Aims

We wish to investigate two hypotheses:

1. Are psychotic symptoms (PLIKS) that occur in adolescence associated with poor social functioning?
2. Are life events and other markers of stress in pregnancy associated with PLIKS in adolescence, independently of later stress?

Justification

1. Are psychotic symptoms (PLIKS) that occur in adolescence associated with poor social functioning?

There is a great deal of interest in psychotic symptoms occurring in adolescence at present. A number of surveys, including ALSPAC, have documented that these phenomena are quite common and there is some evidence they are linked with future psychotic illness in adults. However, it is not clear whether the psychotic symptoms identified via population based studies such as birth cohorts and surveys are an "illness" in the sense that they lead to problems in the young person. It is possible that young people are reporting these symptoms but are not in anyway "troubled" by them and manage to continue with their education and social life unaffected by the psychotic symptoms. We are not aware of any studies that have investigated this possibility in young people, though Rossler has reported this in adults1. We would propose to examine whether PLIKS are associated with later social functioning in ALSPAC. This would complement the study of Sarah Sullivan (who would also be involved in this project) who is interested in whether early social functioning deficits are associated with PLIKS.

2. Are life events and other markers of stress in pregnancy associated with PLIKS in adolescence, independently of later stress?

The hypothesis that early stress can increase the risk of psychosis is gaining some credence at present. There is relatively little investigation of how stressful events might be related to PLIKS in adolescence. Of particular interest is the possibility that stressful events in pregnancy could have a particular powerful influence on later risk, possibly by an influence on the HPA axis of the foetus. We wish to examine the hypothesis that early life stress is associated with the later development of PLIKS. Part of this investigation should also examine markers of socioeconomic position as these could also be a proxy marker of adversity. Maternal depression and anxiety is also something that is related to stress in pregnancy and would need to be investigated though more difficult to interpret. This project is related to a previous unsuccessful application by Giovanni Salvi for a training fellowship and he is aware of this application.

Resources

It is proposed that Laura Asher and Sarah Dorrington who are on the Academic Foundation programme will help with this proposal. All the variables that are requested have been used by other funded projects including the ESRC large grant and original PLIKS proposal. We therefore think there will be a minimal need for alspac resources apart from preparing a datset.

Reference List

1. Rossler W, Riecher-Rossler A, Angst J, et al. Psychotic experiences in the general population: a twenty-year prospective community study. Schizophr Res 2007;92:1-14.