Childhood adversities have been linked to psychosocial outcomes, but it remains uncertain whether subtypes of adversity exert different effects on outcomes. Research is also needed to explore the dynamic interplay between adversity and psychosocial outcomes from childhood to mid-adolescence. This study aimed to investigate these relationships and their role in shaping adolescent wellbeing. Data were extracted from three timepoints of the UK Household Longitudinal Survey when participants (n = 646) were aged 10–15. Cross-lagged panel models were used to explore the relationship between cumulative adversities, and separately non-household (i.e., bullying victimization and adverse neighborhood) and household (i.e., sibling victimization, quarrelsome relationship with parents, financial struggles, and maternal psychological distress) adversities, and psychosocial outcomes (i.e., internalizing and externalizing problems, delinquency, and life satisfaction). Our results revealed that heightened cumulative adversity predicted psychosocial outcomes from childhood to mid-adolescence. Increased levels of household adversity predicted psychosocial outcomes throughout early to mid-adolescence, while non-household adversity only predicted psychosocial outcomes in early adolescence. Furthermore, worse psychosocial outcomes predicted higher levels of adversities during adolescence, highlighting bidirectionality between adversity and psychosocial outcomes. These findings underscore the varying impacts of adversity subtypes and the mutually reinforcing effects of adversities and psychosocial functioning from childhood to mid-adolescence.

Adverse childhood experiences can have a significant impact on adult psychosocial outcomes. However, negative outcomes are not inevitable, and protective factors can interrupt the realisation of negative developmental trajectories and result in positive adaptation in spite of childhood adversity. Interventions that promote social support, encourage education and academic achievement, and address specific personality and dispositional factors are likely to beneficial for those with experience of childhood adversity. Holistic assessment that considers both neurodevelopmental conditions and trauma symptoms is also important for promoting resilience and avoiding assumptions that mental and behavioural problems in children with cumulative adversity are purely ‘social’.

In 2018, the Neurodevelopmental and Psychosocial Interventions Working Group of the Cardiac Neurodevelopmental Outcome Collaborative convened through support from an R13 grant from the National Heart, Lung, and Blood Institute to survey the state of neurodevelopmental and psychosocial intervention research in CHD and to propose a slate of critical questions and investigations required to improve outcomes for this growing population of survivors and their families. Prior research, although limited, suggests that individualised developmental care interventions delivered early in life are beneficial for improving a range of outcomes including feeding, motor and cognitive development, and physiological regulation. Interventions to address self-regulatory, cognitive, and social-emotional challenges have shown promise in other medical populations, yet their applicability and effectiveness for use in individuals with CHD have not been examined. To move this field of research forward, we must strive to better understand the impact of neurodevelopmental and psychosocial intervention within the CHD population including adapting existing interventions for individuals with CHD. We must examine the ways in which dedicated cardiac neurodevelopmental follow-up programmes bolster resilience and support children and families through the myriad transitions inherent to the experience of living with CHD. And, we must ensure that interventions are person-/family-centred, inclusive of individuals from diverse cultural backgrounds as well as those with genetic/medical comorbidities, and proactive in their efforts to include individuals who are at highest risk but who may be traditionally less likely to participate in intervention trials.

Compared to the general population, individuals with complex congenital heart disease are at increased risk for deficits in cognitive, neurodevelopmental, psychosocial, and physical functioning, resulting in a diminished health-related quality of life. These deficits have been well described over the past 25 years, but significant gaps remain in our understanding of the best practices to improve neurodevelopmental and psychosocial outcomes and health-related quality of life for individuals with paediatric and congenital heart disease. Innovative clinical, quality improvement, and research opportunities with collaboration across multiple disciplines and institutions were needed to address these gaps. The Cardiac Neurodevelopmental Outcome Collaborative was founded in 2016 with a described mission to determine and implement best practices of neurodevelopmental and psychosocial services for individuals and their families with paediatric and congenital heart disease through clinical, quality improvement, and research initiatives. The vision is to be a multi-centre, multi-national, multi-disciplinary group of healthcare professionals committed to working together and partnering with families to optimise neurodevelopmental outcomes for individuals with paediatric and congenital heart disease through clinical, quality, and research initiatives, intending to maximise quality of life for every individual across the lifespan. This manuscript describes the development and organisation of the Cardiac Neurodevelopmental Outcome Collaborative.

Our aim was to determine the effect of risperidone monotherapy treatment on disability and on the quality of life of 318 schizophrenic outpatients who had been previously treated with other neuroleptics. Patients were assessed at baseline 2, 4 and 8 months using the BPRS, CGI, WHO/DDS and SF-36. BPRS scores showed a significant decrease at month 2, both in the total score and in each of the three clusters, negative, positive and depression/anxiety. WHO/DDS scores significantly decreased both in the overall score (from 51.8 to 37.4, P < 0.0001) and in the four dimensions. SF-36 scale scores and summary measures showed a significant improvement after 8 months of risperidone treatment. Risperidone long-term treatment (8 months) has a positive effect on clinical and on psychosocial outcomes. Females, paranoids patients and patients without history of use-abuse of substances showed greater improvements in quality of life.

Uncertainty exists regarding the degree to which infants with congenitally malformed hearts are at risk of behavioural disorders in childhood. Data was collected as part of a randomized clinical trial involving 155 children with surgically corrected transposition (concordant atrioventricular and ventriculo-arterial connections or alignments). As infants, they underwent the arterial switch operation, involving deep hypothermia with predominantly total circulatory arrest or predominantly low-flow continuous cardiopulmonary bypass as the method of providing support to the vital organs. Parents completed the Child Behavior Checklist when the patients were aged 4 and 8 years, and the Connors’ Parent Rating Scale at the age of 8 years. When the children were aged 8, teachers completed the Teacher’s Report Form and the Connors’ Teacher Rating Scale. In the cohort as a whole, the frequencies of behavioural problems identified by both parents and teachers were elevated, particularly on the scales for competence of the Child Behavior Checklist, and the Adaptive scales of the Teacher’s Report Form. Approximately 1 in 5 patients had scores for Total Problem Behavior in the range of clinical concern on both the Child Behavior Checklist and the Teacher’s Report Form. Few differences were found, however, according to the method of operative treatment. Postoperative seizures were associated with social and attention problems. Children experiencing academic problems at the age of 8 showed a larger increase in behavioural problems between the ages of 4 and 8 than did children making adequate academic progress. Children with congenitally malformed hearts who underwent reparative surgery in infancy using a strategy of severe haemodilution and alpha stat are at increased risk of behavioural problems in middle childhood.