B4349 - Investigating associations between social connectedness mental health stress and inflammation across childhood development - 13/06/2023

B number: 
B4349
Principal applicant name: 
Anja Heilmann | UCL
Co-applicants: 
Miss Alison Nicoll, Professor Yvonne Kelly, Dr Rebecca Lacey
Title of project: 
Investigating associations between social connectedness, mental health, stress and inflammation across childhood development
Proposal summary: 

How children develop both emotionally and physically may be shaped by their social experiences. Studies investigating adverse experiences in early life suggest that such experiences may have long-term negative effects on mental wellbeing and stress that continue into adulthood. Furthermore, experiencing chronic stress can have physical effects on the body – for example, increased levels of the stress hormone cortisol can elevate inflammation. Over the long term, these effects may increase the risk of diseases such as heart disease and diabetes. This evidence establishes the role of a “psychosocial pathway” linking our social experiences to mental and physical health.

In contrast, social relationships research suggests that positive, supportive social connections confer a psychological benefit, that promotes wellbeing in children and adults and may improve resilience in face of stressful events. This may be achieved by providing a sense of belonging and attachment to others – in other words, social connectedness. Children may experience social connectedness to a range of people across different social contexts, for example within their family; their school; their peers; and their community.

Unpinning the functional aspects of social connections that foster this may therefore identify opportunities to promote mental and physical health and development. However, to date, there has been limited research exploring the physiological effects of social connectedness, and how these may be mediated via stress and its downstream effects, such as inflammation. Epigenetic modification of stress-response genes may underpin long-term effects, however there has been limited research investigating these pathways using birth cohort data. Furthermore, few studies exploring these associations in childhood have included or compared multiple social contexts. Lastly, there is limited research utilising longitudinal data to explore how associations between social connectedness, mental health, stress and inflammation may change over time.

This project aims to address these research gaps by investigating the associations between early life social connectedness, mental health and biological indicators of stress and inflammation across different social contexts – namely, family, school, friends, and community. This project will investigate how these social experiences may establish longitudinal trends in mental health and stress across childhood and into early adulthood. To investigate one potential mechanism that may underpin long-term physical effects, this project will assess the relationship between social connectedness and epigenetic modification of stress-response genes.

Impact of research: 
This research aims to inform the development of meaningful interventions. This project aims to build on the existing social relationships literature to ask 3 important questions: what, where and when: what functional components of social connectedness are associated with mental health and stress, where do children experience social connectedness, and what is the relevance of timing to these associations? By exploring each of these components, this research has the potential to inform the development of meaningful interventions that effectively promote social connectedness within the most appropriate social context, at the most relevant stage of development. By informing such interventions, this research has the potential to yield long-term benefits to mental health and stress that may be observable into adulthood, which may in turn alleviate the future burden of inflammation and stress-related non-communicable diseases such as cardiovascular disease. The impact of such interventions could additionally yield an economic benefit. Both mental health conditions and stress-related non-communicable diseases present a significant cost to the NHS and overall productivity in the UK. For example, the London School of Economics (LSE) and the Mental Health Foundation (MHF) have estimated an annual cost of mental health conditions to the UK economy of at least £117.9 billion, whilst the cost of the inflammation-related conditions CVD and diabetes are estimated to cost the UK economy £15.8 billion and £23.7 billion, respectively. Furthermore, the prevalence of these conditions, and therefore the associated costs, is rising and is anticipated to do so. For example, the Mental Health of Children and Young People in England survey reported that the prevalence of probable mental disorder in young people aged 17-19 rose from 1 in 10 to 1 in 4 between 2017 and 2022. There is increasing need to effectively mitigate these increases by identifying and addressing the factors contributing to this rise. Notably, this marked increase in mental disorders corresponds to the COVID-19 outbreak – a period characterised by low social connectedness. This project may therefore mitigate this rising burden by informing the development of meaningful interventions that improve social connectedness within a post-COVID world.
Date proposal received: 
Thursday, 1 June, 2023
Date proposal approved: 
Monday, 12 June, 2023
Keywords: 
Epidemiology, Mental health, Stress, inflammation, Statistical methods, Biological samples -e.g. blood, cell lines, saliva, etc., Biomarkers - e.g. cotinine, fatty acids, haemoglobin, etc., Cohort studies - attrition, bias, participant engagement, ethics, Childhood - childcare, childhood adversity, Epigenetics, Parenting, Statistical methods