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Professor Gordon Harold Andrew and Virginia Rudd Chair in Child and Adolescent Mental Health

Family Relationship Influences on Children’s Mental Health: Bridging the Causes versus Outcomes Divide. Professor Gordon Harold Andrew and Virginia Rudd Chair in Child and Adolescent Mental Health Director, Rudd Centre for Adoption Research and Practice University of Sussex.

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Professor Gordon Harold Andrew and Virginia Rudd Chair in Child and Adolescent Mental Health

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  1. Family Relationship Influences on Children’s Mental Health: Bridging the Causes versus Outcomes Divide Professor Gordon Harold Andrew and Virginia Rudd Chair in Child and Adolescent Mental Health Director, Rudd Centre for Adoption Research and Practice University of Sussex

  2. Family Factors and Child Mental Health • Depression • Leading cause of Global (UK) disease burden (2020 DALYs) • Substance misuse, school failure, self-harm, delinquency, conduct problems, suicide • Conduct problems/disorder • Conduct disorder (5-15 years) = 30% of all crime (UK) at a cost of £22 billion/year • Substance misuse, psychosis, violent crime, future criminality • Family Factors • Economic stress/pressure • Parent mental health • Parenting practices • Divorce (>1:2) • Inter-parental conflict • Toxic family stress

  3. Chronic Stress Effects on Early Brain Architecture Toxic Stress Changes Brain Architecture Typical neuron— many connections Normal Toxic stress Damaged neuron— fewer connections Prefrontal Cortex and Hippocampus Radley et al., 2004

  4. Family Stress Effects on Child Mental Health: Synapse to Society Family Influences Biological, Cognitive, Emotional Mechanisms Child Psychological Outputs Genetic Factors Neurobiological Deficits Serious Mental Health Problems Parental Conflict/ViolenceHarsh Parenting Cognitive and Emotional Problems Early Mental Health Symptoms VanGoozen, Fairchild, Snoek & Harold, Psychological Bulletin, 2007.

  5. Challenges for Past Research • Salience of the family environment ? • Predominantly conducted with biologically related parents-children • Limited examination of maternal versus paternal parenting influences on children • What if it is all in the genes? • Associations between parental behaviour (e.g. parenting) and child behaviour is BECAUSE children share genes with their parents?? • Passive/evocative genetic effects • Disentangling genetic factors from rearing environment factors • Relevance of intervention/prevention • What we target, when and how?

  6. Recent Research Evidence • Two novel research designs • Early Growth and Development Study (US) • Longitudinal adoption-at-birth study (>500 children, biological and adoptive parents, 2004+) • Cardiff In vitro fertilisation Study (UK) • Adoption at conception study (genetically unrelated mothers and fathers; >1000 children, parents, 2006+) • Bottom line benefits of research designs • Associations between parental behaviour (e.g. inter-parental, parent-child conflict) and child behaviour CANNOT be due to common genes shared between rearing parents and children • IMPORTANCE of the rearing environment

  7. Family Stress Effects on Child Mental Health: Synapse to Society Family Influences Biological, Cognitive, Emotional Mechanisms Child Psychological Outputs Genetic Factors Neurobiological Deficits Serious Mental Health Problems Parental Conflict/ViolenceHarsh Parenting Cognitive and Emotional Problems Early Mental Health Symptoms VanGoozen, Fairchild, Snoek & Harold, Psychological Bulletin, 2007.

  8. Family Experiences Really Matter(UK-IVF / US-EGDS) Mother-Child Hostility ** / ** ** / ** Child Conduct Problems Inter-Parental Conflict ** / ** ** / **+ Father-Child Hostility Harold et al., Journal of Family Psychology, 2013. *p <.05, ** p < .01

  9. Summary and Bottom Line Family relationship influences on children’s mental health Children of all ages (6 months to 16 years) are affected by acrimonious inter-parental and parent-child relationship (silence to violence continuum) Family relationship experiences AFFECT children’s mental health Serious mental health problems Depression, conduct problems, self-harm, substance misuse, psychosis, suicidality (and others) UK – one of the riskiest nations in the world (OECD) in terms of child and adolescent mental health welfare and well-being Targeting solutions A move away from outcome focused research and dialogue A focus on mechanism/process Target early causes (research evidence) to affect later outcomes Intervening when and where it actually matters for children A shift in focus from late intervention to early intervention/prevention An issue of public health (divorce >1:2, information/policy?) Turning Negatives into Positives (A Long-Game Approach) Helping parents Improves outcomes for children Reduces costs (depression, conduct problems) Improves future relationship quality Reduces future rates of family breakdown Improves future child outcomes Promoting positive intergenerational cycles through the promotion of positive relationship support (resilient parents/parenting = resilient children (future parents) Present state of UK child mental health: Afford not to invest??

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