Publications

Publications relevant to the PAEDS project will be posted here when they become available. If you have trouble accessing any of the academic articles, please email Dr Cliodhna O’Connor, who will be happy to provide you with a copy.

Title: What Differentiates Children with ADHD Symptoms Who Do and Do Not Receive a Formal Diagnosis? Results from a Prospective Longitudinal Cohort Study
Journal: Child Psychiatry & Human Development
Year: 2019
Abstract: ADHD diagnoses are increasing worldwide, in patterns involving both overdiagnosis of some groups and underdiagnosis of others. The current study uses data from a national longitudinal study of Irish children (N = 8568) to examine the sociodemographic, clinical and psychological variables that differentiate children with high hyperactivity/inattention symptoms, who had and had not received a diagnosis of ADHD. Analysis identified no significant differences in the demographic characteristics or socio-emotional wellbeing of 9-year-olds with hyperactivity/inattention who had and who had not received a diagnosis of ADHD. However, by age 13, those who had held a diagnosis at 9 years showed more emotional and peer relationship problems, worse prosocial behaviour, and poorer self-concept. Further research is required to clarify the developmental pathways responsible for these effects.

Title: How does psychiatric diagnosis affect young people’s self-concept and social identity? A systematic review and synthesis of the qualitative literature
Journal: Social Science & Medicine
Year: 2018
Abstract: Receiving a psychiatric diagnosis in childhood or adolescence can have numerous social, emotional and practical repercussions. Among the most important of these are the implications for a young person’s self-concept and social identity. To ensure diagnoses are communicated and managed in a way that optimally benefits mental health trajectories, understanding young people’s first-hand experience of living with a diagnosis is paramount. This systematic review collates, evaluates and synthesises the qualitative research that has explored how psychiatric diagnosis interacts with young people’s self-concept and social identity. A search of 10 electronic databases identified 3892 citations, 38 of which met inclusion criteria. The 38 studies were generally evaluated as moderate-to-high quality research. Thematic synthesis of their findings highlighted the multifaceted ways diagnosis affects young people’s self-concept and social identity. Diagnosis can sometimes threaten and devalue young people’s self-concept, but can also facilitate self-understanding, self-legitimation and self-enhancement. A diagnosis can lead to social alienation, invalidation and stigmatisation, yet can also promote social identification and acceptance. Further research is needed to clarify which self and identity outcomes can be expected in a given set of circumstances, and to establish how self and identity effects interact with diagnoses’ other clinical, practical, social and emotional consequences.
Title: A prospective longitudinal investigation of the (dis)continuity of mental health difficulties between mid- to late-childhood and the predictive role of familial factors
Journal: European Child & Adolescent Psychiatry
Year: 2018
Abstract: Understanding individual variation in the continuity of youth mental health difficulties is critical for identifying the factors that promote recovery or chronicity. This study establishes the proportion of children showing psychopathology at 9 years, whose pathology had either remitted or persisted at 13. It describes the socio-demographic and clinical profiles of these groups, and examines the factors in 9-year-olds’ familial environments that predict longitudinal remission vs. persistence of psychopathology. The study utilised data from a prospective longitudinal study of 8568 Irish children. Child psychopathology was assessed using the Strengths and Difficulties Questionnaire (SDQ). Analysis established the rates of continuity of SDQ classifications between 9 and 13 years. Analysis also investigated the familial factors that predicted the remission vs. persistence of psychopathological symptoms, controlling for socio-demographic and child factors. Average SDQ scores improved between the ages of 9 and 13, F(1, 7292) = 276.52, p < 0.001. Of children classified Abnormal aged 9, 41.1% remained so classified at 13, 21.4% were reclassified Borderline, and 37.6% Normal. Demographic and child risk factors for persistence of pathology were maleness (β = −1.00, p = 0.001, CI = 0.20–0.67), one-carer households (β = −0.71, p = 0.04, CI = 0.25–0.97), poor physical health (β = −0.64, p = 0.03, CI = 0.30–0.92), and low cognitive ability (β = 0.61, p = 0.002, CI = 1.26–2.70). Controlling for these factors, the only familial variable at 9 years that predicted subsequent pathological persistence was caregiver depression (β = −0.07, p = 0.03, CI = 0.87–0.99). The analysis highlights substantial rates of psychopathological discontinuity in a community sample and identifies the children most at risk of chronic mental health problems. These results will inform the targeting of early interventions and distribution of clinical resources.