Disseminating in different ways

DOI.ORG/10.58214/YUDG3947

Professor Rebecca Pearson graduated from Cardiff University with a degree in Applied Psychology before gaining her PhD from Bristol Medical School where she studied maternal preparations for motherhood, parenting and mental health.

Profile: Professor Rebecca Pearson is Professor of Psychology at Manchester Metropolitan University. Her key focus is intergenerational mental health and how research can help those parents suffering from mental health become part of the process of supporting their children with similar conditions.

Since then, she has developed an interdisciplinary programme of research investigating the mechanisms underlying the intergenerational transmission of mental health disorders. Combining psychology and epidemiology, she has a particular focus on using novel observational and computational methods to understand parenting relationships and apply this to real-world interventions.

Rebecca also led the Mental Health IntergeneratioNal Transmission - European Research Council (MHINT – ERC) project, which received funding from the European Union via the Horizon 2020 programme.

Now Professor of Psychology at Manchester Metropolitan University, Rebecca gives her thoughts on a wide range of subjects, including an insight into her research as well as her reflections on the day to day life of a researcher, the difficulties that have come about from the Brexit referendum and the continued uncertainty for UK researchers therein, and the need to level the playing field in terms of UK institutions and their ability to attract the best researchers and funding programmes.

Can you tell us a little about your career and research thus far?

What is interesting in my career, and where I started from, is that it has been about moving up the developmental age of the child. I started my PhD in 2009 and my research was on depression in pregnancy and the well-known phenomena of post-natal depression, but actually, there were a few and growing number of researchers looking at what then became perinatal mental health as well. It was changing our understanding of the role of mental health. The follow-on from this kind of concept is how you can prevent the impact on a child, which is very interesting. But the issue I found was that you can get stuck in focusing on the early years and forgetting, almost, that parents remain parents for life.

As a result, there is now quite a lot of interest in trying to understand how mental health transitions from parent to child in adolescence. What I am trying to do is to join it all up and bring in the parents and the role of the parent in adolescence and into adulthood as well, to see where there are other pockets or relevant periods of time and opportunities to prevent intergenerational risk of mental health.

It is well known that if a parent has a mental health disorder, then their child is more likely to. It is just not clear how and why. It is not necessarily a big association on an individual basis, and it is not as though it is inevitable; from an individual point of view, even if your parent is depressed you are still less likely to be depressed than not, because the population rate is about 20% of people. However, there is perhaps a two-fold increase in the likelihood of being depressed than a friend who isn’t. There is a risk, but people don’t necessarily understand the risk at an individual level because it is not inevitable. A psychiatrist might see a good number of people who have no family history of depression, but that is where it gets complicated; it is a small, elevated risk.

There is an opportunity there, and this is what I am currently thinking about, in that in adolescents, when they first start to develop emotional symptoms such as anxiety and depression, there is a peak rise in symptoms. Typically for girls it is when they turn 12 or 13, and in boys usually at age 14, but there is very little understanding to what extent that’s going to become problematic for some and it is the beginning of a dysfunctional level of depression and anxiety, and in others emotional maturation and understanding and reaction.

The truth is we don’t know enough about this. We do know a few things at a population level when girls experience a rise in their symptoms, so if you ask them how they are feeling, whether they have felt down or stressed or worrying more than usual, they will all creep up at a population level at the age of twelve to thirteen. But there are those for which those symptoms come down again and there are those where it carries on rising. We do not know which trajectory an individual child is on, but we do know there is overall a rise. Some will rise and fall, some will rise and rise and rise.

So, what can you do to know and try to ensure that your child is one that allows some emotional development that isn’t going to escalate? That we do not know, and that is where I am heading with my research. I have done a lot of research in what was funded by the MHINT study and the ERC great where we investigated the idea of interactions at home, wearable technology and behavioural signatures. We want to speak to teenagers, and we want to find out how parents interact, how family members or peers, how do they interact? What are the behavioural signatures? How do these things manifest? What are the early signs of something classic, categorising some of them? And how can parents help handle that? Lots of parents are probably a little anxious about all of these things. And if there is misunderstanding, they may take it personally.

So, from the point of view of parents, especially those who have suffered themselves, what happens in those early interactions around that period of time that can support or maybe slightly reinforce anxieties that can become more problematic? I think there is a promotional validation in not being afraid of the emotion, but you probably are going to be if you have had it yourself; an anxious parent may know about the opportunities out there, but that doesn’t mean the support process is working. The issue is far from being solved, but there are support groups out there and there is a lot of recognition, but I’m not sure there are support groups specifically aimed at helping parents deal with their adolescent’s anxieties.

Our ultimate aim now is to develop something that will support parents so that there is another opportunity around that early period of adolescence, which is very misunderstood. There is something about the adolescent where they begin to separate away from their parents. There might be more conflict; the classic teenage stereotype of “I hate you! You don’t understand me!” But my question is, what lies underneath that?

There has been a general movement recently, driven by researchers with lots of funding around adolescent mental health. Most of it, however, isn’t thinking about the parents. That is where our research comes in. Obviously, we need to have the voice of the adolescent, but the parent is really important; they almost have that same support and understanding and presence that they would have had in those early years. It is all about mothers and fathers and supporting them. It is about getting them to put on their oxygen mask first before helping someone else. I don’t think the parents of teenagers feel that they have got permission to ask for help. They ask for help for their adolescent, but they also need help. The level of depression and anxiety in the parents of teenagers is as high, if not higher, than in post-natal depression, but not enough is known about it.

So, the goal is to provide support for the parent to help their child, with a focus on their own behaviours?

Yes, and the other area to look at is the join. It’s rather philosophical, but it is about the relationships and that dyadic interaction you’re hoping to achieve. That is looking at both sides, looking at their understanding of each other, their perspectives, and that it will be supporting each other.

Video feedback is something that works quite well in that there is good evidence-based research in early years, where parents can have video clips of interaction and they can learn those strengths and positive moments. Perhaps a depressed mother who has had some previous rejection in her life or who has that common interpretation of “Everybody hates me, hates my baby. They are not interested in me. Whatever I do they don’t love me.” And then you can show back some footage of the baby looking up and smiling, which is something they hadn’t seen. Objectively when they are shown it back it changes their confidence and mindset of that relationship and they become more confident, perhaps, to interact more with the baby, which then reinforces back to the baby that the baby knows mum is responsive, so they engage more.

It is dyadic; this idea that you can change behaviours on both sides where your target is the relationship, the shared emotion, and the shared understanding.

How do you anticipate your research developing over time?

I read a paper the other day about eating disorders, and someone stated: “Why has this field not moved on? I could have written this paragraph 20 years ago.” That is how research can feel sometimes, that the same questions are being answered, but I do think there has been progress in the early years. There is a lot more recognition for mental health in mothers during pregnancy, but where I think the trend is now is going towards our understanding of parents at different stages.

The tangible outcomes in early years have been screening for depression in pregnancy. That did not exist years ago. But in terms of tangible outcomes, I don’t believe it currently happens that if a parent takes their child or adolescent to mental health services they themselves are asked how they are feeling. They are not screened for their depression and that is a huge barrier to any success of the intervention on the adolescent. We are looking to treat that parent first in dealing with their own anxieties, where they are really worried about it to give them some techniques to help themselves, then they can support their adolescent better.

Our understanding is shifting and there are things that could change. As a researcher, I think there needs to be much more to be driven to always think about that feedback, rather than just do it for science’s sake. We know other researchers might have an understanding that mental health is just as high in parents as teenagers, but no one asks them.

There is a recognition of that which is why articles such as this, being in a different format from peer-reviewed journals, are the very type that are also needed. Because they are written in a different way, hopefully that reaches a different audience. It is a question I have to keep asking myself; will this research make a difference?

Another thing that appeals to me is the possibility of animations, for instance. It is worth it. I have sent out articles in certain ways to museums for example, and they have been a useful way of work to send to those kinds of institutions where they have a bit of an understanding. They would not take a peer-reviewed article; that would go over their heads and they just would not have the time to read them. There is a big push for us to make it understandable and there is something to be said for that, because the traditional route is for all these peer-review journals, which are also quite moneymaking.

However, researchers and academics don’t want to just be given ‘you can do it!’; they want to feel somebody else is assessing. There is something to be said for not wanting to be biased as researchers. You don’t want to put your own thoughts out there without it having feedback. That’s not what we’re used to, it’s not what we’re trained to do, so there is a resistance to doing that.

What’s been useful for me to do is to take things that have been peer-reviewed and I am just using it to disseminate in different ways, or challenging assumptions to different audiences.

The European Commission is changing its approach slightly to include the phrase ‘exploitation’ in research to increase its applicability. Is that something you welcome?

Yes. Absolutely. I have had some conversations with a philosopher colleague, and she says that the most important task is for us to ask the right questions. If I ask a question and we know how to answer the question with science, then we have to be asking questions that are going to be exploitable. It sounds like an odd term, but it is absolutely right. What question do I need to be asking for teen/ parent interactions that is going to be important?

The fact is we are not always very good at knowing how to make sure we ask the right question. There has been a big movement towards co-production with those with lived experiences saying, “What questions would you ask?” It is about identifying those tangible questions that seem to be associated with better outcomes so that we are getting less distress. If your teenager returns home saying they’ve had a terrible day and everyone hates them, what types of things are parents saying or asking so that the teenager calms down and feels happier rather than those situations that might escalate and people storm out of the room for example.

Asking tangible questions that can then change or support behaviours is what we need to get back to doing, otherwise people will ask, “What is the point?” It is a question I always ask whenever I do a mock interview, “What is the point? What will this tell us that we did not know before?”

It is really important. I’ve done a lot of epidemiology work, where you are just doing statistics that everybody already knows. We are all finding the same things; people who are poorer, people who have a family history of mental health, people who have worse experiences in their lives, they are more likely to be depressed. So what? We already knew this, but what can we do to change it? How much of it happens when? When and where should we target? You have to be making sure you know what the point is.

Changing tack, you were an ERC grantee with your work on the MHINT project. How difficult is it to get research grants?

Very hard. There are a lot of calls out there and in the research world you can either go for standard grants and come up with an idea and then you can decide what you are going to research, or there are increasingly examples where the funding provider says they want people to submit research ideas about mental health. The Wellcome Trust has done it recently, and so has UKRI, which is the overarching body for the Medical Research Council and the Economic and Social Research Council. The deadlines are very tight and they are often quite big projects, which makes it tricky; you might have to go for a very well- structured, thought-out major programme, which you might not be ready for.

We had an idea which we wanted to adapt for teenagers. We are not quite ready for the bigger grants, but we put in to UKRI and we didn’t get it. But we did receive some very useful feedback. Now what we really need to do is pilot some smaller scale research to find out whether teenagers would actually wear recording devices, to get some small amount of data to take our bid forward. Quite often you are doing that on left-over funding or some small seed money. There needs to be more in between. The process is also hard to predict; there is a long time lapse between submitting and knowing the outcome and you cannot submit anything in between. That is a barrier.

The European Research Council was a very good funder because it was very open. Before ERC funding I used to find I would fall between the MRC and the ESRC; the medical body would say there was too much social science, and the social science side would say it was too medical. That was one aspect for me to consider; was I looking at symptoms, or was it all about wellbeing?

Interestingly with parenting, we were told in one review that we were focusing on mental health, but that parenting isn’t a mental health issue. No, it isn’t, but it is part of the prevention. Luckily, for people like me, there is a recognition of the two being merged. Quite often now you have got MRC meets ESRC and they come together; the ERC is somewhere in the middle and they don’t have a constraint on that field.

Is there a playing field across UK institutions in terms of getting grants?

It is difficult because the traditional more well-known universities have more infrastructure, whether it be supporting applications or how much time researchers have got. It is part replication, but not necessarily. You might have some places that are really research-intensive and strategic and have lots of senior academics who have had lots of grants, who are on the panels who read applications for more junior staff and so provide a way in.

Newer universities are obviously going to have a harder job at building that, but at the same time quite often they are more nested within the real world. I do think there is a slight change there that is growing. It’s whether or not they are confident they are looking at the same infrastructure support.

What weight does the name of the main researcher carry?

You do have to have environment statements and there’s a lot on the principal investigator, but they do want to support diverse researchers, so you’re track record needs to be supported. You can make the case with the team and there is a lot on who it is and whether they have the track record. They will invest in those that have produced work and that is fine. It still goes to peer review, so if they know of their work, they are more likely to know them personally. That is a conflict and they shouldn’t be reviewing their work, but we are all human beings, and we are all wired to be influenced by knowledge of each other to some extent. You will have situations where someone thinks another’s work is great, that they have seen it, and some institutions are much better at visibility.

Other institutions have to get those smaller pots of money before they get the bigger ones. It’s almost as if before you apply for a grant you have to have done half of it already to convince the funder. You almost have to have done a review to show that your idea is quite novel, but you can’t just whip that up in one day. To do it properly is a lot of work. For example, for me to say there aren’t any interventions or support groups for the parents of teenagers and to really be sure that statement is true to pitch to a funder, I will have had to do thorough research and I don’t necessarily have time to do that.

The question might come back, “So, you want £1m to get teenagers to wear wearable cameras, but will they?”

I don’t know if they will, because I want to do a study now, which I am going to have to fund from other places to get the big funding, to make sure they do. You have to have time to set that up and write it up. If a university can support that, because they have got a backlog of money, or access to lots of students then great. But that is not the case for all researchers.

There is also a thing called the Research Excellence Framework where universities are judged on their impact and on their papers every six or seven years and that is where they have started to introduce impact as a tangible thing. I believe the landscape is changing.

On MHINT you worked with researchers in different countries, to what extent do you keep in touch with those colleagues post-Brexit?

Academia is quite good for that. Since Covid I have remained active within those groups I worked in pre-Covid. There is something that is very good about the ERC grants. I hosted some workshops where you invite people in, and the mechanism worked quite well at the time. We had the funds to pay for data access, although that is really difficult in terms of data transfer and for ethical reasons. To get around that, we have invited in early career researchers and students to come and learn the method, then they run up their own data. That worked really well. It’s like a snowball effect; some of them had their interest piqued. What has happened is that there are now two or three research teams elsewhere, such as in South Africa, where they have got their own Wellcome Trust grants to then do a similar, related version.

It is like anything, if you have got one core structure for funding, it breeds more funding. It is reinforcing your work, but it is getting that started that is hard and probably harder for some institutions than others. Someone like me, when I was in Bristol, there were seed funds and I did still have to work quite hard to get some out, but ultimately if I track back my career, if I hadn’t had some early seed funders, such as the Wellcome Trust, or L’Oreal where I got £1,000, where organisations took a bit of a chance, then a year later I brought £1.5m into the university. I could consequently go somewhere else because now I had a big programme, and organisations like that because they quite like diversity.

But it is hard for early career researchers. There are places like Manchester Metropolitan University, which is really popular with students, so you can have security for staff because there are so many positions that are secured by teaching and lecturing a very popular psychology course. However, that can mean it is harder to find time to do the research.

I come from a background where it was research-intensive with short-term contracts because it was externally funded. You would be funded on whatever research grant, and you would have to get more research grants. Then when you finally get your own salary, it is more stable, but then you get to the stage where your team is going to run out of money, so you have to apply for another grant.

It sounds as though it is a constant battle.

It is constant. You are either having to battle between whether you want to do research, or juggling your time to make room for teaching. That is what some institutions and departments have and there is a balance to get right. In others, it is just about getting in funds for people’s salaries from different grants. I went through a phase of sourcing research grants because I knew a number of researchers on the grant were running out of money. They could apply for it themselves, but you also knew you had to keep the research going to get more money.

People don’t really know what academics do. In an ideal world I’d be much more research than I am teaching. I supervise students to do their research, but that research often also feeds into my own research programmes so it is very bi- directional. The teaching I do is sometimes talking about the research that I am doing.

It is a really complicated job. On the one hand you have to be able to get down and simply do the research and the analysis, but a lot of it is also connecting to people, networking and getting your work out there. There is a big push for us to knowledge transfer, so we need to know how to speak to the real world.

To what extent has Brexit left the UK researcher in a state of limbo?

There is caution.

I would be applying to the ERC now for the next step of the programme and I’m not; I’m going to the Wellcome Trust and I’m also going to UKRI instead, but they only have so much because it is UK- specific and that is a shame. There are too many things I could say about all the other uncertainties, and it is a really difficult process applying for a grant, but because I am not confident that the ERC would still be available to me, I am not going to them. There have been reports, and I don’t know if they’re true, that the contracts don’t go through, or you don’t get it. Right now, it is just too high risk to go for the grants, but 100% the ERC would have been my first choice. It was the first choice in most institutions because it paid. The EU has been a great funder, they really have, but I won’t be trying because it is just too high risk.

At the same we are losing a lot of European researchers. It is definitely putting people off. One of my best students coming to the end of her PhD and wants to carry on doing this research. She is absolutely brilliant; she’s done loads of publications and she came in on the Erasmus scheme.

There is a great tradition of international science surpassing the political will of the day. Do you think that will continue even if researchers based in different countries might need to go for different funding streams?

I was in France recently at a conference meeting lots of Europeans and that is still key. In an ideal world in academia, you work in quite a small field, whatever you are doing. You really are at the top of your game; you really are supposed to be cutting edge. There are only going to be a small number of other teams doing similar research to you and you are going to link up with them.

We invest a lot of time in our research subjects and we are very good at a very tiny thing. Researchers are experts in their field, but they are an expert on a tiny part of a single research area.

It is why researchers do join up, and you join up with whoever is the expert on that tiny thing. I personally have not experienced a change in that kind of operation; you make it work. I think it is probably hitting the early career staff harder such as the PhD students and the costs there. There will be barriers for talented researchers to work for you and to come, but as far as sharing the science, communicating and so on, that hasn’t changed. I don’t think it will. Expertise is still expertise and it has and will survive wars, pandemics and Brexit!