Alcohol is the leading cause of ill-health in young adults in the UK and Europe and is the fifth leading cause across all ages in the UK population and is estimated to be the seventh leading cause globally . There are over 1 million alcohol related hospital admissions and nearly 25,000 alcohol related deaths a year in England with trends, in stark comparison to other major causes of death, not yet decreasing.

Since our previous grant (ALSPAC Alcohol at 24) there have been several important changes to our understanding of the risks of alcohol, patterns of drinking in the population, and UK response to preventing alcohol related harms.

First, levels of drinking reported by adolescents in UK and many other countries have fallen, corresponding with a fall in alcohol related hospital admissions in those under 18, but not yet resulting in any measurable decline in alcohol related harms in young adults . The motivation, reasons (and potential modifiable factors) causing the decline are not yet known but under investigation. In adults in the UK there is some evidence that changes in alcohol use has been differential with greater reductions in low level drinkers and no change in heavier drinkers with subsequently little overall impact on alcohol related harms. At the same time harmful alcohol use has been recognised as an important contributor to the “deaths of despair” that have reduced life expectancy – especially among poorer and more marginal populations - in North America.

Second, in large well powered genetic studies (and against decades of observational data) the cardio-protective effect of alcohol has been shown to be false – and instead likely to be due to non-causal factors all along (such as confounding, selection bias and reverse causation). This implies that there is no compensation of low levels of alcohol use improving morbidity and mortality and no absolutely “safe” or “non-risky” levels of drinking – and clear benefits from reducing average consumption. The UK in line with other countries issued new guidelines on safe drinking levels – which are now the same for men and women – though evidence is unclear whether there have been any changes in the UK population as a result of the new guidance. Policy changes also are underway – notably in Scotland - based on economic models that show how introducing and raising minimum price of alcohol can reduce future alcohol related morbidity and mortality. [There have been other advances in use of MR and genetic markers to identify new targets for drug discovery, compare the impact of interventions, and test for interactions between behavioural exposures – but in European populations MR of alcohol use and AUD have been limited by lack of robust markers.]

Third, it is argued that alcohol related health harms may be under-estimated in part because cohort studies under-represent heavier drinking marginal populations but also because of an under-appreciation of the interaction of alcohol with other exposures. The burden of alcohol is greater in poorer communities, alcohol combines with other exposures to increase risk of liver disease, and alcohol can act as a “snare” increasing the persistence and halting the resolution of antisocial behaviour. This has led to a renewed focus on understanding how adverse alcohol trajectories develop and interact with other exposures to increase health and social harms to strengthen the evidence base ultimately for policy-makers but also for alcohol policy models that can show the impact of alternative prevention strategies.

Data collection

For the last 20 years the effects of bilingualism have been extensively studied in experimental psychology. Despite numerous well-designed studies and meta-analysis there is no consensus whether or not there are executive functioning benefits in those who speak more than one language. Potentially small sample sizes and retrospective data collection are the cause of this.

The bilingual advantage is embedded in the theory that bilinguals constantly inhibit a non-target language when speaking; strengthening a non-specific cognitive domain inhibitory control mechanism resulting in benefits on tasks that require inhibition. By investigating cognition (in particular inhibitory control) throughout a child’s life alongside their exposure to a second language and other confounding variables we hope to finally gain consensus on whether bilingualism can affect cognition.

The bilingual advantage has been thought to have a protective effect over dementia and cognitive decline in older adults. By establishing that there is a bilingual advantage that could be protective of dementia has the potential to be a major public health advantage.

ADHD is a condition marked by symptoms of inattention and hyperactivity/impulsivity persistent over time, present and causing impairment in at least two contexts, such as in the school and at home. However, the degree to which symptoms are present across situations varies from individual to individual. At one end of the spectrum, children may show severe symptoms in several contexts (that is, pervasive ADHD) while others show severe symptoms only in one context (that is, situational ADHD). What underpins the pervasive and situational manifestations is not well understood, and the impact of pervasive and situational dysfunction on future outcome (such as mental health, occupation, and educational status) needs further investigation. Different underlying mechanisms may relate in specific ways to the degree to which ADHD is expressed pervasively or situationally in the school or home setting. In the current study, we focus specifically on the role of executive functioning (that is, goal-directed behavior), emotion processing, and aspects of the family environment, in this matter. We will examine how pervasive and situational ADHD symptoms evolve over time, mapping possible underlying mechanisms, gender differences, and long-term outcome in a large community sample. The findings will have implications for our understanding of the etiology, maintenance, treatment, and prevention of the diagnosis.

The aim of this project's initial phase is to determine the feasibility of batch converting existing 3D whole body scans data into a generic file type so that they can be readily analysed. This is to support the development of future funding bids to use the scan data to investigate genetic determinant of body shape and its cardiovascular consequences.

Tobacco and cannabis use are key public health concerns. Both tobacco and cannabis are consistently associated with the development of common mental health disorders such as anxiety and depression. Prevalence of mental illness in the UK is rapidly increasing, and has increased particularly among adolescents and young adults. Tobacco and cannabis use appear to be plausible targets for intervention to improve mental health. However, there are a number of challenges that have hindered understanding of this relationship, and which have implications for how interventions should be targeted. Firstly, substance use and common mental disorders both tend to have onset in adolescence, so it is difficult to establish temporality in this relationship. Secondly, substance use and mental health share common risk factors through genes and early-life events, so it is difficult to establish whether the relationship is causal or due to shared confounding. Thirdly, the effect of substance use on mental health may not be a direct effect. It is plausible that this relationship is mediated by the social and economic adult role transitions following adolescence, or that substance use itself may be a mediating factor between early life exposures and mental health. Finally, the effects of the aforementioned changes in tobacco and cannabis products on substance use patterns and mental health are currently unknown.

We propose to investigate key questions regarding causality and opportunities for intervention in the relationship between tobacco use, cannabis use (and their constituents) and mental health.

This proof of concept proposal (to ESRC Research Methods Development https://esrc.ukri.org/funding/funding-opportunities/esrc-rmdg-2020/), aims to test the validity of an innovative research approach bringing narrative/life history methods to quantitative longitudinal data, to deepen their explanatory power. Drawing on Singer et al (1998), the investigators have to date developed the method to yield insights (missing from aggregate analyses) into the impact of illness on women’s employment trajectories (Holland, 2006), and counterintuitive aggregate findings that children and families receiving social work fare worse over time than similar others (Sharland et al, 2017).The validity of the approach now needs testing. If successful, it may be applied to multiple research questions and cohort/panel datasets, releasing narrative potential to discover the people behind the data and to explain complexity and change, especially in the absence of complementary qualitative longitudinal data.

Substantive focus will be on children with significant health-related difficulties as teenagers, exploring how these vulnerabilities are affected and affect their lives over time. A small sample of longstanding ALSPAC child, and unrelated parent, participants will be invited to: i) allow the research team to craft the child and family’s life history from multiple variables collected directly from and/or administratively linked to the respondent over time; ii) participate in research interviews exploring the fit between their own and ‘research-assembled’ life story accounts; iii) permit analysis of this fit to be informed by further ALSPAC data mapped to their self-reports. Care will be taken to ensure informed consent and confidentiality throughout. If the inter-story compatibility is sufficiently strong, a scaled-up bid to a further ESRC call will follow.

Strong associations exist between alcohol consumption and crime, but the extent to which these associations are causal is unclear. One hypothesised explanation is that the pharmacological effects of alcohol reduce cognitive capacity, and risk perception leading to an increased risk of committing a crime while under the influence of alcohol. We propose to examine the extent to which associations detected are causal using data collected at the ALSPAC focus clinic at age 24 years on committing crime while sober (which cannot be due to the situational effects of intoxication) and while under the influence of alcohol. We will examine the effects of alcohol consumption (prevalence, frequency, quantity) on violent and nonviolent crime, compare the association between drinking and engaging in crime while sober to the association between drinking and crime, and investigate whether cognitive factors (such as impulsivity, poor working memory and poor emotion recognition) increase the risk of crime while under the influence of alcohol.