The Gauging Risk and Resilience in Teenagers (GRIT) Study: Predictors of Mental Health Outcomes from Birth to Adolescence in a High-Risk Cohort.
Could you share a summary of your research project and what inspired you to pursue it?
The primary aim of the Gauging Risk and Resilience in Teenagers (GRIT) Study is to examine the mental health and developmental needs of children affected by parental substance dependence and identify trajectories to both later risk and resilience. The study design consists of a 17-year prospective longitudinal study of 100 children born to pregnant women with an opioid use disorder alongside a regionally representative comparison group of 110 non-opioid-exposed children. We are currently undertaking a 16–18-year follow-up with funding support from both the Whau Mental Health Research Foundation and the Canterbury Medical Research Foundation. All study participants and their parents are completing a range of measures including an interview about each young person’s current personal circumstances, health, education, behaviour, and mental health. They also complete a brief IQ test and computer-based cognitive and risk-taking measures. Observing the multi-domain challenges this high-risk group was more likely to experience in early and middle childhood inspired us to pursue the adolescent phase of this study to better understand the nature and extent of their risk and their support needs.
How did the Foundation support your research?
The Foundation awarded us a grant-in-aid to support a study research coordinator for our 17-year GRIT follow-up evaluation. The role has been critical in tracking and tracing, as well as recruiting our participants, many of whom have complex needs and often require considerable support to attend appointments. The coordinator has been vital in building rapport with the participants, and ensuring we provide extra support for young people and their families who often face numerous barriers to research participation.
Were there any unique or surprising findings in your research?
Although our data collection is ongoing, preliminary findings support our original hypotheses that young people born to mothers with an opioid use disorder are at increased risk for mental health problems, with around half of the cohort experiencing clinically significant levels of conduct/behaviour problems, hyperactivity, and inattention. We have also found a significantly increased risk for problematic substance use, with close to two out of three high-risk young people vaping daily. Alarmingly, their risk for alcohol use disorder was twice as high, and risk for cannabis use disorder almost three times higher than the comparison group of their same age peers. Despite these high rates of significant mental health problems, it is concerning that few are in treatment or have support to access treatment.
What impact did receiving support from the Foundation have on your career or future research opportunities?
Receiving support from the Foundation significantly impacted my career and future research opportunities. The grant-in-aid was crucial for continuing the GRIT study, my debut research project as an early career academic. This experience has enhanced my research skills, leadership and project management capabilities. Additionally, the support facilitated a successful postdoctoral experience, during which I have had access to numerous learning opportunities that deepened my academic growth. It helped me develop a clear plan for future research projects, positioning me to pursue impactful work, such as developing and evaluating early and ongoing integrated wrap-around support interventions for families affected by substance use disorder and associated early adversity.
How has this project contributed to the field, or impacted the wider community?
Longitudinal studies of this high risk population of children are extremely rare both in New Zealand and internationally. Most studies to date have focused on the newborn and early infancy period, with few studies following these children into the early childhood and school years when many problems often only begin to emerge in development. The GRIT Study is the first longitudinal study of a large group of young people born to mothers with an opioid use disorder worldwide to describe their health, well-being and behaviour outcomes to late adolescence in detail, and highlight the long-term support required by a large proportion of high-risk youth. Thus, our findings will be very important in highlighting the longer term mental health needs of these young people and the critical importance of early developmental monitoring and follow-up support for families affected by parental substance dependence. The developmental trajectory to intergenerational mental ill health and substance use for this high-risk group are particularly concerning and of clear public health concern.
How would you describe the significance of support from Whau Mental Health Research Foundation for researchers in mental health?
The Whau Mental Health Research Foundation plays an essential role in fostering research projects that ultimately aim to improve the lives of individuals affected by mental health challenges. Having a dedicated funding body that supports mental health research and identifies unique studies in the field that may be overlooked and underfunded ensures that researchers have the resources to fill critical gaps in knowledge and develop evidence-based interventions.
Have there been any specific end users or groups who have directly benefited from your research findings?
Young people born to parents with substance use disorders appear to be falling through the cracks, with one in five experiencing significant distress yet little support to access treatment and achieve optimal well-being. Although treatment was not available as part of our observational study, we have made GP referrals for our high-risk young people experiencing severe well-being challenges for further mental health evaluation and treatment. The study’s preliminary findings strongly emphasise that ongoing monitoring and wrap-around support are necessary for these children and families, and indicate that routine early interventions will be crucial to assist in parental recovery and promote optimal child developmental trajectories.
