Background Mental health is a term frequently used to describe mental health problems. However, mental healthincludes both mental health problems and well-being. Therefore, mental health can be seen as having two distinctyet related dimensions, as described in the two-continua model of mental health (Westerhof & Keyes, 2010) wherean individual can simultaneously experience any combination of well-being and problems, suggesting four classes:(i) high well-being, low problems; (ii) high well-being, high problems; (iii) low well-being, low problems; and (iv) lowwell-being, high problems. Through this framework an understanding of differences in putative risk and protectivefactors can be gained when compared across classes. While the model has received support, it is unclear how itapplies to children. In particular, children with disabilities, as disabilities pose a risk factor to poor mental health. Agreater understanding of similarities and differences between children with and without disabilities, and of risk andprotective factors, could help tailor support focused on enhancing well-being, both as a goal and as a means to betterself-management of mental health.

Methods The present project utilizes Sweden Statistics (SCB) study (barnULF) to measure life conditions. Nearly4000 children aged 10–18, with and without disabilities, and their caregivers (ULF/SILC) were studied throughyearly interview-based sample surveys conducted between 2013 and 2019. Latent class analysis was performed toassess whether the data fit a 4-class model in line with the two-continua model. Possible factors influencing mentalhealth, including participation, were compared across the identified classes and between children with and withoutdisabilities.

Results The analysis confirmed the predicted model. Each class showed distinct features regarding putative riskand protective factors of mental health and demographics in both the child and caregiver. These features differedsignificantly between children with and without disabilities, especially relating to participation, social bonds, familyfunctioning, digital media use, and perceived safety. Age, disability, and gender predicted class adversity. 

Conclusions The results suggest that mental health problems and well-being are two related but separateconstructs, highlighting the importance of promoting participation and recognizing well-being and not just mentalhealth problems when planning interventions. The results also highlight the importance of providing support for notonly the child but also their caregiver.

Introduction

With the increase in longevity and changes in welfare states, policies aim to make extended working lives possible. At the same time, there may be various work-related risks that may act as barriers to an extended working life and re-entry into the labour market. The focus of this presentation is resilience, both of the labour market and of older workers themselves, in handling work-related and organizational risks in later working life.

Methods

This presentation draws on 100 problem-oriented interviews with older workers in Germany, Poland, Sweden and the UK focusing on their work life course. Respondents varied in education- and skill-level and current type of employment. The research teams from the four countries coded interviews according to a standardized theory-driven coding guide and summarized work trajectories through mapping risk-related turning points in the work life. 

Results 

We identify three different work trajectories based on the prevalence of work-related risks. Further, we present a comparative analysis of the individuals’ experiences of coping strategies and unmet needs to maintain or re-enter work.

Conclusions

Received formal and informal support reveals the psychosocial resilience of the individuals and the resilience of the labour market and welfare system to meet different kinds of risks in a working life. Altogether, the presentation contributes to the increased knowledge on possibilities for extending working lives by focusing on psychosocial and social resilience, and how different support channels throughout the work life course are employed.

The relation between religiosity and well-being is one of the most researched topics in the psychology of religion, yet the directionality and robustness of the effect remains debated. Here, we adopted a many-analysts approach to assess the robustness of this relation based on a new cross-cultural dataset (N = 10, 535 participants from 24 countries). We recruited 120 analysis teams to investigate (1) whether religious people self-report higher well-being, and (2) whether the relation between religiosity and self-reported well-being depends on perceived cultural norms of religion (i.e., whether it is considered normal and desirable to be religious in a given country). In a two-stage procedure, the teams first created an analysis plan and then executed their planned analysis on the data. For the first research question, all but 3 teams reported positive effect sizes with credible/confidence intervals excluding zero (median reported beta = 0.120). For the second research question, this was the case for 65% of the teams (median reported beta = 0.039). While most teams applied (multilevel) linear regression models, there was considerable variability in the choice of items used to construct the independent variables, the dependent variable, and the included covariates.

Objective: The aim of the present study was to assess the validity of the Ease of Language Understanding (ELU) model through a statistical assessment of the relationships among its main parameters: processing speed, phonology, working memory (WM), and dB Speech Noise Ratio (SNR) for a given Speech Recognition Threshold (SRT) in a sample of hearing aid users from the n200 database.

Methods: Hearing aid users were assessed on several hearing and cognitive tests. Latent Structural Equation Models (SEMs) were applied to investigate the relationship between the main parameters of the ELU model while controlling for age and PTA. Several competing models were assessed.

Results: Analyses indicated that a mediating SEM was the best fit for the data. The results showed that (i) phonology independently predicted speech recognition threshold in both easy and adverse listening conditions and (ii) WM was not predictive of dB SNR for a given SRT in the easier listening conditions (iii) processing speed was predictive of dB SNR for a given SRT mediated via WM in the more adverse conditions.

Conclusion: The results were in line with the predictions of the ELU model: (i) phonology contributed to dB SNR for a given SRT in all listening conditions, (ii) WM is only invoked when listening conditions are adverse, (iii) better WM capacity aids the understanding of what has been said in adverse listening conditions, and finally (iv) the results highlight the importance and optimization of processing speed in conditions when listening conditions are adverse and WM is activated.

Introduction

Our aim was to, firstly, identify characteristics at first-episode of psychosis that are associated with later antipsychotic treatment resistance (TR) and, secondly, to develop a parsimonious prediction model for TR.

Methods

We combined data from ten prospective, first-episode psychosis cohorts from across Europe and categorised patients as TR or non-treatment resistant (NTR) after a mean follow up of 4.18 years (s.d. = 3.20) for secondary data analysis. We identified a list of potential predictors from clinical and demographic data recorded at first-episode. These potential predictors were entered in two models: a multivariable logistic regression to identify which were independently associated with TR and a penalised logistic regression, which performed variable selection, to produce a parsimonious prediction model. This model was internally validated using a 5-fold, 50-repeat cross-validation optimism-correction.

Results

Our sample consisted of N = 2216 participants of which 385 (17 %) developed TR. Younger age of psychosis onset and fewer years in education were independently associated with increased odds of developing TR. The prediction model selected 7 out of 17 variables that, when combined, could quantify the risk of being TR better than chance. These included age of onset, years in education, gender, BMI, relationship status, alcohol use, and positive symptoms. The optimism-corrected area under the curve was 0.59 (accuracy = 64 %, sensitivity = 48 %, and specificity = 76 %).

Implications

Our findings show that treatment resistance can be predicted, at first-episode of psychosis. Pending a model update and external validation, we demonstrate the potential value of prediction models for TR.

Importance  About 20% to 30% of people with schizophrenia have psychotic symptoms that do not respond adequately to first-line antipsychotic treatment. This clinical presentation, chronic and highly disabling, is known as treatment-resistant schizophrenia (TRS). The causes of treatment resistance and their relationships with causes underlying schizophrenia are largely unknown. Adequately powered genetic studies of TRS are scarce because of the difficulty in collecting data from well-characterized TRS cohorts.

Objective  To examine the genetic architecture of TRS through the reassessment of genetic data from schizophrenia studies and its validation in carefully ascertained clinical samples.

Design, Setting, and Participants  Two case-control genome-wide association studies (GWASs) of schizophrenia were performed in which the case samples were defined as individuals with TRS (n = 10 501) and individuals with non-TRS (n = 20 325). The differences in effect sizes for allelic associations were then determined between both studies, the reasoning being such differences reflect treatment resistance instead of schizophrenia. Genotype data were retrieved from the CLOZUK and Psychiatric Genomics Consortium (PGC) schizophrenia studies. The output was validated using polygenic risk score (PRS) profiling of 2 independent schizophrenia cohorts with TRS and non-TRS: a prevalence sample with 817 individuals (Cardiff Cognition in Schizophrenia [CardiffCOGS]) and an incidence sample with 563 individuals (Genetics Workstream of the Schizophrenia Treatment Resistance and Therapeutic Advances [STRATA-G]).

Main Outcomes and Measures  GWAS of treatment resistance in schizophrenia. The results of the GWAS were compared with complex polygenic traits through a genetic correlation approach and were used for PRS analysis on the independent validation cohorts using the same TRS definition.

Results  The study included a total of 85 490 participants (48 635 [56.9%] male) in its GWAS stage and 1380 participants (859 [62.2%] male) in its PRS validation stage. Treatment resistance in schizophrenia emerged as a polygenic trait with detectable heritability (1% to 4%), and several traits related to intelligence and cognition were found to be genetically correlated with it (genetic correlation, 0.41-0.69). PRS analysis in the CardiffCOGS prevalence sample showed a positive association between TRS and a history of taking clozapine (r2 = 2.03%; P = .001), which was replicated in the STRATA-G incidence sample (r2 = 1.09%; P = .04).

Conclusions and Relevance  In this GWAS, common genetic variants were differentially associated with TRS, and these associations may have been obscured through the amalgamation of large GWAS samples in previous studies of broadly defined schizophrenia. Findings of this study suggest the validity of meta-analytic approaches for studies on patient outcomes, including treatment resistance.

Touch is a powerful communication tool, but we have a limited understanding of the role played by particular physical features of interpersonal touch communication. In this study, adults living in Sweden performed a task in which messages (attention, love, happiness, calming, sadness, and gratitude) were conveyed by a sender touching the forearm of a receiver, who interpreted the messages. Two experiments (N = 32, N = 20) showed that within close relationships, receivers could identify the intuitive touch expressions of the senders, and we characterized the physical features of the touches associated with successful communication. Facial expressions measured with electromyography varied by message but were uncorrelated with communication performance. We developed standardized touch expressions and quantified the physical features with 3D hand tracking. In two further experiments (N = 20, N = 16), these standardized expressions were conveyed by trained senders and were readily understood by strangers unacquainted with the senders. Thus, the possibility emerges of a standardized, intuitively understood language of social touch.

The literature supports a relationship between alcohol use disorders and internalising disorders, but how they relate to each other is unclear. Both disorders, as well as their comorbidity increase in adolescence, making adolescence of particular interest. The main objective of the present thesis was to investigate the relationship between alcohol use disorders and internalising disorders in longitudinal cohorts of adolescents. I was interested in the relationship in terms of causality, developmental growth relationships, latent growth trajectories, gender differences, whether the relationship differs with age and whether externalising disorders had an impact on the relationship. To assess these aims, two longitudinal, self-reported, prospective cohorts of adolescents were available for the present thesis. Several models addressing different issues were applied to assess the relationship of alcohol use disorders and internalising disorders. The direction of effect between the phenotypes was assessed using cross-lagged models. Latent growth models were applied in order to investigate the development of each phenotype across time. Parallel growth models of the latent growth curves assessed whether the development of one phenotype was predictive of the other phenotype. Growth mixture models were used in order to establish whether latent trajectory classes of each phenotype were present and whether trajectories of each phenotype were associated with the other phenotype. Finally, externalising symptoms were added as a covariate to the cross-lagged models in order to assess whether externalising symptoms impacted the relationship between alcohol use/problems and internalising symptoms. Additionally, all analysis assessed for gender differences as well as differences between alcohol use and alcohol problems in their relationship to internalising symptoms. Moreover, all analysis was performed on both samples in order to test whether the results were consistent across different age groups, different settings and different geographical locations. Results did indicate a significant relationship between alcohol use disorders and internalising disorder, but the relationship differed by age, gender and sample. However, when growth of the traits was accounted for, a bidirectional relationship was observed. In addition, a weak or a negative relationship was indicated between alcohol use and internalising disorders. Our final most comprehensive model of latent trajectories indicated similar relationships of alcohol use disorders and internalising disorders in both the samples. Evidence for latent trajectories varying with severity was indicated for alcohol use, alcohol use disorders and internalising symptoms. Evidence indicated a significant relationship between alcohol use disorders and internalising disorders. Several different pathways explained the association between alcohol problems and internalising symptoms; there was not one pathway which accounts for the relationship. The two main pathways observed were a model of self-medication (consistent in both samples) and one of a bidirectional relationship, driven by alcohol problems in some individuals and internalising symptoms in other individuals. In a sample of US college students, internalising symptoms and alcohol problems indicated a bidirectional relationship. In a school cohort of mid to late adolescents in Northern Ireland, depression predicted alcohol problems in males while alcohol problems acted as the main driver of a comorbid relationship of the phenotypes in females. Pathway presented tended to depend on factors such as age, gender, whether anxiety was assessed or not, and characteristics of the sample. Finally, externalising symptoms did not significantly account for the relationship between alcohol problems and internalising symptoms but did account for the positive relationships between alcohol use and internalising symptoms and enhanced the negative. Our results provided a possible explanation to the inconsistencies in the literature, either by suggesting that several pathways are present between the two disorders or that the association is so weak that it is hard to pick up on.