Sheree J. Gibb

Burden of psychiatric disorder in young adulthood and life outcomes at age 30

BACKGROUND Psychiatric disorders are common during young adulthood and comorbidity is frequent. Individual psychiatric disorders have been shown to be associated with negative economic and educational outcomes, but few studies have addressed the relationship between the total extent of psychiatric disorder and life outcomes. AIMS To examine whether the extent of common psychiatric disorder between ages 18 and 25 is associated with negative economic and educational outcomes at age 30, before and after controlling for confounding factors. METHOD Participants were 987 individuals from the Christchurch Health and Development Study, a longitudinal study of a birth cohort of individuals born in Christchurch, New Zealand, in 1977 and followed to age 30. Linear and logistic regression models were used to examine the associations between psychiatric disorder from age 18 to 25 and workforce participation, income and living standards, and educational achievement at age 30, before and after adjustment for confounding factors. RESULTS There were significant associations between the extent of psychiatric disorder reported between ages 18 and 25 and all of the outcome measures (all P<0.05). After adjustment for confounding factors, the associations between psychiatric disorder and workforce participation, income and living standards remained significant (all P<0.05), but the associations between psychiatric disorder and educational achievement were not significant (all P>0.10). CONCLUSIONS After due allowance had been made for a range of confounding factors, psychiatric disorder between ages 18 and 25 was associated with reduced workforce participation, lower income and lower economic living standards at age 30.

Postcard intervention for repeat self-harm: randomised controlled trial

BACKGROUND Self-harm and suicidal behaviour are common reasons for emergency department presentation. Those who present with self-harm have an elevated risk of further suicidal behaviour and death. AIMS To examine whether a postcard intervention reduces self-harm re-presentations in individuals presenting to the emergency department. METHOD Randomised controlled trial conducted in Christchurch, New Zealand. The intervention consisted of six postcards mailed during the 12 months following an index emergency department attendance for self-harm. Outcome measures were the proportion of participants re-presenting with self-harm and the number of re-presentations for self-harm in the 12 months following the initial presentation. RESULTS After adjustment for prior self-harm, there were no significant differences between the control and intervention groups in the proportion of participants re-presenting with self-harm or in the total number of re-presentations for self-harm. CONCLUSIONS The postcard intervention did not reduce further self-harm. Together with previous results this finding suggests that the postcard intervention may be effective only for selected subgroups.

Gender Differences in Educational Achievement to Age 25.

Gender differences in educational achievement were examined in a cohort of 1265 individuals studied from birth to age 25. There was a small but pervasive tendency for females to score better than males on standardised tests and to achieve more school and post-school qualifications. The differences could not be explained by differences in cognitive ability as males and females had similar IQ scores. Teacher ratings of classroom behaviour revealed that males were more prone to inattentive, restless and distractible behaviours and aggressive, antisocial and oppositional behaviours than females. When the associations between gender and measures of educational achievement were adjusted for teacher ratings of classroom behaviour the gender differences were reduced substantially. These results suggest that one approach to reducing gender differences in educational achievement lies in improving classroom behaviour.

Health-care staff attitudes towards self-harm patients

Objective: To examine attitudes towards self-harm patients and need for training about self-harm amongst health-care staff in Christchurch, New Zealand. Methods: Health-care staff from a general and a psychiatric hospital completed a questionnaire about their attitudes towards self-harm patients and their need for training about self-harm. Results: A total of 195 staff members completed the questionnaire (response rate 64.4%). Overall, health-care staff had both positive and negative attitudes towards self-harm patients. Staff believed that their contact was helpful to self-harm patients, that they were patient and understanding, and were optimistic about patients’ outcomes. However, staff did not feel confident working with self-harm patients and believed that their training in this area was inadequate. Attitudes were not significantly associated with age, gender, or experience. However, more negative attitudes were significantly associated with higher levels of burnout (through high emotional exhaustion (p <0.0002) and low personal accomplishment (p <0.003)). Staff comments indicated that their greatest difficulties working with self-harm patients included repetitive self-harm, frustrating and difficult patient behaviour, communication difficulties, and time pressure. Staff suggestions for improvement included more training, provision of a handbook or guidelines, and greater flexibility with patient allocations. Conclusions: Overall, health-care staff had positive attitudes towards self-harm patients, and a strong desire to help such patients. However, staff did not feel confident working with self-harm patients and had a strong desire for additional training in this area. Additional staff training in working with self-harm patients could have the potential to increase staff confidence and attitudes and enhance patient care.

Childhood family income and life outcomes in adulthood: Findings from a 30-year longitudinal study in New Zealand

The aims of this study were to use data gathered over the course of a 30-year longitudinal study to examine the linkages between economic circumstances in childhood and subsequent developmental outcomes spanning educational achievement; economic circumstances; crime; mental health; and teenage pregnancy. All of these outcomes have been linked with childhood economic conditions and it is frequently argued that reducing income inequalities will mitigate psychosocial risks of children reared in families facing economic hardship. Alternatively it may be suggested that the associations between childhood family economic circumstances and later outcomes are mediated by individual, family and social factors that are correlated with low family income and contribute to later outcomes. To examine these issues, data were drawn from a birth cohort of New Zealand children born in 1977 and followed to age 30. Declining childhood family income was associated with a range of negative outcomes in adulthood, including: lower educational achievement; poorer economic circumstances; higher rates of criminal offending; higher rates of mental health problems; and higher rates of teenage pregnancy. After covariate adjustment, childhood family income remained significantly associated with educational achievement and economic circumstances, but was no longer significantly associated with the mental health, offending and teenage pregnancy outcomes. These findings suggest that, after due allowance has been made for social, family and individual contextual factors, low family income during childhood is associated with a range of educational and economic disadvantages in adulthood but is not directly related to increased risks of crime, mental health problems or teen pregnancy.

Bullying victimization/perpetration in childhood and later adjustment: findings from a 30 year longitudinal study

Purpose – This paper aims to report on the associations between reports of bullying victimization and bullying perpetration in childhood and subsequent mental health and adjustment difficulties in late adolescence/adulthood (16‐30 years) in a New Zealand birth cohort.Design/methodology/approach – The paper uses data from the Christchurch Health and Development Study, a longitudinal study of a birth cohort of 1,265 individuals born in Christchurch, New Zealand in 1977 and followed to age 30.Findings – There were general trends for rates of mental health/adjustment problems to be significantly associated with parental reports of bullying victimization in adolescence, and with parent and teacher reports of bullying perpetration in middle childhood or adolescence. Effect sizes were typically in the small to moderate range, and were reduced by covariate adjustment. After adjustment the majority of associations were statistically non‐significant. Effect sizes did not vary significantly with gender or the age at...

Removing bridge barriers stimulates suicides: an unfortunate natural experiment

Objectives: Safety barriers to prevent suicide by jumping were removed from Grafton Bridge in Auckland, New Zealand, in 1996 after having been in place for 60 years. This study compared the number of suicides due to jumping from the bridge after the reinstallation of safety barriers in 2003. Methods: National mortality data for suicide deaths were compared for three time periods: 1991–1995 (old barrier in place); 1997–2002 (no barriers in place); 2003–2006 (after barriers were reinstated). Results: Removal of barriers was followed by a fivefold increase in the number and rate of suicides from the bridge. These increases led to a decision to reinstall safety barriers. Since the reinstallation of barriers, of an improved design, in 2003, there have been no suicides from the bridge. Conclusions: This natural experiment, using a powerful a-b-a (reversal) design, shows that safety barriers are effective in preventing suicide: their removal increases suicides; their reinstatement prevents suicides.

Relationship duration and mental health outcomes: findings from a 30-year longitudinal study

BACKGROUND Marriage is known to be associated with improved mental health, but little research has examined whether the duration of a cohabiting relationship is associated with mental health. AIMS To examine the associations between relationship duration and mental health problems in a birth cohort of 30-year-olds. METHOD Associations between relationship duration and mental health were examined using a generalised estimating equation approach. Associations were adjusted for covariates, including prior mental health problems. RESULTS Longer relationship duration was significantly associated with lower rates of depression, suicidal behaviour and substance abuse/dependence, even after adjustment for covariates. In most cases the associations did not vary with gender. Legal relationship status (legally or de facto married) was not significantly related to mental health once due allowance was made for relationship duration. CONCLUSIONS Increasing relationship duration, but not legal relationship status, has a protective effect on mental health for men and women.

Effects of Single-Sex and Coeducational Schooling on the Gender Gap in Educational Achievement.

This study examined the effects of single-sex and coeducational schooling on the gender gap in educational achievement to age 25. Data were drawn from the Christchurch Health and Development Study, a longitudinal study of a birth cohort of 1265 individuals born in 1977 in Christchurch, New Zealand. After adjustment for a series of covariates related to school choice, there were significant differences between single-sex and coeducational schools in the size and direction of the gender gap. At coeducational schools, there was a statistically significant gap favouring females, while at single-sex schools there was a non-significant gap favouring males. This pattern was apparent for educational achievement both at high school and in tertiary education. These results indicate that single-sex schooling may mitigate male disadvantages in educational achievement.

Alcohol and cannabis abuse/dependence symptoms and life satisfaction in young adulthood.

INTRODUCTION AND AIMS To examine the associations between substance abuse/dependence symptoms and life satisfaction, before and after adjustment for fixed and time-dynamic sources of confounding. DESIGN AND METHODS Data were drawn from a 30year longitudinal study of a birth cohort of 987 individuals. Associations between alcohol abuse/dependence symptoms, cannabis abuse/dependence symptoms and life satisfaction were examined using repeated measures regression models. Associations were adjusted for fixed and time-dynamic sources of confounding, including family background, personality, demographics, recent life events, current employment and recent mental illness. RESULTS There were significant associations between alcohol abuse/dependence and life satisfaction (P<0.0001) and between cannabis abuse/dependence and life satisfaction (P<0.0001). These significant associations remained after adjustment for fixed sources of confounding. However, adjusting for time-dynamic sources of confounding substantially reduced the associations. After adjustment for time-dynamic sources of confounding there were no significant associations between alcohol abuse/dependence and life satisfaction (P>0.17) or cannabis abuse/dependence and life satisfaction (P>0.25). DISCUSSION AND CONCLUSIONS These findings suggest that associations between life substance abuse/dependence and life satisfaction can be explained by time-dynamic factors, such as employment, life events and comorbid mental illness that are associated with reduced life satisfaction. When due allowance is made for confounding, alcohol and cannabis abuse/dependence are not associated with reduced life satisfaction.