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Biomedical subjects

Richard Harrington

Publications and source records attributed to Richard Harrington.

At least 19 recordsLinked to original sources
PubMed2006

Early adult outcomes of adolescents who deliberately poisoned themselves.

OBJECTIVE: To describe the early adult psychopathological and social outcomes of adolescents who deliberately poisoned themselves. METHOD: Prospective cohort study with a 6-year follow-up of 132 of 158 (84%) adolescents who, between ages 11 and 16 years, had taken part in a randomized trial of a brief family intervention after deliberate self-poisoning. Comparisons were made with a sample of participants matched for age, gender, and childhood social class. Both groups were assessed using standardized measures of psychopathology and social functioning. RESULTS: In most cases (93/132 or 70%) self-harm stopped within 3 years. Psychiatric disorders, particularly depression (74/132 or 56%), were prevalent, and self-harm in adulthood was restricted to this subgroup. There was a strong association between childhood adversity, in particular childhood sexual abuse, and self-harming risk in adulthood. Adulthood adversity also added to the risk, especially for those who had experienced index episode major depression. These associations were not mediated by childhood problem solving and hopelessness. CONCLUSIONS: For some young people, deliberate self-poisoning in adolescence seems to be part of a complex and continuing network of problems, marked by high rates of psychopathology, comorbidity, with other disorders and high psychosocial adversity.

Adolescent↗
PubMed2005

Ethnicity and its relevance in a seven-year admission cohort to an English national adolescent medium secure health service unit.

BACKGROUND: There is some research which variously suggests that adults from some ethnic minority groups in the UK may be disproportionately likely to attract certain psychiatric diagnoses, and, in turn, to be admitted to inpatient facilities and compulsorily detained there; there are concerns too about over-representation in the criminal justice system. Little such work has been done with adolescents. AIMS: To determine the proportion of young people from ethnic minorities admitted to one UK specialist medium secure hospital unit for adolescents and describe their diagnoses. METHODS: Data were extracted from the case records of all 61 young people admitted to this unit at any time between 1 April 1995 and 31 March 2002. RESULTS: Inpatients from ethnic minority backgrounds were significantly over-represented when compared with National Census data. This was mainly accounted for by inpatients from Black African (11%) and Black Caribbean backgrounds (8%). There were, however, no within unit differences in final diagnoses between the ethnic groups. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Our findings confirm both a high overall proportion of young people from ethnic minorities using a national medium secure hospital service and considerable ethnic diversity within that. They are discussed in the context of one relevant national government initiative for improving responses to minority groups.

Adolescent↗
PubMed2005

Maternal attributions and expressed emotion as predictors of attendance at parent management training.

BACKGROUND: The effectiveness of parent management training (PMT) as a treatment for child behaviour problems is reduced by high attrition rates. One difficulty with engaging mothers is that, by definition, PMT is directed at the parent, yet many parents believe the cause of the problem lies within the child. Hence the model of therapy offered contradicts their understanding about the cause and nature of the problem. Moreover, the emotional consequence of holding child-responsibility causal attributions is associated with high expressed emotion (EE), a known predictor of poor compliance with therapy in other child psychiatric disorders. METHODS: Seventy-five consecutive referrals of mothers to a PMT programme were recruited. EE was assessed using the Camberwell Family Interview methodology. Spontaneous causal attributions about their child's problem behaviour were collected from the same interview material and independently coded using the Leeds Attributional Coding System. Attendance data at the PMT programme was collected following completion of programmes. RESULTS: Contrary to expectations, mothers who made child-responsibility attributions and were highly critical about their child's behaviour were no more likely than non-blaming, low EE parents to drop out prematurely from a course of PMT. However, expressing an understanding of their own role in managing their child's behaviour was predictive of attendance. Two factors were, however, more closely associated with greater attrition: having been offered a clinical diagnosis and being from a lower socio-economic family. CONCLUSIONS: Socio-economic factors should be viewed as barriers to uptake of services and successful strategies for increasing engagement of families are likely to be economical rather than psychological. However, although the causal attributions mothers make about their child's behaviour did not predict whether they were likely to attend PMT, an exploratory analysis found evidence to suggest that successful engagement with PMT begins early in the referral process and that referring clinicians should ensure treatment options are aligned with diagnoses provided.

Affect↗
PubMed2004

Dynamics of production of sexual forms in aphids: theoretical and experimental evidence for adaptive "coin-flipping" plasticity.

The best strategy for an organism to deal with unpredictable environmental conditions is a stochastic one, but it is not easy to distinguish it from nonadaptive randomness in phenotype production, and its convincing demonstrations are lacking. Here we describe a new method for detection of adaptive stochastic polyphenism and apply it to the following problem. In fall, each female of the bird cherry-oat aphid, Rhopalosiphum padi, faces a decision either to produce sexuals, which mate and lay cold-tolerant eggs, or to continue production of cold-sensitive parthenogenetic females, which potentially yields a higher population growth rate but is risky because a cold winter can kill all of her descendants. Using a simulation model, we show that global investment in sexual reproduction should be proportional to winter severity and that variance in the peak date of production of sexual individuals should depend on climate predictability. Both predictions are validated against standardized trap data on aphid flight accompanied by meteorological data, and the predictions support adaptive phenotypic plasticity.

Adaptation, Physiological↗
PubMed2004

Impact of maternal depression on infant nutritional status and illness: a cohort study.

BACKGROUND: The risk for emotional and behavioral problems is known to be high among children of depressed mothers, but little is known about the impact of prenatal and postnatal depression on the physical health of infants. OBJECTIVE: To determine whether maternal depression is a risk factor for malnutrition and illness in infants living in a low-income country. DESIGN: Prospective cohort study. SETTING: Rural community in Rawalpindi, Pakistan. PARTICIPANTS: Six hundred thirty-two physically healthy women were assessed in their third trimester of pregnancy to obtain at birth a cohort of 160 infants of depressed mothers and 160 infants of psychologically well mothers. MAIN OUTCOME MEASURES: All infants were weighed and measured at birth and at 2, 6, and 12 months of age, and they were monitored for episodes of diarrhea and acute respiratory infections. The mothers' mental states were reassessed at 2, 6, and 12 months. Data were collected on potential confounders of infant outcomes, such as birth weight and socioeconomic status. RESULTS: Infants of prenatally depressed mothers showed significantly more growth retardation than controls at all time points. The relative risks for being underweight (weight-for-age z score of less than -2) were 4.0 (95% confidence interval [CI], 2.1 to 7.7) at 6 months of age and 2.6 (95% CI, 1.7 to 4.1) at 12 months of age, and the relative risks for stunting (length-for-age z score of less than -2) were 4.4 (95% CI, 1.7 to 11.4) at 6 months of age and 2.5 (95% CI, 1.6 to 4.0) at 12 months of age. The relative risk for 5 or more diarrheal episodes per year was 2.4 (95% CI, 1.7 to 3.3). Chronic depression carried a greater risk for poor outcome than episodic depression. The associations remained significant after adjustment for confounders by multivariate analyses. CONCLUSIONS: Maternal depression in the prenatal and postnatal periods predicts poorer growth and higher risk of diarrhea in a community sample of infants. As depression can be identified relatively easily, it could be an important marker for a high-risk infant group. Early treatment of prenatal and postnatal depression could benefit not only the mother's mental health but also the infant's physical health and development.

Birth Weight↗
PubMed2004

Occurrence of barley yellow dwarf virus in autumn-sown cereal crops in the United Kingdom in relation to field characteristics.

The incidence of barley yellow dwarf virus and of its aphid vectors was surveyed in untreated parts of autumn-sown cereal crops, mainly wheat and barley, in the United Kingdom in 1995-8. The incidence of virus in the spring was related to the incidence of aphids in the preceding autumn. Both virus and aphid incidences could also be related to a range of crop and field characteristics, in particular sowing date, regions as defined by their geographical position, topography and climate, the proximity of the field to the sea, the extent of arable land in the vicinity of the field, and the aspect and size of the field. Proximity of cropped fields to setaside areas had no significant effect on either aphid or virus incidence.

Animals↗
PubMed2004

Decision making in controlling virus yellows of sugar beet in the UK.

Virus yellows is an important disease affecting yield in sugar beet in the UK. Myzus persicae (Sulzer) is the most effective and efficient aphid vector of the three viruses causing the disease: beet yellows virus, beet mild yellowing virus and beet chlorosis virus. Control of virus yellows disease is thus focused on the study and control of this aphid species. UK national surveys of virus yellows began in 1946 and these data helped to formulate disease forecasting schemes to optimise control. Over the years, in addition to improvements in farm hygiene, periodic changes and developments in control of the disease have occurred. To accommodate these important developments, virus yellows forecasting schemes have evolved accordingly. The most recent version has been adapted to take account of the current widespread use of imidacloprid seed treatment. Its application offers potential to optimise the rational use of aphicides such as imidacloprid so as to benefit beet growers and the environment by reducing prophylactic use of seed treatment.

Animals↗
PubMed2004

A step too far? Randomized trial of cognitive-behaviour therapy delivered by social workers to depressed adolescents.

OBJECTIVE: To test the hypothesis that depressed adolescents given brief cognitive behaviour therapy by trained social workers will be less depressed after this treatment than depressed adolescents who have routine care from their social workers. METHOD: Open study, two randomized parallel groups. 86 social workers were randomized to training in brief CBT or delayed training by remote telephone randomization. 25 social workers who attended CBT training recruited 29 depressed adolescents. 22 social workers in the control group recruited 23 depressed adolescents. RESULTS: Social workers' perceptions of their knowledge and skills in dealing with adolescent depression were better after the training than before. However, in intention to treat analyses, adolescents who had therapy from trained social workers had a similar level of depression post treatment (mean depression score 17.5, 95% CI 11.8 to 23.3) to those who did not have such therapy (mean depression score 16.7, 95 % CI 11.3 to 22.1). There were no significant differences between the groups on other outcomes or at follow-up. CONCLUSIONS: This study failed to recruit enough cases and probably did not therefore have enough statistical power to detect an effect of the intervention. It was also based on a severely impaired sample with many comorbid problems. However, the results suggest that training community-based social workers in cognitive behaviour therapy is neither practical nor effective in improving the outcomes of their clients.

Adolescent↗
PubMed2004

Development and preliminary validation of the Meta-cognitions Questionnaire-Adolescent Version.

This study describes the development of the Meta-cognitions Questionnaire for Adolescents (MCQ-A). The adult version of this questionnaire has been widely used, and the meta-cognitive theory of emotional disorders has become influential in the adult literature. This study sought to examine the prevalence and emotional correlates of meta-cognition in adolescents. The MCQ-A was administered to 177 schoolchildren aged 13 through 17 years, together with measures of emotional well-being. Factor analysis suggested a five-factor solution similar to that reported for the adult version. Internal consistency of the scale was high. Scores ranged from low to high across the age range, suggesting that meta-cognitive beliefs are well-established by adolescence. Scores on the MCQ-A were highly correlated with a number of measures of emotional symptoms. The MCQ-A is a reliable and valid instrument for measuring meta-cognitive beliefs in adolescents. Young people aged between 13 and 17 years report a range of types and levels of meta-cognitive beliefs and these are positively associated with emotional symptoms.

Adolescent↗
PubMed2004

Primary mental health workers in child and adolescent mental health services.

BACKGROUND: The interface between primary care and specialist services is increasingly seen as crucial in the effective management of child and adolescent mental health (CAMH) problems. In the United Kingdom, a new role of primary mental health worker (PMHW), has been established in order to achieve effective collaboration across the interface through the provision of clinical care in primary care settings and by improving the skills and confidence of primary care staff. However, little is known about the development of this innovative role in service contexts. Issues raised during the early stages of implementation may have important implications for the preparation and development of professionals who undertake the role. AIMS: The aim of this paper is to report on a study that examined key issues in implementation of the PMHW role in six health authorities in England. METHODS: Case study evaluation was conducted, using thematic analysis of 75 qualitative interviews with key stakeholders from different professions (e.g. PMHWs, general practitioners, health visitors, psychiatrists and service managers) and representing different sectors (primary care, specialist services and community child health services). FINDINGS: The study identified three models of organization (outreach, primary care-based and teams). Each was associated with different advantages and disadvantages in its effects on referral rates to specialist services and the development of effective working relationships with primary care providers. Problems associated with accommodation and effective integration of PMHWs with specialist services, and tensions caused by the two different roles that PMHWs could undertake (direct clinical care vs. consultation-liaison) were common across all sites. CONCLUSIONS: The PMHW role is an important development that may go some way towards realizing the potential of primary care services in CAMH. The implementation of new roles and models of working in primary care is complex, but may be facilitated by effective planning with primary care providers, clear goals for staff, and a long-term perspective on service development.

Adolescent↗
PubMed2004

The Child Attention-Deficit Hyperactivity Disorder Teacher Telephone Interview (CHATTI): reliability and validity.

BACKGROUND: The ICD-10 and DSM-IV diagnostic criteria for hyperkinetic disorder and attention-deficit hyperactivity disorder (ADHD) require symptoms or impairment in two or more settings. Thus, information on children's symptoms in school is usually required. This paper presents the Child ADHD Teacher Telephone Interview (CHATTI), an instrument aimed at systematically obtaining this information. AIMS: To examine the stability, test-retest reliability and criterion validity of the CHATTI for children referred with a suspected diagnosis of ADHD. METHOD: Data were obtained from 79 teachers, of whom 36 were interviewed on two occasions. RESULTS: Overall, the CHATTI shows good stability, test-retest reliability and criterion validity for symptom scores. Test-retest reliability for some individual items was low. Reliability for the operationalised criteria of 'pervasiveness' (i.e. symptoms at school and home) and 'school impairment' was excellent (kappa=1). CONCLUSIONS: The CHATTI appears to be a promising tool for assessing ADHD symptoms in a school setting and could be useful in clinical as well as research settings.

Attention Deficit Disorder with Hyperactivity↗
PubMed2004

Systematic review of the efficacy of cognitive behaviour therapies for childhood and adolescent anxiety disorders.

PURPOSE: To review the effectiveness of cognitive behaviour therapy (CBT) as a treatment for anxiety disorders of childhood and adolescence. METHOD: Studies were included if they treated young people (under 19 yrs) with diagnosed anxiety disorder (excluding trials solely treating phobia, PTSD or OCD), had a no-treatment control group, and used diagnosis as an outcome variable. A search of the literature, incorporating electronic databases, hand search and expert consultation, yielded 10 randomized controlled trials that were appropriate for inclusion. RESULTS: The outcome of interest was remission of anxiety disorder. Employing conservative criteria, the remission rate in the CBT groups (56.5%) was higher than that in the control groups (34.8%). The pooled odds ratio was 3.3 (CI = 1.9-5.6), suggesting that CBT has a significant effect. CONCLUSIONS: CBT is useful for the treatment of anxiety in children over the age of 6 years. However, we still know little about the treatment of younger children or about the comparative efficacy of alternative treatments. Most of the trials were efficacy trials, and have limited generalizability. Reporting of many aspects of the trials was weak.

Adolescent↗
PubMed2003

Visualisation and graph-theoretic analysis of a large-scale protein structural interactome.

BACKGROUND: Large-scale protein interaction maps provide a new, global perspective with which to analyse protein function. PSIMAP, the Protein Structural Interactome Map, is a database of all the structurally observed interactions between superfamilies of protein domains with known three-dimensional structure in the PDB. PSIMAP incorporates both functional and evolutionary information into a single network. RESULTS: We present a global analysis of PSIMAP using several distinct network measures relating to centrality, interactivity, fault-tolerance, and taxonomic diversity. We found the following results: Centrality: we show that the center and barycenter of PSIMAP do not coincide, and that the superfamilies forming the barycenter relate to very general functions, while those constituting the center relate to enzymatic activity. Interactivity: we identify the P-loop and immunoglobulin superfamilies as the most highly interactive. We successfully use connectivity and cluster index, which characterise the connectivity of a superfamily's neighbourhood, to discover superfamilies of complex I and II. This is particularly significant as the structure of complex I is not yet solved. Taxonomic diversity: we found that highly interactive superfamilies are in general taxonomically very diverse and are thus amongst the oldest. Fault-tolerance: we found that the network is very robust as for the majority of superfamilies removal from the network will not break up the network. CONCLUSIONS: Overall, we can single out the P-loop containing nucleotide triphosphate hydrolases superfamily as it is the most highly connected and has the highest taxonomic diversity. In addition, this superfamily has the highest interaction rank, is the barycenter of the network (it has the shortest average path to every other superfamily in the network), and is an articulation vertex, whose removal will disconnect the network. More generally, we conclude that the graph-theoretic and taxonomic analysis of PSIMAP is an important step towards the understanding of protein function and could be an important tool for tracing the evolution of life at the molecular level.

Archaeal Proteins↗
PubMed2003

Is preadolescent mania the same condition as adult mania? A British perspective.

Until relatively recently, the prevailing view was that mania was uncommon in preadolescent children. In the past 15 years, however, there has been increasing interest in the idea that mania may be much more common at younger ages than previously recognized. This article is concerned with the issue of whether preadolescent mania represents the same kind of problem as adult mania. It reviews concepts of bipolar disorder and mania in adults and preadolescents, some of the issue that arise in diagnosing mania in children, and the evidence for continuities between preadolescent and adult mania. The diagnosis of mania in preadolescent children often requires that inferences are made about the meaning of some symptoms but it is not always clear that these inferences are valid. It is concluded that the extant evidence does not provide a clear conclusion about the links between preadolescent and adult mania. More work is needed on the phenomenology and diagnosis of mania in children, on its natural history and on its familial correlates.

Adolescent↗
PubMed2003

Predicting repeat self-harm in children--how accurate can we expect to be?

The main objective of the study was to find which variables predict repetition of deliberate self-harm in children. The study is based on a group of children who took part in a randomized control trial investigating the effects of a home-based family intervention for children who had deliberately poisoned themselves. These children had a range of baseline and outcome measures collected on two occasions (two and six months follow-up). Outcome data were collected from 149 (92 %) of the initial 162 children over the six months. Twenty-three children made a further deliberate self-harm attempt within the follow-up period. A number of variables at baseline were found to be significantly associated with repeat self-harm. Parental mental health and a history of previous attempts were the strongest predictors. A model of prediction of further deliberate self-harm combining these significant individual variables produced a high positive predictive value (86 %) but had low sensitivity (28 %). Predicting repeat self-harm in children is difficult, even with a comprehensive series of assessments over multiple time points, and we need to adapt services with this in mind. We propose a model of service provision which takes these findings into account.

Adolescent↗
PubMed2003

Maternal depression and child behaviour problems. Randomised placebo-controlled trial of a cognitive-behavioural group intervention.

BACKGROUND: Despite the frequently reported association between maternal depression and childhood psychopathological disorder, few studies have attempted to intervene with both conditions. AIMS: To evaluate the effect of group cognitive-behavioural therapy (CBT) on child behaviour problems and maternal depression in a group of women with young children. METHOD: An assessor-masked, randomised placebo-controlled trial compared three treatments: CBT for depression and parenting skills enhancement; a mothers' support group; and no intervention. An epidemiological (general population) sample was recruited. RESULTS: Analysis showed no significant difference between the groups. Within-group comparison suggested that at the end of treatment and at 6-month and 12-month follow-up, child problems and maternal depression had improved significantly in the CBT group. CONCLUSIONS: There was no statistically significant difference between groups. Both contact interventions seemed to provide some benefits to mothers with depression, with a possibly improved outcome resulting from CBT for children with behavioural problems. The results must be treated with caution.

Adult↗
PubMed2002

Altered performance of forest pests under atmospheres enriched by CO2 and O3.

Human activity causes increasing background concentrations of the greenhouse gases CO2 and O3. Increased levels of CO2 can be found in all terrestrial ecosystems. Damaging O3 concentrations currently occur over 29% of the world's temperate and subpolar forests but are predicted to affect fully 60% by 2100 (ref. 3). Although individual effects of CO2 and O3 on vegetation have been widely investigated, very little is known about their interaction, and long-term studies on mature trees and higher trophic levels are extremely rare. Here we present evidence from the most widely distributed North American tree species, Populus tremuloides, showing that CO2 and O3, singly and in combination, affected productivity, physical and chemical leaf defences and, because of changes in plant quality, insect and disease populations. Our data show that feedbacks to plant growth from changes induced by CO2 and O3 in plant quality and pest performance are likely. Assessments of global change effects on forest ecosystems must therefore consider the interacting effects of CO2 and O3 on plant performance, as well as the implications of increased pest activity.

Animals↗