Proposal summaries

These are research proposals that have been approved by the ALSPAC exec. The titles include a B number which identifies the proposal and the date on which the proposals received ALSPAC exec approval.

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B4074 - Optimising outcomes in children of depressed parents identification of modifiable promoters of mental health resilience - 26/05/2022

B number: 
B4074
Principal applicant name: 
Stephan Collishaw | Cardiff University (UK)
Co-applicants: 
Ms Egle Padaigaite, Professor Frances Rice, Dr Gemma Hammerton
Title of project: 
Optimising outcomes in children of depressed parents: identification of modifiable promoters of mental health resilience
Proposal summary: 

Parental depression is associated with various mental health conditions and other difficulties in offspring. Nevertheless, some individuals do not develop mental health difficulties or do so only temporarily. It indicates that certain protective factors may buffer risks associated with being raised by a depressed parent. Individual, family, social, and lifestyle protective factors were identified in previous research to be relevant for mental health resilience in adolescence. However, as people mature, different protective factors may be relevant in young adulthood - a peak period for the emergence of mental health problems.

Therefore, this study will aim to understand if various protective factors could explain why some individuals do not develop mental health problems or recover from them despite being at higher risk due to genetic and environmental influences. Furthermore, we will aim to test the causal role of the identified protective factors and potential biological, psychosocial and environmental mechanisms that could explain protective factors’ joint contribution to mental health resilience in children of depressed parents.

We expect to identify modifiable protective factors that could be targeted to develop prevention and intervention strategies that could potentially interrupt the transmission of mental health problems from parents to offspring. In this way, the research could improve the lives of both depressed parents and their offspring.

Impact of research: 
Adolescence and young adulthood is a critical developmental period for developing mental health difficulties that may have long-lasting adverse effects. These difficulties may impact social relationships and education and contribute to poor long-term prognosis. The study will help to better understand mental health resilience and why some individuals do not develop mental health problems or recover from earlier problems despite being at high familial risk. The findings are also expected to identify modifiable targets for evidence-based prevention and intervention strategies, thus improving the lives of both depressed parents and their offspring.
Date proposal received: 
Thursday, 19 May, 2022
Date proposal approved: 
Thursday, 26 May, 2022
Keywords: 
Mental health - Psychology, Psychiatry, Cognition, Mental health, GWAS, Statistical methods, Development, Methods - e.g. cross cohort analysis, data mining, mendelian randomisation, etc.

B4078 - Genome-wide association study GWAS of lipid traits in adults - 26/05/2022

B number: 
B4078
Principal applicant name: 
Qian Yang | MRC IEU (UK)
Co-applicants: 
Prof Deborah A Lawlor, Prof Nicholas J Timpson
Title of project: 
Genome-wide association study (GWAS) of lipid traits in adults
Proposal summary: 

The Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium invites ALSPAC and Bristol researchers’ to take part in a large GWAS of lipid traits (incl. high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), and triglycerides). The main aims of CHARGE’s GWAS are to (1) identify novel loci for lipids trait separately by sex; (2) identify gene-sleep duration interaction effects on lipid traits separately by sex. These analyses will follow the ‘Phase II Analysis Plan for Sleep and Lipids’ version 7.4 provided by CHARGE. Only GWAS summary statistics will be shared with CHARGE. Based on the GWAS results, subsequent analyses (e.g. validation of the gene-by-environment effects using longitudinal data of lipid traits, and Mendelian randomization) would be suggested by CHARGE.

Impact of research: 
This study will help identify novel genetic variants involved in lipid traits and how genetic variants affect these traits taking into account potential interaction with a lifestyle factor, i.e. sleep.
Date proposal received: 
Wednesday, 25 May, 2022
Date proposal approved: 
Thursday, 26 May, 2022
Keywords: 
Genetic epidemiology (including association studies and mendelian randomisation), lipid disorder, GWAS, Biomarkers - e.g. cotinine, fatty acids, haemoglobin, etc.

B4073 - Mental health trajectories following mental health treatments - 24/05/2022

B number: 
B4073
Principal applicant name: 
Alex Kwong | IEU, PHS
Co-applicants: 
Professor Kate Tilling, Dr Ahmed Elhakeem, Dr Richard Parker
Title of project: 
Mental health trajectories following mental health treatments
Proposal summary: 

Mental health treatments, including antidepressant treatment such as Selective Serotonin Reuptake Inhibitors (SSRIs) and Cognitive Behavioural Therapy (CBT) are effective interventions for depression and anxiety in young people. However, the short and long term effects of one or both of these forms of treatment are unknown in longitudinal population studies. There remains a paucity in how these treatments work, what combination of treatments work, what works best for whom, whether some symptoms are treated better than others and how variable mental health responses are following treatment. We will use data recently collected in ALSPAC on mental health treatments and examine mental health responses to address those research gaps. We will develop a longitudinal research tool which highlights these results which will be made freely available to researchers to apply to other research questions.

Impact of research: 
measuring efficacy of mental health treatment and development of a longitudinal research tool
Date proposal received: 
Wednesday, 18 May, 2022
Date proposal approved: 
Monday, 23 May, 2022
Keywords: 
Mental health - Psychology, Psychiatry, Cognition, Mental health, Statistical methods, Psychology - personality

B4070 - Rapid evaluation of interventions for close contact infectious diseases - 31/05/2022

B number: 
B4070
Principal applicant name: 
Ellen Brooks Pollock | University of Bristol (United Kingdom)
Co-applicants: 
Dr Leon Danon, Dr Amy Thomas, Dr Emily Nixon, Prof Nicholas Timpson, Dr Kate Northstone
Title of project: 
Rapid evaluation of interventions for close contact infectious diseases
Proposal summary: 

During the COVID-19 pandemic, ALSPAC ran a rapid survey of risk mitigation behaviours. We used the data to inform a transmission model of the SARS-CoV-2 Omicron-variant wave. We would like to develop the methods we started during the COVID-19 pandemic to create a public health decision-making tool. We propose to work with the ALSPAC cohort to characterise infection prevention practices and to understand the trade-offs between measures.

Impact of research: 
We are developing a tool for public health decision makers to use. The impact will be an increased evidence-base for public health decisions.
Date proposal received: 
Tuesday, 17 May, 2022
Date proposal approved: 
Friday, 20 May, 2022
Keywords: 
Epidemiology, Behaviour - e.g. antisocial behaviour, risk behaviour, etc., Infection, Mathematical/infectious disease modelling, Infectious diseases

B4040 - CADSET proposal Obstructive lung function phenotypes and early life - 20/05/2022

B number: 
B4040
Principal applicant name: 
Raquel Granell | MRC Integrative Epidemiology Unit (MRC-IEU) (United Kingdom)
Co-applicants: 
Prof Anna Hansell, Miss Katie Eminson, Professor John Gulliver, Miss Yoni van Dijk
Title of project: 
CADSET proposal: Obstructive lung function phenotypes and early life
Proposal summary: 

It is crucial to understand which early-life factors influence lung function development, since impaired lung function has been associated with respiratory, cardiovascular and metabolic anomalies, and even all-cause mortality. This project will focus on further understanding how lung function develops and what early life factors are key at imparing its development.

Impact of research: 
It is intended to publish results in high impact journals at the end of the project, which might contribute to policy decision-making and/or future follow-up studies.
Date proposal received: 
Thursday, 5 May, 2022
Date proposal approved: 
Friday, 20 May, 2022
Keywords: 
Epidemiology, Respiratory - asthma, Statistical methods, Cohort studies - attrition, bias, participant engagement, ethics

B4062 - C-section Delivery and blood DNA Methylation at Birth and in Childhood - 20/05/2022

B number: 
B4062
Principal applicant name: 
Giulia Mancano | University of Bristol (United Kingdom)
Co-applicants: 
Ms Fernanda Morales Berstein, Dr Hannah Elliott, Dr Gemma Sharp, Dr Rebecca Richmond, Dr Marie-France Hivert , Joanne Sordillo
Title of project: 
C-section Delivery and blood DNA Methylation at Birth and in Childhood
Proposal summary: 

Emerging evidence suggests that babies born by C-section (Cesarean section) have different hormonal, physical, bacterial, and medical exposures, and that these exposures can subtly alter neonatal physiology. (Sandall et la, 2018) C-section delivery has been associated with a number of chronic disease outcomes in children, including metabolic risk phenotypes and asthma. One of the potential mechanisms through which C-section delivery may increase risk of adverse health outcomes is via epigenetic alterations. (Dahlen et al, 2013)

Dahlen, HG et al. “The EPIIC hypothesis: intrapartum effects on the neonatal epigenome and consequent health outcomes.” Med Hypotheses. 2013. May; 80(5):656-62.

Sandall, J et al. “Short-term and long-term effects of caesarean section on the health of women and children.” Lancet. 2018. Oct 13; 392(10155):1349-1357.

Impact of research: 
This research will contribute to the identification of novel differentially methylated CpG sites in the offspring, and therefore, to our understanding of epigenetic mechanisms underlying observed associations between mode of delivery and adverse offspring health outcomes.
Date proposal received: 
Friday, 20 May, 2022
Date proposal approved: 
Friday, 20 May, 2022
Keywords: 
Epidemiology, Pregnancy - e.g. reproductive health, postnatal depression, birth outcomes, etc., DNA methylation, Birth outcomes, Epigenetics, Microbiome, Offspring

B4064 - Associations of diabetic traits blood pressure general and central adiposity with COVID-19 and long COVID a prospective study - 20/05/2022

B number: 
B4064
Principal applicant name: 
Nic Timpson | MRC-IEU
Co-applicants: 
Fergus Hamilton
Title of project: 
Associations of diabetic traits, blood pressure, general and central adiposity with COVID-19 and long COVID: a prospective study
Proposal summary: 

COVID-19 patients with high BMI and waist to hip ratio (WHR), diabetes and hypertension showed a higher risk of dying and severe disease in the early pandemic (1-3), but the role in susceptibility for COVID-19 and long COVID and the extent to which associations are due to confounding is still mostly unclear (4-7). Previous analysis on infection and long Covid risk mainly used binary measures of obesity or overweight, known diabetes status and hypertension, which could introduce measurement error, reduce statistical power, and does not allow to disentangle whether an association is related to treatment or due to the disease itself. Using pre-pandemic diabetes, measured blood glucose and HbA1c, BMI, WHR, body fat and blood pressure could improve measurement quality by identifying disease control, severity, and those with prediabetes.

Impact of research: 
Help understand impact of BMI, weight, height, and other linked variables on long covid.
Date proposal received: 
Tuesday, 17 May, 2022
Date proposal approved: 
Friday, 20 May, 2022
Keywords: 
Immunology, Infection, GWAS, Biological samples -e.g. blood, cell lines, saliva, etc.

B4066 - Exploring the pathways between mental health symptom stages from early adolescence to young adulthood - 20/05/2022

B number: 
B4066
Principal applicant name: 
Aswin Ratheesh | Orygen and The University of Melbourne (Australia)
Co-applicants: 
Ms Sarah Walmsley
Title of project: 
Exploring the pathways between mental health symptom stages from early adolescence to young adulthood
Proposal summary: 

Early adolescence is a sensitive period of significant social and physiological growth, and represents the time when symptoms of mental disorders commonly emerge. Clinical staging models have been proposed to provide framework for identifying early risk factors and symptoms in adolescence and young adulthood, that may predict future progression to mood disorders and psychosis. It has been suggested that sub-threshold symptoms may be predictive of later stages of more serious mental disorders. We propose to examine the associations between parent rated sub-threshold mental health symptoms in early adolescence and mental health symptom stages in young adulthood. This will help determine which of these symptoms could represent risk of progression to stages associated with need for care. Parents offer unique insight into early mental health symptoms, observing their children in a home environment. It is important to understand the trajectories associated with parental accounts. If specific parent rated sub-threshold symptoms in early adolescence can be identified, that are predictive of progression to later stages of mood, anxiety and psychotic symptom stages in young adulthood, this could provide understanding of prognosis and intervention needs to adolescents and their families. Cannabis use, alcohol use and negative life events may mediate the relationship between parent rated symptoms in early adolescence and mental health difficulties in young adulthood. We propose to analyse these pathways in order to understand whether these factors are associated with increased risk of progression to later clinical stages. This project will contribute to understanding the validity of clinical staging models for psychotic and mood disorders in youth mental health, in particular contributing to understanding of early risk factors in these models, and could provide opportunities for targeted intervention and prevention.

Impact of research: 
If parent rated sub-threshold symptoms in early adolescence can be identified that are predictive of progression to later clinical stages in young adulthood, this could assist in the understanding of prognosis and early intervention needs for adolescents and their parents and treating teams. Additionally, if risk factors can be identified that are associated with worse outcomes, including cannabis use, alcohol use and negative life events, this could provide opportunity for targeted intervention to reduce or prevent progression from early sub-threshold stages to later clinical stages and increased need for care.
Date proposal received: 
Wednesday, 11 May, 2022
Date proposal approved: 
Friday, 20 May, 2022
Keywords: 
Epidemiology, Mental health, Statistical methods, Staging, symptoms, onset

B4071 - Childhood adversity DNA methylation risk scores and risk for depression across development - 20/05/2022

B number: 
B4071
Principal applicant name: 
Alexandre Lussier | Massachusetts General Hospital (United States)
Co-applicants: 
Dr. Erin C. Dunn
Title of project: 
Childhood adversity, DNA methylation risk scores, and risk for depression across development
Proposal summary: 

Childhood adversity (e.g., abuse or maltreatment, family disruption or dysfunction, poverty, etc.) is one of the most potent life experiences linked to depression, nearly doubling the risk for a first onset. Emerging evidence also suggests that the effects of adversity on depression may vary based on when in the lifespan it occurs. In other words, there may be sensitive periods when the brain is “plastic” and experiences can impart more enduring effects field. However, the biological mechanisms linking childhood adversity to long-term vulnerability for depression remain poorly understood. One possibility is that adversity reprograms the epigenome through DNA methylation (DNAm), epigenetic modifications that do not change the sequence of the genome, but can alter gene expression. Recent evidence also suggests that DNAm risk scores (MRS) generated from large-scale studies of early-life exposures and/or mental outcomes may help predict and interpret risk for depression and other mental disorders.

To this end, we recently completed the largest analysis of time-varying childhood adversity and genome-wide DNAm in childhood, analyzing the impact of five types of adversity across seven longitudinal birth cohorts (N=2,347-3,279). Through these analyses, we identified distinct epigenetic signatures for five types of childhood adversity, as well as further evidence of sensitive periods for the effects of adversity on DNAm. However, it remains unknown whether DNAm risk scores generated from these data can accurately explain and predict depression risk across development.

As such, we seek to extend this research, which included data from the ALSPAC cohort, to further investigate the relationship between childhood adversity, DNAm, and depressive symptom trajectories across development. The central hypothesis we will test is that DNA methylation patterns linked to childhood adversity can be used as predictors of both prior exposures to adversity and future depressive outcomes, with measurable effects on depressive symptom trajectories.

Impact of research: 
By testing our central hypothesis, we will determine whether composite measures of childhood adversity can be identified through epigenetic alterations and whether these biological measures can predict the onset and severity of psychopathology. As the first longitudinal investigation of DNA methylation risk scores for childhood adversity and depression, this research the stage for a broader research program aimed at determining how epigenetic mechanisms can be used to predict and interpret risk for mental illness across the life course. Importantly, this work will help identify the molecular mechanisms that drive risk for depression across development, as well as delineate the periods when childhood adversity and DNA methylation have greater effects on depression risk, which will help guide optimally-timed interventions to reduce the burden of depression. Such efforts will help target prevention and treatment efforts to people who are at higher risk for mental illness and ultimately, will help improve the overall well-being of youth and adults affected by depression.
Date proposal received: 
Friday, 13 May, 2022
Date proposal approved: 
Friday, 20 May, 2022
Keywords: 
Mental health - Psychology, Psychiatry, Cognition, Behaviour - e.g. antisocial behaviour, risk behaviour, etc., Mental health, Computer simulations/modelling/algorithms, Statistical methods, Biomarkers - e.g. cotinine, fatty acids, haemoglobin, etc., Childhood - childcare, childhood adversity, Environment - enviromental exposure, pollution, Epigenetics, Genetics

B4069 - Autistic traits anxiety and eating behaviours Longitudinal trajectories across child development - 20/05/2022

B number: 
B4069
Principal applicant name: 
Moritz Herle | Kings College London (United Kingdom)
Co-applicants: 
Dr Helena Zavos , Dr Virginia Carter Leno
Title of project: 
Autistic traits, anxiety, and eating behaviours: Longitudinal trajectories across child development
Proposal summary: 

Recent empirical work suggests the prevalence of eating disorders may be raised in autistic individuals, however, questions remain as to whether the co-occurrence of autism and eating disorders could be due to selective samples and/or difficulties disentangling symptoms of autism as compared to symptoms of eating disorders. An alternative explanation is that autism, or high levels of autistic traits, in childhood, may causally increases risk for eating disorders later in development. In addition, autistic children often experience high level of anxiety, and might use overeating or binge eaitng as a coping strategy to sooth and calm themselves down, which might put them on increased risk for later eating disorders. Further research into the pathways and potential mediators of the link between autism, anxiety,and eating disorders is needed to illuminate underpinning mechanisms, which in turn will highlight targets for prevention/intervention.

Impact of research: 
Date proposal received: 
Friday, 20 May, 2022
Date proposal approved: 
Friday, 20 May, 2022
Keywords: 
Mental health - Psychology, Psychiatry, Cognition, Eating disorders - anorexia, bulimia, Mental health, Statistical methods, Statistical methods

B4072 - Subtypes of persistent developmental stammering - 20/05/2022

B number: 
B4072
Principal applicant name: 
Michel Belyk | Edge Hill University (United Kingdom)
Co-applicants: 
Title of project: 
Subtypes of persistent developmental stammering
Proposal summary: 

There are speech therapies that can help them to cope, but most children will recover on their own. However, about one person in every hundred keeps stammering into adulthood. Stammering is tends to run in families, which means that it is genetic. There are also markers in the brain that help us to understand how stammering happens. However, they don’t seem to be very consistent across people. This project proposes to use a big data base of Magnetic Resonance Imaging (MRI) and genetics data covering thousands of parents and children, many of whom will have stammered. These data will be used to understand both how the brains of people who stammer are different from fluent speakers, and how they are different from each other. With a greater understanding of what makes some brains stammer, it is hoped that we can inform the development of better speech therapies. People who stammer also have a strong interest in understanding why they are the way they are and are growing community advocacy movements around the idea of neurodiversity. These advocacy groups will benefit as we learn just how diverse their brain can be.

Impact of research: 
Stammering may be amenable to a personalised medicine approach to speech-therapy. Speech and language therapists train people who stammer to use techniques that either enhance fluency or enable stammering in a more controlled manner, usually by changing some aspect of the way that they speak. This may include interventions related to muscle tension, speech timing, auditory feedback, as well dealing with anxiety about the prospect of stammering. These therapies have good efficacy when measured at the clinic, but high rates of relapse (~70%) as patients frequently discontinue the techniques learned in therapy when faced with real-world communication. Understanding variability in the underlying causes of stammering is an initial step towards a personalised medicine approach to speech therapy. Understanding individual differences in the underlying neurobiology of stammering may be used to generate testable predictions about which treatments connect with the mechanisms underlying an individual patient’s condition – matching patients with the treatments that most closely address underlying causes of their stammer. The stammering community are beginning to understand and reference their condition as a form of neurodiversity, in line with contemporary trends that have improved quality of life for people on the Autism Spectrum. In addition to the implications of the proposed research for understanding aetiology and improving treatment, the proposed research aligns directly with the broader advocacy interests of people who stammer.
Date proposal received: 
Tuesday, 17 May, 2022
Date proposal approved: 
Friday, 20 May, 2022
Keywords: 
Mental health - Psychology, Psychiatry, Cognition, Speech/language problem, Medical imaging, Speech and language

B4068 - Understanding the mechanisms linking the urban environment to mental health in childhood adolescence and early adulthood - 25/05/2022

B number: 
B4068
Principal applicant name: 
Joanne Newbury | University of Bristol
Co-applicants: 
Prof Stan Zammit
Title of project: 
Understanding the mechanisms linking the urban environment to mental health in childhood, adolescence, and early adulthood
Proposal summary: 

Individuals who are raised in urban (versus rural) settings are around twice as likely to develop a psychotic disorder such as schizophrenia. Research also suggests that risk for other mental health problems, in particular depression, anxiety and conduct problems, is elevated in urban settings. Given that 70% of the world’s population will live in urban areas by 2050, it is essential that we uncover the pathways linking cities and psychosis so that we can inform intervention efforts.
Air and noise pollution are among the biggest environmental health risks that the world faces, and are particularly problematic in cities. Growing evidence also suggests that air pollution may contribute to the development of mental health problems. However, it is currently unknown whether air and noise pollution might partly explain the elevated risk for mental health problems found in cities. In addition, there has been a lack of longitudinal research, including that using pollution spanning the early years of development. Studies have also often been inadequately controlled for potential confounders.
This project will examine 1) the longitudinal associations of air pollution exposure from pregnancy to age 15 with psychotic experiences at age 12, 18, and 24; and examine specificity by repeating analyses with anxiety, depression, and conduct problems as outcomes; 2) explore the interplay between neighbourhood social characteristics (crime and social fragmentation) and air pollution in the emergence of psychotic experiences, and 3) examine two potential biopsychological mechanisms linking urban neighbourhood exposures with mental health, namely inflammation and cognition.

Impact of research: 
This research will serve a range of stakeholders, including researchers, industry, policymakers, and the general public. Air pollution is a known cause of physical disease, but very little is known about the impact of air pollution on mental health problems. My research will contribute to the evidence base on air pollution and mental health, which is essential for policymakers to make the economic case for tightening air pollution restrictions. Though a major global challenge, urban expansion nevertheless provides a unique opportunity for promoting healthy urban design. My research will also be useful to industry and policymakers to provide evidence for targets in the urban environment that could be modified to improve mental health. By identifying modifiable targets in the urban environment, this research has the strong potential to improve the mental health of urban residents now and for years to come. My plan for maximising impact of the findings is as follows: 1) I expect that the research proposed will lead directly to at least four publications in highly regarded journals with a broad readership. 2) I will disseminate findings via oral presentations at six international psychiatry/epidemiology conferences that attract a wide audience such as MQ Mental Health Science Meeting. 3) I will liaise with press teams such as the Science Media Centre to maximise the impact of the findings through press releases and press briefings. 4) I will ensure that findings are clearly presented to the public by preparing blogs and podcasts, and by participating in interactive open workshops and talks. 5) I will share my findings with policymakers by holding a policy lab with support from Policy Bristol.
Date proposal received: 
Wednesday, 11 May, 2022
Date proposal approved: 
Friday, 20 May, 2022
Keywords: 
Mental health - Psychology, Psychiatry, Cognition, Cognitive impairment, Statistical methods, Biomarkers - e.g. cotinine, fatty acids, haemoglobin, etc.

B4065 - The Impact of Early Child Development on Social Mobility in the UK - 13/06/2022

B number: 
B4065
Principal applicant name: 
Matt Dickson | University of Bath (United Kingdom)
Co-applicants: 
Mrs Rachel Ambler
Title of project: 
The Impact of Early Child Development on Social Mobility in the UK
Proposal summary: 

The main research question that this project will address is: how do parental investments and parenting practices in the pre-school years influence the formation of human capital in children and contribute to the transmission of socio-economic status between generations.

During the pre-school years, though there are many outside influences on children, it is parents that have the greatest impact on their offspring. Parental investments before the age of three are likely to be as important, if not more, than what happens from age three onwards, given the dynamic complementarity between early and later skill development.

The project aims to extend our understanding of how (and when) gaps in attainment across socio-economic status emerge. We will map the relationships between measures of parental investment in the early years and long-term socio-economic outcomes and investigate the extent to which these are mediated through educational attainment. The empirical analysis will use data from the Avon Longitudinal Study of Parents and Children (ALSPAC) with linkage to the National Pupil Database. The data will be used to empirically investigate the extent of differences in early child investments and parenting practices between children/parents and how any differences relate to the later life outcomes of the children.

Impact of research: 
This project will identify the key parental investments in the very earliest years of life which lead to long-term economic success. The over-arching aim is to increase social mobility. To date, research in this domain has focused on experience from pre-school (age 3) onwards, neglecting the role of the very earliest years for human capital formation. We will add to the literature and policy understanding by more precisely quantifying how early-life investments and experiences help, or hinder, social mobility. We will quantify the relative size of the well-documented achievement gaps at school entry between advantaged and disadvantaged children, identifying when and, importantly, why they start to increase. The research will help to inform policy by uncovering which everyday parenting practices during infancy enhance outcomes later in life so we can make robust policy recommendations regarding the timing of targeted interventions in the earliest years of life, and even pre-birth. We will argue that early childhood should be an integral part of policy decisions; using this analysis to show that the role of the earliest phase of life for human capital formation is pivotal in understanding, and overcoming, the inequality and disadvantage that persist for many families. The force of this argument will be underpinned by data from four generations, uniquely available in the ALSPAC, which presents an exciting opportunity to expand our understanding of intergenerational mobility. Our findings will be of interest to policymakers in the Dept. for Education, the Dept. for Health and Social Care, and the Office of the Children’s Commissioner, as well as the Social Mobility Commission and we will actively engage with them. Understanding the role of the earliest interactions between parents and their children in the transmission of socio-economic status from one generation to the next will help in the design of policies aimed at increasing social mobility and widening opportunity, with the potential for significant long-term impact.
Date proposal received: 
Monday, 9 May, 2022
Date proposal approved: 
Monday, 16 May, 2022
Keywords: 
Social Science, Behaviour - e.g. antisocial behaviour, risk behaviour, etc., Cognitive impairment, Statistical methods, Childhood - childcare, childhood adversity, Cognition - cognitive function, Development, Intelligence - memory, Linkage, Parenting, Social science, Statistical methods

B4063 - Determinants of breastfeeding success and health inequalities - 10/05/2022

B number: 
B4063
Principal applicant name: 
Nancy McBride | MRC IEU (United Kingdom)
Co-applicants: 
Dr Luisa Zuccolo, Dr Carolina Borges, Emma Benham
Title of project: 
Determinants of breastfeeding success and health inequalities
Proposal summary: 

Breastfeeding is sustainable, the biological norm, and potentially life-saving, particularly for premature babies. Evidence-based strategies to support breastfeeding have been successful, but inequalities in breastfeeding rates are proving difficult to reduce, affecting the most vulnerable of mothers and babies. Successfully establishing and sustaining breastfeeding can be facilitated by both removing structural and cultural barriers, and overcoming individual challenges. Common factors such as obesity and depression/anxiety could play an important part in explaining some of the variability (and inequality) in breastfeeding duration. Conversely, maternal factors reflecting good mental and physical health could increase resilience to contexts with low systemic and cultural support for breastfeeding, such as the UK. However, the evidence on the individual determinants causally influencing successful and sustained breastfeeding is of poor quality. The identification of causal determinants of early cessation will improve breastfeeding support activities.

Impact of research: 
We hope to identify causal determinants of early cessation - this can then be used to improve breastfeeding support activities.
Date proposal received: 
Wednesday, 4 May, 2022
Date proposal approved: 
Tuesday, 10 May, 2022
Keywords: 
Genetic epidemiology (including association studies and mendelian randomisation), Pregnancy - e.g. reproductive health, postnatal depression, birth outcomes, etc., GWAS, Birth outcomes

B4052 - Gaining Insights Into The Causal Effects Of Electronic Cigarette Use - 03/05/2022

B number: 
B4052
Principal applicant name: 
Jasmine Khouja | University of Bristol (United Kingdom)
Co-applicants: 
Dr Rebecca Richmond, Prof Marcus Munafo, Dr Elizabeth Prom-Wormley, Dr Megan Cooke, Dr Roseann Peterson, Dr Elizabeth Do, Prof Hermine Maes
Title of project: 
Gaining Insights Into The Causal Effects Of Electronic Cigarette Use
Proposal summary: 

E-cigarettes can help people stop smoking, but the long-term effects of e-cigarette / vaping initiation remain unknown. In this project, we will use our newly established Genetics, E-cigarette and Nicotine Consortium (GENiC) to identify genetic variants associated with vaping. This will provide information about the biological determinants of individual differences in vaping and support causal inference analyses into the downstream behavioural and health consequences of vaping.

At present, it is difficult to determine which genetic variants are specifically associated with vaping rather than smoking combustible cigarettes because most e-cigarette users have also smoked. However, data on non-smoking e-cigarette users are now emerging in large, genetically-informed cohort studies like ALSPAC, which enables – for the first time – the identification of genetic variants associated with vaping initiation (i.e., using e-cigarettes regularly or more than 100 times) in smoking-naïve young people.

We plan to use the available genetic data in ALSPAC and data relating to smoking and e-cigarette initiation to investigate whether a person’s genetic information can be used to predict e-cigarette initiation.

Impact of research: 
Identifying genetic variants associated with e-cigarette initiation will help us understand the genetic architecture of e-cigarette initiation and will provide opportunities for conducting causal analyses in a Mendelian randomisation (MR) framework. These causal analyses will help us to gain insight into the causal effects of e-cigarette use.
Date proposal received: 
Thursday, 21 April, 2022
Date proposal approved: 
Tuesday, 3 May, 2022
Keywords: 
Genetic epidemiology (including association studies and mendelian randomisation), Addiction - e.g. alcohol, illicit drugs, smoking, gambling, etc., GWAS, Genome wide association study

B4061 - Prevention of high levels of depression across adolescence and young adulthood the role of active ingredients - 03/05/2022

B number: 
B4061
Principal applicant name: 
Isabel Morales-Muñoz | School of Psychology, University of Birmingham (United Kigndom)
Co-applicants: 
Prof Steven Marwaha, Dr Pavan Mallikarjun, Dr Alexander Zhigalov, Prof Christopher Yau, Dr David Wong
Title of project: 
Prevention of high levels of depression across adolescence and young adulthood: the role of active ingredients
Proposal summary: 

Depression is the leading cause of disability worldwide and is a major contributor to the overall global burden of disease, with more than 350 million people of all ages suffering from depression. Especially when recurrent and with moderate or severe intensity, depression may become a serious health condition. Further, we now know that many young people suffer from clinical depression. In fact, major depression is one of the most common mental health disorders in children and adolescents, with an estimated one year prevalence of 4-5% in mid-late adolescence and 5.6% in young people of 13-18 year old. Depression in young people is a precursor of adult depressive disorder which is strongly linked to poor physical health outcomes, lower income and increased unemployment, with half of those with lifelong recurrent depression starting to develop their symptoms before the age of 15 years. Thus, to recognize and treat depression in young ages is crucial. To sum up, depression is a substantial and largely unrecognized problem among young people that warrants an increased need and opportunity for identification and intervention. Understanding how specific factors might prevent and/od be effective in the treatment of depression in young people is crucial for the development of early intervention and treatment of depression among youths.
Depression results from a complex interaction of social, psychological, and biological factors. Recent attempts have been made by the Wellcome Trust to investigate the evidence for different active ingredients (i.e. those aspects of an intervention that drive clinical effect, are conceptually well defined, and link to specific hypothesised mechanisms of action) deemed to help prevent, treat, and manage depression in young people globally, including behaviours and activities, beliefs and knowledge, brain/body functions, cognitive and attentional skills, human connections, and socioeconomic factors. However, what is still unknown is which of these potential active ingredients and/or which combination of these active ingredients constitute a more accurate predictor for different groups of young people with depression, including those with high levels of depression.
A number of important issues need further investigation to aid early intervention in depression. First, most studies in young people with depression have focused on single time points, while very few studies have investigated the different trajectories of depression across adolescence and young adulthood, including young people with persistent high levels of depression. In addition, despite the recent attempt to identify specific active ingredients of effective interventions for depression, it is still unclear which of these active ingredients (and their combinations/interactions) are the most relevant to prevent depression across childhood and adolescence. For this reason, new statistical approaches, including predictive modelling are required and will help advance the field of early intervention in depression.
Therefore, the main purpose of this research proposal will be to characterize the most relevant active ingredients (and their combination) that prevent the development of persistent high levels of depression across adolescence and young adulthood. More specifically, we will aim to answer to the following main research questions: "What combination/s of active ingredients prevent the development of persistent high levels of depression across adolescence and young adulthood?"
To do this, we will use the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort, which is a longitudinal birth cohort study, set in the UK, examining the determinants of development, health and disease during childhood and beyond.

Impact of research: 
The results that will come from this research will be of great relevance for young people with depression, for the following reasons: (i) the LCGA will allow detect a group of young people with persistent high levels of depression across adolescence and young adulthood; and by doing this, we will be able to detect the specific group of individuals who are at highest risk for depression; (ii) the regression analyses and the predictive modelling will be essential to characterize which are the most relevant active ingredients to be included in early intervention for depression; and (iii) finally, the digital triaging tool will have an impact in both the mental health researchers and young people, as this will allow better understand the specific characteristics and pathways that lead to specific interventions for different groups of young people with depression, including those at highest risk.
Date proposal received: 
Wednesday, 27 April, 2022
Date proposal approved: 
Tuesday, 3 May, 2022
Keywords: 
Mental health - Psychology, Psychiatry, Cognition, Mental health, Statistical methods

B4060 - UK LLC Association of COVID19 and Long COVID with disruption in employment and finances - 06/05/2022

B number: 
B4060
Principal applicant name: 
Richard Shaw | MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Co-applicants: 
Title of project: 
UK LLC: Association of COVID19 and Long COVID with disruption in employment and finances
Proposal summary: 

Information can be obtained from ALSPAC (B number folder) or the UK LLC on request

Impact of research: 
Information can be obtained from ALSPAC (B number folder) or the UK LLC on request
Date proposal received: 
Tuesday, 26 April, 2022
Date proposal approved: 
Wednesday, 27 April, 2022
Keywords: 
Social Science, Infection

B4055 - Physical Activity throughout Adolescence and Cardiac Structure and Function in Early Adulthood - 25/04/2022

B number: 
B4055
Principal applicant name: 
Linda O'Keeffe | University College Cork
Co-applicants: 
Dr Kate O'Neill, Shane McCarthy
Title of project: 
Physical Activity throughout Adolescence and Cardiac Structure and Function in Early Adulthood
Proposal summary: 

This project will examine whether adolescent physical activity is related to heart function in adulthood. This will be investigated by comparing physical activity levels and measurements of heart structure and function as collected in the Avon Longitudinal Cohort Study of Parents and Children.

Impact of research: 
Date proposal received: 
Tuesday, 19 April, 2022
Date proposal approved: 
Monday, 25 April, 2022
Keywords: 
Epidemiology

B4056 - How does university attendance impact on mental health trajectories of young people - 03/05/2022

B number: 
B4056
Principal applicant name: 
Peter Fonagy | UCL
Co-applicants: 
Mr Tom Osborn, Doctor Rob Saunders, Professor Will Mandy
Title of project: 
How does university attendance impact on mental health trajectories of young people
Proposal summary: 

The mental health of university students is a growing public health concern (1). Findings from population-based studies in the USA, UK and Norway point to a significant increase in mental distress among students over the last decade (2-5). Around 5% of young people in the UK have a diagnosis of either anxiety or depression, and the rate of people attending university has doubled in the past twenty years (6). For many the transition to university coincides with a developmentally high-risk period for the emergence of mental health concerns (7-9). This risk may be made worse by the need to adjust to a new social and academic environment whilst at the same time becoming financially independent (8, 10). This period could be particularly risky for students who have faced adversity, are socially disadvantaged (11), or for people who find it harder adjust to new social groups (8, 9). Few long-term studies have looked at these issues (12). While some evidence has shown how many students are likely to experience a mental disorder and use a mental health service at university (13); we do not currently know how much mental health need occurs prior to university attendance. By understanding this and any risk factors for the emergence and development of mental health need at this transition we could inform support-based prevention for students. This study aims to use data collected in ALSPAC to understand the risk university attendance poses on mental health and service use for a mental health reason among young people.

1. Barkham M, Broglia E, Dufour G, Fudge M, Knowles L, Percy A, et al. Towards an evidence-base for student wellbeing and mental health: Definitions, developmental transitions and data sets. Counselling and Psychotherapy Research. 2019;19(4):351-7.
2. Knapstad M, Sivertsen B, Knudsen AK, Smith ORF, Aarø LE, Lønning KJ, et al. Trends in self-reported psychological distress among college and university students from 2010 to 2018. Psychological Medicine. 2021;51(3):470-8.
3. Lipson SK, Lattie EG, Eisenberg D. Increased Rates of Mental Health Service Utilization by U.S. College Students: 10-Year Population-Level Trends (2007-2017). Psychiatric services (Washington, DC). 2019;70(1):60-3.
4. McManus S, Gunnell D. Trends in mental health, non‐suicidal self‐harm and suicide attempts in 16–24-year old students and non-students in England, 2000–2014. Social Psychiatry and Psychiatric Epidemiology. 2020;55(1):125-8.
5. Tabor E, Patalay P, Bann D. Mental health in higher education students and non-students: evidence from a nationally representative panel study. Social Psychiatry and Psychiatric Epidemiology. 2021;56(5):879-82.
6. Boero G, Nathwani, T., Naylor, R., Smith, J. Graduate Earnings Premia in the UK: Decline or Fall. Higher Education Statistics Agency (HESA): HESA; 2021.
7. Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustün TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry. 2007;20(4):359-64.
8. Lei J, Brosnan M, Ashwin C, Russell A. Evaluating the Role of Autistic Traits, Social Anxiety, and Social Network Changes During Transition to First Year of University in Typically Developing Students and Students on the Autism Spectrum. Journal of Autism and Developmental Disorders. 2020;50(8):2832-51.
9. Adams KL, Saunders KE, Keown-Stoneman CDG, Duffy AC. Mental health trajectories in undergraduate students over the first year of university: a longitudinal cohort study. BMJ Open. 2021;11(12):e047393.
10. McCloud T, Bann D. Financial stress and mental health among higher education students in the UK up to 2018: rapid review of evidence. Journal of Epidemiology and Community Health. 2019;73(10):977-84.
11. Cullinan J, Walsh S, Flannery D. Socioeconomic Disparities in Unmet Need for Student Mental Health Services in Higher Education. Applied Health Economics and Health Policy. 2020;18(2):223-35.
12. Lewis GM, T. Callender, C. Higher Education and Mental Health: Analyses of the LSYPE cohorts: research reports. In: Education. Do, editor. 2021.
13. Eisenberg D, Hunt J, Speer N. Help seeking for mental health on college campuses: review of evidence and next steps for research and practice. Harvard review of psychiatry. 2012;20(4):222-32.

Impact of research: 
The findings from research aim to be published in a peer reviewed open access journal where the implications and recommendations for health service practice and policy can be disseminated. Findings will be shared at relevant academic and health service conferences. The authors are part of current policy initiatives at UCL Partners, the National Institute of Health Research Applied Research Collaboration, and PsychUP for Wellbeing at UCL in London and the UK to strengthen and implement policy initiatives aiming to improve student mental health. The results will directly inform the implementation of these initiatives.
Date proposal received: 
Wednesday, 20 April, 2022
Date proposal approved: 
Monday, 25 April, 2022
Keywords: 
Mental health - Psychology, Psychiatry, Cognition, Mental health, Statistical methods, Childhood - childcare, childhood adversity

B4057 - Epigenetic signatures Association with hormone levels and age - 07/06/2022

B number: 
B4057
Principal applicant name: 
Reinhard Stoger | University of Nottingham (UK)
Co-applicants: 
Philippa Melamed, Maya Sudman, Gillian Bentley
Title of project: 
Epigenetic signatures: Association with hormone levels & and age
Proposal summary: 

Adrenarche is a developmental stage, occurring around ages 6-8 years, during which the adrenal glands produce increasing levels of the steroid hormone DHEAS. The function of this hormone, although extremely abundant in human circulation, is still unclear. Elevated levels of this hormone during this prepubertal stage are associated with earlier pubertal events and susceptibility to developing polycystic ovarian syndrome. Thus, we suspect this hormone has a substantial effect on various physiological systems, including the reproductive axis. Due to its chemical similarity to other steroid hormones, such as estradiol, we suspect it conveys its effect through the induction of epigenetic modifications, such as DNA methylation. Here, we would like to identify epigenetic modifications that are associated with DHEAS levels, using available data from girls at this developmental transition.

Impact of research: 
hypothesis testing: Is there a DNA methylation signature that reflects adrenarche? The human adrenarche signals the production and release into the general circulation of vastly elevated levels of DHEAS. Although occurring at a crucial stage in childhood development, the precise impact of this steroid on the reproductive axis and other physiological systems is very poorly understood. Identifying the changes in methylation that correlate with the levels of this hormone should indicate some of its targets and allow subsequent studies to establish the function and impact of adrenarche.
Date proposal received: 
Thursday, 21 April, 2022
Date proposal approved: 
Monday, 25 April, 2022
Keywords: 
Bioinformatics, Fertility/infertility

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