionnaire. Perpetration of antisocial behaviours was ascertained by self-report at ages 18, 21, 25, 30 and 35. Generalized estimating equation models investigated the association between NS and antisocial behaviours net of individual factors and correlates of NS before age 16 and alcohol and substance use disorders at age 18-35.Higher NS scores were associated with a higher unadjusted incidence of all forms of antisocial behaviour. Assault, theft, property damage and dishonesty offending remained associated with NS after adjustment for individual factors and correlates of NS before age 16. After further adjustment for alcohol and substance use disorders, NS was not associated with any antisocial behaviour outcomes, suggesting those disorders mediate the association between NS and antisocial behaviours.Alcohol and substance use disorders mediate the association between NS and antisocial behaviours in early adulthood. NS may be a useful endophenotype for investigating the causation of externalizing behaviours. Copyright © 2017 John WileySons, Ltd.

To assess the impact of the Canterbury earthquakes on the psychological functioning of university staff, to identify predictors of adverse psychological functioning and to survey how different aspects of work roles (academic, teaching, clinical, administrative) were affected.Eighteen months following the most severe earthquake, 119 staff from the University of Otago based in Christchurch completed a retrospective survey. This included demographic information, a measure of earthquake exposure, standardised and self-rated measures to identify psychological distress and measures of how people perceived different aspects of their work roles were impacted.A substantial minority of staff reported moderate-extreme difficulties on the Depression, Anxiety and Stress Scale (DASS) subscales 18 months following the most severe earthquake (Depression=9%; Anxiety=3%; Stress =13%). Predictors of distress were higher levels of exposure to earthquake-related stressors, neuroticism and prior mental health disorders. There was an association between impact and work roles that was hierarchical; academic and administrative roles were most affected, followed by teaching with the least impact on clinical roles.This study shows that psychological symptoms following a disaster are common, but in a retrospective survey most people report that these improve with time. A minority however, continue to report difficulties which persist even 18 months post disaster. It also gives insights into how different work roles were impacted and from this makes suggestions for how organisations can support staff over difficult times.