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29 results

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  • Mental health in UK Biobank – development, implementation and results from an online questionnaire completed by 157 366 participants: a reanalysis
  • Katrina A. S. Davis, Jonathan R. I. Coleman, Mark Adams, Naomi Allen, Gerome Breen, Breda Cullen, Chris Dickens, Elaine Fox, Nick Graham, Jo Holliday, Louise M. Howard, Ann John, William Lee, Rose McCabe, Andrew McIntosh, Robert Pearsall, Daniel J. Smith, Cathie Sudlow, Joey Ward, Stan Zammit, Matthew Hotopf
  • Journal: BJPsych Open / Volume 6 / Issue 2 / March 2020
  • Published online by Cambridge University Press: 06 February 2020, e18
    • Article
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    Background

    UK Biobank is a well-characterised cohort of over 500 000 participants including genetics, environmental data and imaging. An online mental health questionnaire was designed for UK Biobank participants to expand its potential.

    Aims

    Describe the development, implementation and results of this questionnaire.

    Method

    An expert working group designed the questionnaire, using established measures where possible, and consulting a patient group. Operational criteria were agreed for defining likely disorder and risk states, including lifetime depression, mania/hypomania, generalised anxiety disorder, unusual experiences and self-harm, and current post-traumatic stress and hazardous/harmful alcohol use.

    Results

    A total of 157 366 completed online questionnaires were available by August 2017. Participants were aged 45–82 (53% were ≥65 years) and 57% women. Comparison of self-reported diagnosed mental disorder with a contemporary study shows a similar prevalence, despite respondents being of higher average socioeconomic status. Lifetime depression was a common finding, with 24% (37 434) of participants meeting criteria and current hazardous/harmful alcohol use criteria were met by 21% (32 602), whereas other criteria were met by less than 8% of the participants. There was extensive comorbidity among the syndromes. Mental disorders were associated with a high neuroticism score, adverse life events and long-term illness; addiction and bipolar affective disorder in particular were associated with measures of deprivation.

    Conclusions

    The UK Biobank questionnaire represents a very large mental health survey in itself, and the results presented here show high face validity, although caution is needed because of selection bias. Built into UK Biobank, these data intersect with other health data to offer unparalleled potential for crosscutting biomedical research involving mental health.

  • RETRACTED – Mental health in UK Biobank: development, implementation and results from an online questionnaire completed by 157 366 participants
  • Katrina A. S. Davis, Jonathan R. I. Coleman, Mark Adams, Naomi Allen, Gerome Breen, Breda Cullen, Chris Dickens, Elaine Fox, Nick Graham, Jo Holliday, Louise M. Howard, Ann John, William Lee, Rose McCabe, Andrew McIntosh, Robert Pearsall, Daniel J. Smith, Cathie Sudlow, Joey Ward, Stan Zammit, Matthew Hotopf
  • Journal: BJPsych Open / Volume 4 / Issue 3 / May 2018
  • Published online by Cambridge University Press: 03 April 2018, pp. 83-90
    • Article
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    Background

    UK Biobank is a well-characterised cohort of over 500 000 participants that offers unique opportunities to investigate multiple diseases and risk factors.

    Aims

    An online mental health questionnaire completed by UK Biobank participants was expected to expand the potential for research into mental disorders.

    Method

    An expert working group designed the questionnaire, using established measures where possible, and consulting with a patient group regarding acceptability. Case definitions were defined using operational criteria for lifetime depression, mania, anxiety disorder, psychotic-like experiences and self-harm, as well as current post-traumatic stress and alcohol use disorders.

    Results

    157 366 completed online questionnaires were available by August 2017. Comparison of self-reported diagnosed mental disorder with a contemporary study shows a similar prevalence, despite respondents being of higher average socioeconomic status than the general population across a range of indicators. Thirty-five per cent (55 750) of participants had at least one defined syndrome, of which lifetime depression was the most common at 24% (37 434). There was extensive comorbidity among the syndromes. Mental disorders were associated with high neuroticism score, adverse life events and long-term illness; addiction and bipolar affective disorder in particular were associated with measures of deprivation.

    Conclusions

    The questionnaire represents a very large mental health survey in itself, and the results presented here show high face validity, although caution is needed owing to selection bias. Built into UK Biobank, these data intersect with other health data to offer unparalleled potential for crosscutting biomedical research involving mental health.

    Declaration of interest

    G.B. received grants from the National Institute for Health Research during the study; and support from Illumina Ltd. and the European Commission outside the submitted work. B.C. received grants from the Scottish Executive Chief Scientist Office and from The Dr Mortimer and Theresa Sackler Foundation during the study. C.S. received grants from the Medical Research Council and Wellcome Trust during the study, and is the Chief Scientist for UK Biobank. M.H. received grants from the Innovative Medicines Initiative via the RADAR-CNS programme and personal fees as an expert witness outside the submitted work.

  • 6 - Words, Words, Words: Education, Literacy and Print
  • from PART II - CURRENTS OF CHANGE
    • By
  • Edited by Keith Wrightson, Yale University, Connecticut
  • Book: A Social History of England, 1500–1750
  • Published online: 28 May 2018
  • Print publication: 13 February 2017, pp 129-151
  • View extract

    Summary

    Polonius: What do you read, my lord?

    Hamlet: Words, words, words.

    (W. Shakespeare, Hamlet (1601), II.ii.195)

    Among the greatest changes to come over English society between 1500 and 1750 were the expansion of educational provision, the growth in literacy levels, and the increased use of the written word in both manuscript and print. The consequences of these developments were profound and wide-ranging, and taken together they transformed the experience of almost everyone in England. By the mid eighteenth century, the ability to read the printed word had become a normal part of adult life; the capacity to wield a pen was an increasingly familiar accomplishment; and in books, pamphlets, single-sheets and all manner of printed ephemera people found the words that expressed their mental worlds and the ideas that structured their lives.

    These changes were neither linear in their progress nor even in their effects. They were experienced in different ways by different people, in different times and places, and their selective impact provides graphic illustration of some of the fundamental distinctions that defined English society. In many ways there is no more powerful demonstration of the basic divisions – of wealth, rank and gender – that characterised the early modern period than the extent to which people had access to education and its fruits. In other ways it may be said that the proliferation of the written word and the diffusion of print culture contributed to the gradual reconfiguration of these hierarchies. New avenues of social mobility opened up; novel forms of information and opinion became available to more people; and all English men and women were, at some level, incorporated into a national culture founded upon text.

    For the social elite education began at home under the guidance of a private tutor. The great families of the land could afford to employ the best: the philosopher Thomas Hobbes acted as tutor to the Cavendish family, earls of Devonshire; Lady Anne Clifford, daughter of the third earl of Cumberland, was mentored by the poet and historian Samuel Daniel. For the gentry, domestic instruction was no less the initial stage of a child's career. In the 1560s the future Lord Chancellor, Francis Bacon, was educated on the family estate in Norfolk before being sent to Cambridge at the age of twelve.

  • A Course on Terror Medicine: Content and Evaluations
  • Leonard A. Cole, Brenda Natal, Adam Fox, Arthur Cooper, Cheryl A. Kennedy, Nancy D. Connell, Gregory Sugalski, Miriam Kulkarni, Michael Feravolo, Sangeeta Lamba
  • Journal: Prehospital and Disaster Medicine / Volume 31 / Issue 1 / February 2016
  • Published online by Cambridge University Press: 11 January 2016, pp. 98-101
  • Print publication: February 2016
  • View abstract
    Introduction

    The development of medical school courses on medical responses for disaster victims has been deemed largely inadequate. To address this gap, a 2-week elective course on Terror Medicine (a field related to Disaster and Emergency Medicine) has been designed for fourth year students at Rutgers New Jersey Medical School in Newark, New Jersey (USA). This elective is part of an overall curricular plan to broaden exposure to topics related to Terror Medicine throughout the undergraduate medical education.

    Rationale

    A course on Terror Medicine necessarily includes key aspects of Disaster and Emergency Medicine, though the converse is not the case. Courses on Disaster Medicine may not address features distinctively associated with a terror attack. Thus, a terror-related focus not only assures attention to this important subject but to accidental or naturally occurring incidents as well.

    Methods

    The course, implemented in 2014, uses a variety of teaching modalities including lectures, videos, and tabletop and hands-on simulation exercises. The subject matter includes biological and chemical terrorism, disaster management, mechanisms of injury, and psychiatry. This report outlines the elective’s goals and objectives, describes the course syllabus, and presents outcomes based on student evaluations of the initial iterations of the elective offering.

    Results

    All students rated the course as “excellent” or “very good.” Evaluations included enthusiastic comments about the content, methods of instruction, and especially the value of the simulation exercises. Students also reported finding the course novel and engaging.

    Conclusion

    An elective course on Terror Medicine, as described, is shown to be feasible and successful. The student participants found the content relevant to their education and the manner of instruction effective. This course may serve as a model for other medical schools contemplating the expansion or inclusion of Terror Medicine-related topics in their curriculum.

    ColeLA, NatalB, FoxA, CooperA, KennedyCA, ConnellND, SugalskiG, KulkarniM, FeravoloM, LambaS. A Course on Terror Medicine: Content and Evaluations. Prehosp Disaster Med. 2016;31(1):98–101.

  • Psychopathy and Culpability: How Responsible Is the Psychopath for Criminal Wrongdoing?
  • Adam R. Fox, Trevor H. Kvaran, Reid Griffith Fontaine
  • Journal: Law & Social Inquiry / Volume 38 / Issue 1 / Winter 2013
  • Published online by Cambridge University Press: 27 December 2018, pp. 1-26
  • Print publication: Winter 2013
  • View abstract

    Recent research into the psychological and neurobiological underpinnings of psychopathy has raised the question of whether, or to what degree, psychopaths should be considered morally and criminally responsible for their actions. In this article, we review the current empirical literature on psychopathy, focusing particularly on deficits in moral reasoning, and consider several potential conclusions that could be drawn based on this evidence. Our analysis of the empirical evidence on psychopathy suggests that while psychopaths do not meet the criteria for full criminal responsibility, they nonetheless retain some criminal responsibility. We conclude, by introducing the notion of rights as correlative, that even if psychopaths were to be fully nonresponsible, imposing some form of civil commitment would still be warranted.

  • 13 - Psychopathy, Criminal Responsibility, Punishment, and the Eighth Amendment
    • By
  • Edited by John T. Parry, Lewis and Clark College, Portland, L. Song Richardson
  • Book: The Constitution and the Future of Criminal Justice in America
  • Published online: 05 June 2014
  • Print publication: 26 August 2013, pp 222-238
  • View extract

    Summary

    Introduction

    Criminal responsibility is a complex subject, and in a retributive system such as that in the United States, it rests on presuppositions about the cognitive capacities of individuals whom we intend to punish. Under the Eighth Amendment, which prohibits “cruel and unusual punishment,” considerations of proportionality limit the extent to which a criminal offender may be punished for a particular crime. In some cases, a defendant’s “subrationality” or “cognitive incapacities” may serve to mitigate or fully excuse criminal responsibility, but standards tend to be very high when it comes to criminal excuses. The M’Naghten standard for legal insanity, for example, requires that a defendant, at the time of his act, not know the nature and quality of said act or know that it was wrong. In practice, this standard will often only be met by individuals suffering from such a profound mental disturbance (such as a psychotic/thought disorder) that most observers would be compelled to declare the defendant resolutely “insane.”

    Recently, however, the United States Supreme Court has made a number of rulings aimed at staking out the boundaries of mitigation of responsibility, based upon empirical research on human cognition and psychological development. Defendants who were previously held fully responsible for severe offenses are now held to a reduced standard of responsibility, and certain penalties that were formerly considered acceptable are now prohibited for some classes of criminal offenders. The scope of these rulings has thus far been limited to cases where public sentiment weighed in favor of mitigation, such as in cases of juveniles and individuals with severe mental handicaps. In this chapter, we will explore whether psychopathy, a condition that is considerably less likely to attract public sympathy, may nonetheless be appropriately treated as a mitigating condition given modern research in psychology and neuroscience. We close with a discussion of what this may mean for future developments in Eighth Amendment law.

  • 7 - Food, Drink and Social Distinction in Early Modern England
    • By
  • Edited by Steve Hindle, Foundation Director of Research at the Huntington Library, San Marino, California, Alexandra Shepard, Reader in History, University of Glasgow, John Walter, Professor of History, University of Essex
  • Book: Remaking English Society
  • Published by: Boydell & Brewer
  • Published online: 05 May 2013
  • Print publication: 16 May 2013, pp 165-188
  • View extract

    Summary

    In almost all human societies, access to the resources necessary to sustain life is one of the defining expressions of rank. The extent to which individuals and groups are able to satisfy their most basic requirements for food and drink are as sure an indication as any of their place within the hierarchy of wealth and esteem. In many communities, both the quantity and the quality of essential consumption serve not only to express but also to create those fine grains of distinction and difference upon which caste systems or class structures are built.

    In early modern England the food and drink that people ingested provided resonant markers in the expression of worth and the articulation of status. This essay seeks to explore some of the social significance invested in these forms of consumption between the late sixteenth and early eighteenth centuries. As Keith Wrightson has demonstrated, however, this was a period in which the constitution of English society and the texture of relations between its inhabitants were evolving and diversifying in important ways. Thanks to Wrightson's work we have a much more vivid sense not only of the manner in which economic distinctions between the ‘poorer sorts’, ‘middle sorts’ and ‘better sorts’ of people were being reconfigured in these generations, but also of the new forms of social identity that this bequeathed. One reflection of contemporary changes in economy and society was the introduction of novel foodstuffs and the revision of established attitudes towards old ones.

  • PRINTED QUESTIONNAIRES, RESEARCH NETWORKS, AND THE DISCOVERY OF THE BRITISH ISLES, 1650–1800*
  • ADAM FOX
  • Journal: The Historical Journal / Volume 53 / Issue 3 / September 2010
  • Published online by Cambridge University Press: 17 August 2010, pp. 593-621
  • Print publication: September 2010
  • View abstract

    This article examines the circulation of printed questionnaires as a research strategy among those investigating the constituent parts of the British Isles between the mid-seventeenth and late eighteenth centuries. It traces the origins and development of published ‘heads’ or ‘articles of enquiry’ as a means of acquiring information on antiquities, geography, and natural history and pieces together the research networks through which this methodology was shared and elaborated. The learned societies, ecclesiastical infrastructure, and periodical publications of the day are shown to have been instrumental in promoting this practice and in forging links between scholars and the ‘learned and ingenious’ in the parishes to whom such ‘queries’ were addressed. It is argued that these questionnaires were an important and insufficiently appreciated aspect of regional studies during the period. Though the responses to them are shown to have been highly variable, both in quantity and quality, it is suggested that they helped to establish what has become an important technique of data collection in modern academic inquiry.

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