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Biomedical subjects

B Maughan

Publications and source records attributed to B Maughan.

At least 19 recordsLinked to original sources
PubMed2001

Financial cost of social exclusion: follow up study of antisocial children into adulthood.

OBJECTIVES: To compare the cumulative costs of public services used through to adulthood by individuals with three levels of antisocial behaviour in childhood. DESIGN: Costs applied to data of 10 year old children from the inner London longitudinal study selectively followed up to adulthood. SETTING: Inner London borough. PARTICIPANTS: 142 individuals divided into three groups in childhood: no problems, conduct problems, and conduct disorder. MAIN OUTCOME MEASURES: Costs in 1998 prices for public services (excluding private, voluntary agency, indirect, and personal costs) used over and above basic universal provision. RESULTS: By age 28, costs for individuals with conduct disorder were 10.0 times higher than for those with no problems (95% confidence interval of bootstrap ratio 3.6 to 20.9) and 3.5 times higher than for those with conduct problems (1.7 to 6.2). Mean individual total costs were 70 019 pounds sterling for the conduct disorder group (bootstrap mean difference from no problem group 62 pound sterling; 898 pound sterling 22 692 pound sterling to 117 pound sterling) and 24 324 pound sterling (16 707 pound sterling; 6594 pound sterling to 28 149 pound sterling) for the conduct problem group, compared with 7423 pound sterling for the no problem group. In all groups crime incurred the greatest cost, followed by extra educational provision, foster and residential care, and state benefits; health costs were smaller. Parental social class had a relatively small effect on antisocial behaviour, and although substantial independent contributions came from being male, having a low reading age, and attending more than two primary schools, conduct disorder still predicted the greatest cost. CONCLUSIONS: Antisocial behaviour in childhood is a major predictor of how much an individual will cost society. The cost is large and falls on many agencies, yet few agencies contribute to prevention, which could be cost effective.

Child↗
PubMed2001

Adolescent psychological problems, partnership transitions and adult mental health: an investigation of selection effects.

BACKGROUND: Marital status is a strong correlate of psychiatric morbidity in adulthood, but debate continues on how far this association reflects causal influences or selection effects based on prior psychological characteristics. METHOD: Prospective data from the National Child Development Study were used to examine effects of adolescent emotional and behavioural problems on transitions into and out of first partnerships, and their implications for psychiatric morbidity at age 33. RESULTS: Emotional and behavioural problems in adolescence showed systematic links with early partnership transitions (age at partnership formation, type of first partnership, and risks of first partnership breakdown). More detailed tests suggested that these effects only accounted for a modest proportion of the associations between partnership status and psychiatric morbidity at age 33. CONCLUSIONS: In a non-referred community sample selection effects associated with adolescent emotional and behavioural problems appear to play only a modest role in links between partnership status and adult mental health.

Adolescent↗
PubMed2001

Pregnancy smoking and childhood conduct problems: a causal association?

Recent investigations have highlighted associations between maternal smoking in pregnancy and antisocial behaviour in offspring, and suggested the possibility of a causal effect. We used data from the 1970 British birth cohort study (BCS70) to examine these links in a large. population-based sample studied prospectively from birth to age 16. We found a strong dose-response relationship between the extent of pregnancy smoking and childhood-onset conduct problems, but no links with adolescent-onset antisocial behaviours. Effects on childhood-onset conduct problems were as marked for girls as for boys, and were robust to controls for a variety of social background factors and maternal characteristics. Controls for mothers' subsequent smoking history modified this picture, however, suggesting that the prime risks for early-onset conduct problems may be associated with persistent maternal smoking--or correlates of persistent smoking--rather than with pregnancy smoking per se.

Adolescent↗
PubMed2001

Long-term affective disorder in people with mild learning disability.

BACKGROUND: Increased risk of affective disorder in learning disability has been reported, although the extent to which this is due to adverse social and material circumstances is uncertain and there have been potential limitations in the measurement of affective disorder. AIMS: To determine risk of affective disorder in those classified with mild learning disability in the British 1946 birth cohort and to investigate whether this risk was accounted for by disadvantage in childhood and adulthood. METHOD: Learning disability was defined as the equivalent of an IQ < or =69 at age 15 years. The Present State Examination at age 36 years and the Psychiatric Symptom Frequency Scale at age 43 years provided psychiatric outcome measures. RESULTS: Learning disability was associated with a fourfold increase in risk of affective disorder, not accounted for by social and material disadvantage or by medical disorder. CONCLUSIONS: Learning disability is strongly associated with risk of affective disorder, persisting well into midlife.

Adolescent↗
PubMed1999

Psychological disturbance and service provision in parentally bereaved children: prospective case-control study.

OBJECTIVES: To identify whether psychiatric disturbance in parentally bereaved children and surviving parents is related to service provision. DESIGN: Prospective case-control study. SETTING: Two adjacent outer London health authorities. PARTICIPANTS: 45 bereaved families with children aged 2 to 16 years. MAIN OUTCOME MEASURES: Psychological disturbance in parentally bereaved children and surviving parents, and statistical associations between sample characteristics and service provision. RESULTS: Parentally bereaved children and surviving parents showed higher than expected levels of psychiatric difficulties. Boys were more affected than girls, and bereaved mothers had more mental health difficulties than bereaved fathers. Levels of psychiatric disturbance in children were higher when parents showed probable psychiatric disorder. Service provision related to the age of the children and the manner of parental death. Children under 5 years of age were less likely to be offered services than older children even though their parents desired it. Children were significantly more likely to be offered services when the parent had committed suicide or when the death was expected. Children least likely to receive service support were those who were not in touch with services before parental death. CONCLUSIONS: Service provision was not significantly related to parental wishes or to level of psychiatric disturbance in parents or children. There is a role for general practitioners and primary care workers in identifying psychologically distressed surviving parents whose children may be psychiatrically disturbed, and referring them to appropriate services.

Adolescent↗
PubMed1999

Validity of the Malaise Inventory in general population samples.

BACKGROUND: The Malaise Inventory is a commonly used self-completion scale for assessing psychiatric morbidity. There is some evidence that it may represent two separate psychological and somatic subscales rather than a single underlying factor of distress. This paper provides further information on the factor structure of the Inventory and on the reliability and validity of the total scale and two sub-scales. METHODS: Two general population samples completed the full Inventory: over 11,000 subjects from the National Child Development Study at ages 23 and 33, and 544 mothers of adolescents included in the Isle of Wight epidemiological surveys. RESULTS: The internal consistency of the full 24-item scale and the 15-item psychological subscale were found to be acceptable, but the eight-item somatic sub-scale was less reliable. Factor analysis of all 24 items identified a first main general factor and a second more purely psychological factor. Receiver operating characteristic (ROC) analysis indicated that the validity of the scale held for men and women separately and for different socio-economic groups, by reference to external criteria covering current or recent psychiatric morbidity and service use, and that the psychological sub-scale had no greater validity than the full scale. CONCLUSIONS: This study did not support the separate scoring of a somatic sub-scale of the Malaise Inventory. Use of the 15-item psychological sub-scale can be justified on the grounds of reduced time and cost for completion, with little loss of reliability or validity, but this approach would not significantly enhance the properties of the Inventory by comparison with the full 24-item scale. Inclusion of somatic items may be more problematic when the full scale is used to compare particular sub-populations with different propensities for physical morbidity, such as different age groups, and in these circumstances it would be a sensible precaution to utilise the 15-item psychological sub-scale.

Adult↗
PubMed1999

Mild mental retardation: psychosocial functioning in adulthood.

BACKGROUND: Evidence on the adult adaptation of individuals with mild mental retardation (MMR) is sparse, and knowledge of the factors associated with more and less successful functioning in MMR samples yet more limited. METHOD: Prospective data from the National Child Development Study were used to examine social circumstances and psychosocial functioning in adulthood in individuals with MMR and in a non-retarded comparison group. RESULTS: For many individuals with MMR, living circumstances and social conditions in adulthood were poor and potential stressors high. Self-reports of psychological distress in adulthood were markedly elevated, but relative rates of psychiatric service use fell between childhood and adulthood, as reflected in attributable risks. Childhood family and social disadvantage accounted for some 20-30% of variations between MMR and non-retarded samples on a range of adult outcomes. Early social adversity also played a significant role in contributing to variations in functioning within the MMR sample. CONCLUSIONS: MMR appears to be associated with substantial continuing impairment for many individuals.

Adaptation, Psychological↗
PubMed1998

Infant adoption: psychosocial outcomes in adulthood.

Adoption studies are able to provide important insights into the impact of changed rearing environments for children's development. A number of studies reporting on the childhood adjustment of adoptees have found an increased risk for disruptive behaviour problems when compared with children brought up in intact families. The long-term implications of adoption for psychosocial adjustment in adult life are less clear. We have used data from the National Child Development Study (NCDS) to examine the psychosocial functioning over a number of life-domains of an unselected sample of adoptees, non-adopted children from similar birth circumstances, and other members of the cohort. Adopted women showed very positive adult adjustment across all the domains examined in this study, whilst our findings suggest some difficulty in two specific domains (employment and social support) for adopted men. Implications of the findings are discussed.

Adaptation, Psychological↗
PubMed1998

School achievement and adult qualifications among adoptees: a longitudinal study.

Data from the National Child Development study (NCDS) were used to examine predictors of attainment among adoptees, nonadopted children from similar birth circumstances, and other members of this national birth cohort. Adoptees performed more positively than nonadopted children from similar birth circumstances on childhood tests of reading, mathematics, and general ability, and retained this advantage in school-leaving and later adult qualifications. In addition to family SES and material circumstances, measures of the educational environment of the home and of parental interest in education emerged as central predictors of these variations. Further analyses suggested possible differences in the mode of operation of these variables between boys and girls, and at different stages of young people's educational careers.

Achievement↗
PubMed1997

Secular change in psychosocial risks: the case of teenage motherhood.

BACKGROUND: Many social and demographic correlates of psychiatric disorder have shown marked secular changes in recent decades. This study was designed to explore some of the implications of these trends, focusing on the illustrative case of teenage motherhood. METHOD: Prospective data from two British birth cohort studies (the 1946 and 1958 cohorts) were used to examine the social, educational and behavioural precursors of teenage versus older age at motherhood, and the implications of teenage motherhood for women's later marital and social circumstances and risks of psychiatric morbidity, in samples born 12 years apart. RESULTS: Educational and social disadvantage were associated with similarly increased risks of teenage motherhood in both cohorts, but the findings suggested an additional association with teacher-rated adolescent conduct problems in the more recent sample. Rates of teacher-rated emotional problems were not elevated among teenage mothers in either cohort. In adult life, teenage motherhood was associated with a range of adverse social outcomes, including partnership breakdowns, large family size, and poorer housing conditions. Relative risks of these adult adversities were similar for teenage mothers in the two cohorts, but absolute levels of adversity were higher in the more recent sample, reflecting general secular changes in many of the indicators involved. In the later, but not the earlier, cohort, teenage motherhood was also associated with increased risks for psychiatric morbidity in adulthood. CONCLUSIONS: The findings underline the importance of taking account of secular trends in examining the impact of psychosocial risks.

Adolescent↗
PubMed1997

Integrating nature and nurture: implications of person-environment correlations and interactions for developmental psychopathology.

The developmental interplay between nature and nurture is discussed, with particular reference to implications for research in developmental psychopathology. The general principles include individual differences in reactivity to the environment, two-way interplay between intraindividual biology and environmental influences, and the need to consider broader social contextual features. Individuals actively process their experiences; they also act on their environment to shape and select their experiences, and individual characteristics change over time. Key findings on genetic effects include their ubiquitous influence, the multifactorial origin of most psychopathology, the involvement of several genes in most mental disorders, some genetic effects operate through dimensional risk features rather than directly on disorder, some genetic effects are dependent on gene-environment correlations and interactions, and genetic effects increase with age. Key findings on environmental effects include their ubiquitous influence, the genetic mediation of some supposed environmental effects, the importance of passive gene-environment correlations, the paucity of evidence regarding environmental effects on lifetime liability to psychopathology, the lack of understanding of environmental effects on the organism, and the importance of nonshared environmental effects. Research strategies to investigate environmental risk mediation include the range of genetically sensitive designs, migration studies, secular trend investigations, studies of nonfamilial environments, and examination of intraindividual change in relation to measured environmental alterations. Proximal processes involved in person-environment interplay are discussed in relation to person-environment interactions and evocative and active person-environment correlations.

Adaptation, Psychological↗
PubMed1997

Childhood adversities and psychosocial disorders.

Adverse childhood experiences--especially inadequacies in early parental care--are associated with elevated rates of both acute and chronic psychosocial disorders in adult life. In most instances, adverse outcomes are confined to a minority of children exposed; variations in the severity or pervasiveness of early risk, individual differences in susceptibility, and interactions with later stressors are all thus likely to be important in mediating effects. At present, knowledge of intervening processes is limited, and dependent on retrospective studies of adult samples or short-term longitudinal findings in childhood. We review current evidence on the long-term outcomes of prenatal divorce, childhood maltreatment, and institutional rearing, and on the early antecedents of depression and antisocial behaviour in adult life, to highlight possible interviewing mechanisms. Most long-term sequelae seem likely to depend on a series of shorter-term links, some running through elevated risks of continued environmental adversity, others through psychological vulnerabilities and problems in social relationships.

Adult↗
PubMed1997

Retrospective reporting of childhood adversity: issues in assessing long-term recall.

Much evidence for associations between adverse experiences in childhood and personality disorder in adult life comes from retrospective accounts. This raises important questions over the reliability and validity of long-term recall. The strengths and limitations of different methods for assessing the accuracy and stability of retrospective reports are discussed. Evidence from cognitive psychology on memory and memory processes, and on the phenomenon of infantile amnesia, provides important background for assessing issues more specific to recall in studies of risk for psychopathology. Here, topics of particular concern include: memory for traumatic early experience; the effects of mood state and symptomatology on recall; recovered or false memories; and the implications of mental representations of early experience for understanding psychopathology. Current evidence suggests that while adequately reliable accounts of many early experiences can be gained using appropriate techniques, further methodological studies are needed, and investigations using retrospective methods would be wise to include corroborative evidence whenever feasible.

Adult↗
PubMed1997

Psychosocial adversities in childhood and adult psychopathology.

Numerous studies have reported statistical associations between adverse childhood experiences and psychopathology in adult life. A range of conceptual and methodological issues needs to be borne in mind in interpreting these findings. Methodological issues include implications of base rates of postulated risk and outcome measures, and the possibility of third variable effects. Conceptually, further evidence is needed on the aspects of early experience most likely to contribute to risk (acute vs chronic stressors: actively negative vs lack of positive experiences; and the implications of cognitive processing of events); the specificity of effects; possible mechanisms involved in mediating effects in childhood, and approaches to testing them: and factors involved in persistence into adult life. There are good reasons to assume that adverse early experience plays a contributory role in the genesis of personality disorder. However, at this stage, evidence is still limited on how this comes about.

Adult↗
PubMed1996

Reading problems and antisocial behaviour: developmental trends in comorbidity.

Samples of poor and normal readers were followed through adolescence and into early adulthood to assess continuities in the comorbidity between reading difficulties and disruptive behaviour problems. Reading-disabled boys showed high rates of inattentiveness in middle childhood, but no excess of teacher-rated behaviour problems at age 14 and no elevated rates of aggression, antisocial personality disorder or officially recorded offending in early adulthood. Increased risks of juvenile offending among specifically retarded-reading boys seemed associated with poor school attendance, rather than reading difficulties per se. Reading problems were associated with some increases in disruptive behaviour in their teens in girls.

Adolescent↗
PubMed1989

Growing up in the inner city: findings from the inner London longitudinal study.

In the late 1960s, a series of epidemiological studies of educational and behavioural problems in middle childhood was undertaken on the Isle of Wight. In 1970, similar methods were used with an inner London sample of 10-year-olds to explore area differences in prevalence rates and correlates. Members of the London cohort have since been followed-up through their teens, to assess the longer-term implications of such problems for educational attainments, early employment prospects, and adolescent behavioural difficulties. School influences on children's development also constituted a central focus of these later stages of the work. This paper draws together the main findings of the London studies to date, and includes a full list of the main publications.

Adolescent↗