Proposal summaries
B81 - Adaptive modelling of human infant growth - 01/11/2002
(No outline received).
B290 - Long and short term health impact of parent-child relationships - 01/10/2002
1) To test the hypothesis that the quality of the parent-child relationship predicts subsequent physical health independently of socio-economic factors such as social class, maternal education, household income, maternal age and biological factors such as parental smoking and breast feeding.
2) To estimate the role of potential mediators such as parental mental health, the quality of the parent-parent relationship, the child's temperament and child mental health in the possible causal pathways between parent-child relationship quality and subsequent health.
To test the hypothesis that the quality of the parent-child relationship predicts indicators of subsequent physical health such as waist circumference relative to BMI (internal adipose tissue) and blood pressure.
B79 - Investigating the heritability and epidemiology of non-clinical psychotic phenomena in the general population - 01/10/2002
(No outline received).
B78 - The long-term consequences of exposure to dioxin dioxin-like PCBs on the childs neurodevelopment - and their interaction with susceptible genotype a genetic approach - 01/10/2002
(No outline received).
B77 - Caffeine consumption and its impact on mood cognition and behaviour in children - 01/10/2002
(No outline received).
B76 - MRC Senior Non-Clinical Research Fellowship - 01/09/2002
(No outline received).
B75 - Understanding the relationship between diet and dental erosion in a cohort of 12 year olds - 01/09/2002
(No outline received).
B74 - Effects of lifestyle on bone mass acquisition in early puberty - 01/08/2002
We aim to investigate whether lifestyle in early puberty influences bone mass acquisition during this period, and as a result likely to effect the risk of developing osteoporosis in later life. This will be addressed by analysing whether diet, exercise or other factors as assessed at age 10.5 years are associated with gain in bone mass, as measured between the ages of 9.5 and 11.5 years in the ALSPAC cohort.
B73 - Childrens attitudes and experiences of race racism inter-relationships - 01/08/2002
Background
Statistics suggest that race and experiences of racial discrimination have an important impact upon almost every aspect of children's lives, affecting their emotional, social and cultural well-being, as well as physical and mental health. These issues also have an impact upon both academic attainment and employment prospects, and in turn with the transition into adulthood (Greater London Authority, 2007).
In England and Wales, health inequalities attributable to ethnicity and social deprivation are reflected in epidemiological data and infant mortality statistics (Davey-Smith et al, 2000; Office for National Statistics; Hessol et al, 2005). One study has shown a higher rate of admission to paediatric intensive care for children from certain ethnic minority backgrounds (most notably South Asian children, with a 36% higher admission rate compared with Caucasian children) (Parslow et al, 2009).
However, there are limited published data exploring childrens' racial attitudes and experiences, particularly from the UK. One recent study has suggested that implicit maternal beliefs regarding race are a significant predictor of a child's racial attitudes (Castelli et al, 2009). Several studies have suggested that the degree of inter-racial mixing decreases with advancing age (Virdee et al, 1999; Pitts et al, 2000).
Research from the United States has suggested that children from ethnically homogenous schools tend to evaluate ethnic minority peers more critically and are less likely to form friendships with these children than with other children of a similar racial background (McGlothlin et al, 2006).
Aim:
To assess the attitudes and experiences of race and inter-racial relationships amongst children aged 12 years.
Objectives:
- To analyse the attitudes of young people towards race and racism.
- To assess the nature of inter-racial relationships amongst children at school and in the community.
- To ascertain children's experiences of racial bullying and discrimination.
- To analyse the ways in which experiences of inter-racial relationships differ according to ethnicity, gender and social class.
- To explore the impact of race and inter-racial relationships upon a child's social, cultural and emotional well-being.
Methods
A written questionnaire survey of approximately 10,000 ALSPAC children aged 12 years was used to assess attitudes to race and racism. In consultation with the funders (NSPCC) and in collaboration with Prof Tariq Modood, a series of questions were developed on racial attitudes, drawing on questions used in previous surveys of young people in the UK. Predominantly closed questions were used to assess responses, and the questions were included in the 'All around me' questionnaire completed by 12 year olds in 2003-5.
These data have yet to be analysed, so initial analysis will be univariate and descriptive. Associations will be explored between racial identity, gender, friendship groups, bullying and school context.
Exposure and outcome variables
The exposure measured in this study is the questionnaire answers relating to racial attitudes and experiences.
The primary outcome variable is the experience of bulling and racism. Secondary outcome variables are self-esteem, impact upon personal identity and self-categorisation of ethnicity, mental health problems including anxiety and depression, physical health, friendships, academic achievement and employment prospects.
Confounding factors
Confounding factors are likely to include maternal and paternal age, attitudes of parents or guardians, sibling attitudes and behaviour, social class, poverty, disability, ethnicity, religion, nature of residence in the UK (whether temporary or permanent), gender, schooling (including whether private, grammar or state school), and ethnic composition of the school the child attends and local community in which they live.
References
Greater London Authority. The State of London's Children Report. 2007. Accessed at http://www.legacy.london.gov.uk/mayor/children/docs/solc-main-2007.rtf. Last accessed 22/02/11.
Davey-Smith G, Chaturvedi N, Harding S et al. Ethnic inequalities in health: a review of the epidemiological evidence. Critical Public Health. 2000; 10: 375-408.
Office for National Statistics. Infant mortality by ethnic group, England and Wales. Series DH3 no.36. London: Office for National Statistics, 2005. Accessed from http://www.statistics.gov.uk/statbase/Product.asp?vlnk=15111&Pos=1&ColRa...
Last accessed 22/02/11.
Hessol NA, Fuentes-Afflick E. Ethnic differences in neonatal and postneonatal mortality. Pediatrics. 2005; 115: 44-51.
Parslow RC, Tasker RC, Draper ES et al. Epidemiology of critically ill children in England and Wales: incidence, mortality, deprivation and ethnicity. Archives of Disease in Childhood. 2009; 94: 210-15.
Castelli L, Zogmaister C and Tomelleri. The transmission of racial attitudes within the family. Developmental Psychology. 2009; 42 (2): 586-591.
Virdee S, Modood T, Newburn T et al. Understanding racial harassment in schools. Funded by the Economic and Social Research Council. University of Strathclyde and Bristol. 1999. Accessed at http://www.regard.ac.uk.
Pitts J, Marlow A, Porteous D et al. Inter-group and inter-racial violence and the victimisation of school students in a London neighbourhood. Funded by the Economic and Social Research Council, Violence Research Programme. University of Luton. 2000. Accessed at http://www.regard.ac.uk.
McGlothlin H, Killen M. Intergroup attitudes of European American children attending ethnically homogenous schools. Child Development. 2006; 77 (5): 1375-86.
B72 - Middle childhood risk protective factors for the onset of risky sexual behaviours in adolescence - 01/08/2002
(No outline received).
B71 - Collagen genes and urinary continence - 01/07/2002
(No outline received).
B70 - Identification of children with autism and autistic spectrum disorder - 01/07/2002
(No outline received).
B68 - Is the prevalence of peanut allergy increasing - 01/07/2002
(No outline received).
B67 - Do invasive antenatal procedures affect the respiratory health of children - 01/07/2002
(No outline received).
B289 - Prevalence of borderline personality disorder in children - 01/07/2002
(No outline received).
B66 - Fellowship no further details on file - 01/06/2002
(No outline received).
B65 - Glycosylated haemoglobin A1c in a well characterised prospective study of children - 01/06/2002
(No outline received).
B64 - Teenage pregnancy housing and accidents - 01/06/2002
(No outline received).
B63 - Issues of risk and resilience in childrens development - 01/05/2002
(No outline received).
B62 - Eating disorders and motherhood Diet growth and physical activity in the children of mothers with eating disorders - 01/05/2002
Aims and Objectives
To determine if children of mothers with eating disorders have different patterns of: physical development, eating habits and levels of physical activity in childhood, compared to children born to women with other psychiatric disorders and control women, using a large longitudinal prospective design (ALSPAC).
Background
Lifestyle choices such as diet and exercise begin to develop at a very early age in life. Parental influences are an important factor in childhood dietary patterns, physical activity, weight and growth [1, 2]. This is a challenge for mothers suffering with eating disorders, who are often unable to appropriately judge and manage their own dietary and exercise needs, therefore leaving their children at risk of developing similar eating pathology.
Diet and Growth
Research suggests that there is a link between early childhood feeding problems and the presence of a maternal eating disorder [3-7]. Infant under nutrition [8] and growth retardation has also been reported in the offspring of women with anorexia nervosa [9]. Furthermore, the rates of conflict at meal times [10, 11] and over concern for their child's weight or shape [5, 12] have found to be higher in mothers with eating disorders.
ALSPAC Studies
A recent study of the ALSPAC data found that infants of women with anorexia nervosa had a heightened risk for feeding difficulties up to six months of age, compared with healthy controls and women with other psychiatric problems [13]. On the other hand, women suffering from bulimia were shown to be associated with accelerated growth rates and being overweight at nine months [13].
Results from studies of obesity within the ALSPAC cohort suggest that there are key factors associated with a risk of childhood obesity, including: parental obesity and early activity patterns [14]. Furthermore, delayed introduction of certain foods has been associated with increased feeding problems[15]. Additionally, ALSPAC results indicate that maternal characteristics such as social, demographic and lifestyle factor have a strong influence on the early eating patterns of their children [16]. Specifically, Ong et al [17] described a marked and prolonged effect of maternal smoking, parity and breast vs. bottle feeding on childhood growth rates.
Physical Activity
Excessive exercise is common in women suffering with eating disorders, however there are very few studies in this area, or indeed the impact that high rates of physical activity in mothers may have on their children. In one of the few studies, Davis (2005) [18] found that parental levels of physical activity were related to their daughters activity levels. In addition, hyperactivity is common in women suffering with anorexia and has been observed in varying rates across studies, ranging from 31-81% of AN cases [19, 20].
Recent evidence, from both animal and human studies [19], suggests that hyperactivity may be a trait in women suffering with eating disorders, which may therefore be linked to increased activity levels in their offspring. This has never been research within an eating disorder population. Furthermore, excessive exercising may be an early warning sign for the development of an eating disorder in children, and as such is an important area of research for early detection and prevention of eating disorders.
Hypothesis under investigation:
1) Children born to mothers with anorexia nervosa will eat less and be leaner in childhood compared to children born to control mothers.
2) Children of mothers with bulimia nervosa will be heavier than average in childhood, they will have a tendency to eat more and to eat "snacky"-type foods in childhood.
3) Children of mothers with anorexia will have higher levels of physical activity than healthy controls, and children of women with other psychiatric problems and women with bulimia.
Methodology
Design: A longitudinal prospective study with contrast groups
Participants: This study is based on data collected from the Avon Longitudinal Study of Parents and Children (ALSPAC) 21. ALSPAC is a longitudinal birth cohort study, which enrolled all pregnant women living with-in Avon, England, who were due to deliver their baby between the 1st April 1991 and 31st December 1992. It is estimated that approximately 85-90% of those eligible for inclusion chose to take part and the sample has been shown to be representative of the UK population. The core ALSPAC sample consists of 14,541 pregnancies, 69 of which had unknown birth outcomes. Data was obtained on the remaining 14,272 via postal questionnaires.
For the purpose of this study women will be excluded if they did not respond to the 12 week questionnaire (2,019) or if they had multiple births (208). The remaining 12,254 women are included in the analysis. Of this sample, 171 (1.4%) responded that they had anorexia, 199 (1.6%) reported having bulimia, 82 (0.7%) reported having had anorexia and bulimia and 1,166 (9.5%) reported having had another psychiatric problem. The remaining 10,636 (86.8%) reported no history or current psychiatric problem.
Outcomes: At 12 weeks gestation participants were asked if they had any recent or past psychiatric disorder including depression, schizophrenia, anorexia nervosa and bulimia nervosa. Eating disorder behaviours and attitudes pre and during pregnancy were collected by self report. Socio-demographic data, including smoking, age, occupation, marital status was also obtained via self report. At 18 weeks gestation women were asked if their pregnancy was intentional and if so how long they had been trying to conceive as well as their reactions to pregnancy.
Children have been followed up yearly and data are available on their physical development (body composition), activity levels, and diet up to the age of 11 years.
Data Analysis: The hypotheses will be tested using linear and logistic regression analyses in which maternal eating disorders are used to predict outcomes in childhood. All of the central analyses will include covariates. Data available at several time-points will be initially analysed cross-sectionally; longitudinal and growth modelling will be used as a subsequent step. With the available sample sizes, small to moderate group differences in continuous outcomes can be detected with a power of 90% at the 5% test level. Group differences in proportions amounting to odd ratios above 6 could also be detected with a 90% chance. Data will be analysed taking into account missing data.
REFERENCES
1. Klesges RC, Coates TJ, Brown G, Sturgeon-Tillisch J, Moldenhauer-Klesges LM, Holzer B, et al. Parental influences on children's eating behavior and relative weight. Journal of Applied Behavior Analysis 1983;16(4):371-8.
2. Lopez-Dicastillo O, Grande G, Callery P. Parents' contrasting views on diet versus activity of children: Implications for health promotion and obesity prevention. Patient Education and Counseling 2009.
3. Steiner H, Smith C, Rosenkranz RT, Litt I. The early care and feeding of anorexics. Child Psychiatry and Human Development 1991;21(3):163-7.
4. Agras S, Hammer L, McNicholas F. A prospective study of the influence of eating-disordered mothers on their children. International Journal of Eating Disorders 1999;25(3):253-62.
5. Stein A, Fairburn CG. Children of mothers with bulimia nervosa. British Medical Journal 1989;299(6702):777-8.
6. Stein A, Woolley H, Murray L, Cooper P, Cooper S, Noble F, et al. Influence of psychiatric disorder on the controlling behaviour of mothers with 1-year-old infants. A study of women with maternal eating disorder, postnatal depression and a healthy comparison group. British Journal of Psychiatry 2001;179:157-62.
7. Jacobi C, Agras WS, Hammer L. Predicting children's reported eating disturbances at 8 years of age. Journal of the American Academy of Child and Adolescent Psychiatry 2001;40(3):364-72.
8. Russell GF, Treasure J, Eisler I. Mothers with anorexia nervosa who underfeed their children: their recognition and management. Psychological Medicine 1998;28(1):93-108.
9. van Wezel-Meijler G, Wit JM. The offspring of mothers with anorexia nervosa: a high-risk group for undernutrition and stunting? European Journal of Pediatrics 1989;149(2):130-5.
10. Stein A, Woolley H, Cooper SD, Fairburn CG. An observational study of mothers with eating disorders and their infants. Journal of Child Psychology and Psychiatry and Allied Disciplines 1994;35(4):733-48.
11. Stein A, Woolley H, McPherson K. Conflict between mothers with eating disorders and their infants during mealtimes. British Journal of Psychiatry 1999;175:455-61.
12. Fahy T, Treasure J. Children of mothers with bulimia nervosa. BMJ 1989;299(6706):1031.
13. Micali N, Simonoff E, Treasure J. Infant feeding and weight in the first year of life in babies of women with eating disorders. Journal of Pediatrics 2009;154(1):55-60 e1.
14. Reilly JJ, Armstrong J, Dorosty AR, Emmett PM, Ness A, Rogers I, et al. Early life risk factors for obesity in childhood: cohort study. BMJ 2005;330(7504):1357.
15. Coulthard H, Harris G, Emmett P. Delayed introduction of lumpy foods to children during the complementary feeding period affects child's food acceptance and feeding at 7 years of age. Maternal and Child Nutrition 2009;5(1):75-85.
16. North Stone K, Fleming P, Golding J. Socio-demographic associations with digit and pacifier sucking at 15 months of age and possible associations with infant infection. The ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood. Early Human Development 2000;60(2):137-48.
17. Ong KK, Elmlinger M, Jones R, Emmett P, Holly J, Ranke MB, et al. Growth hormone binding protein levels in children are associated with birth weight, postnatal weight gain, and insulin secretion. Metabolism: Clinical and Experimental 2007;56(10):1412-7.
18. Davis C, Blackmore E, Katzman DK, Fox J. Female adolescents with anorexia nervosa and their parents: a case-control study of exercise attitudes and behaviours.Psychological Medicine 2005;35(3):377-86.
19. Hebebrand J, Exner C, Hebebrand K, Holtkamp C, Casper RC, Remschmidt H, et al.Hyperactivity in patients with anorexia nervosa and in semistarved rats: evidence for a pivotal role of hypoleptinemia. Physiology and Behavior 2003;79(1):25-37.
20. Hillebrand JJ, Kas MJ, van Elburg AA, Hoek HW, Adan RA. Leptin's effect on hyperactivity: potential downstream effector mechanisms. Physiology and Behavior 2008;94(5):689-95.
21. Golding J, Pembrey M, Jones R. ALSPAC--the Avon Longitudinal Study of Parents and Children. I. Study methodology. Paediatric and Perinatal Epidemiology 2001;15(1):74-87.