Title: Self-evaluation in adolescent depression
Funder: Economic and Social Research Council

Abstract: My long-term career ambition is to become a leading, internationally recognised academic working to improve the understanding and treatment of mental health problems in adolescents. Ultimately, I want to lead a research team which aims to improve understanding of the development and maintenance of depression in children and young people; by conducting research to improve prevention, early identification and efficacy of treatment. I am also keen to expand this work into chronic health populations. Depression is one of the most significant health concerns for young people and is associated with large direct costs to both individuals and wider society. Depression contributes to high economic and social burden including increased provision of care, reduced productivity at school/work and in many cases loss of life (World Health Organisation, 2008). Thus, better understanding and treatment of depression in adolescents has significant individual, societal and economic impact. If I am successful in obtaining this fellowship, it will allow me to complete a tailored package of research training, provide opportunities for dissemination, networking and research collaboration. This would develop my skills, leadership and research knowledge needed to progress my career. My objectives are to: 1.Conduct a clinical placement at UCL Great Ormond Street Institute of Child Health working as a research fellow on a NIHR funded trial for the treatment of mental health problems in children supervised by Prof Roz Shafran. This will provide invaluable experience and I will learn more about how to conduct both a treatment trial and research with clinical populations. 2.Develop skills in conducting research in applied healthcare using a variety of study designs including epidemiological studies, qualitative approaches and randomised control trials. I will learn how to use software for more complex statistical analysis using the software package R. 3.Develop research collaborations with national and international academics through the dissemination of my research at conferences and special interest meetings across the UK and internationally. This will provide me with opportunities to develop funding applications and apply for the 'New Investigator Grant' with the ESRC focusing on improving treatment efficacy by improving cognitive models of depression by better understanding symptoms of depression in adolescence including negative self-evaluation. I am also keen to expand this work into chronic health condition populations, thus, one of my objectives to develop research collaborations with inter-disciplinary researchers, this will be facilitated by my mentor Prof Paul Stallard based in the Department of Health at the University of Bath. 4.Improve my understanding of how to secure funding to support future applications, and how to write successful, competitive grant applications. I will also develop my understanding of where to publish papers to maximise impact. 5.Engage in training that will help me better understand how to maximise the impact of my research, and how researchers can engage with Parliament. This is important to ensure that my research is impactful and influences policy where possible. 6.Disseminate my research with non-academic audience via blogs, media engagements, online presentations to local authorities, visits to local schools including presentations to school staff and students, and service users via a public and patient involvement group at the University of Bath. 7.Conduct further limited research; I will undertake further additional analysis of data collected during my PhD and develop three manuscripts that will be submitted for publication in peer-reviewed journals. This is essential to establish my track record as a researcher. 8.Deliver teaching on adolescent depression as part of the MSc in Applied Clinical Psychology at the University of Bath and supervise a MSc student and co-supervise a doctorate student

Lay abstract: This postdoctoral fellowship builds directly on my PhD research which examined associations between how adolescents describe themselves and their future and depression symptoms. I found that a more negative view of the self and the future were associated with elevated depression symptoms in adolescents. The implications of these findings are important as they provide support for the cognitive model of depression (Beck, 1967), in which treatment for depression (Cognitive Behavioural Therapy) is based and suggest that a negative view of the self and future are important components of adolescent depression. In my PhD thesis, I developed a new method to examine adolescent perceptions about the self and the future. In this method, adolescents generated their own individual perceptions of their futures (in comparison to previous research which exclusively used fixed choice responses; Kelvin et al., 1999). The novel process meant that adolescents used their own vocabulary, and generated responses that were truly meaningful to them - with no loss in internal or external validity - and means that further research will be more quickly translational to inform treatments. Crucially, I showed that despite a generally negative view of the self and the future, adolescents with elevated symptoms of depression were able to generate some positive descriptions. However, examining the specific content of positive and negative descriptions was beyond the scope of the PhD - yet this has important implications for both the assessment and treatment of adolescent depression. Therefore, the primary research aim of this fellowship is to better understand the aspects of self-evaluation that are likely to be both helpful and unhelpful. Identifying specific positive self-evaluation from young people with elevated symptoms of depression will act as a building base to improve self-evaluation in therapy. Typically, when assessing negative self-perceptions (one of the key diagnostic symptoms of depression) adolescents are asked how they would describe themselves (i.e., Kiddle Schedule for Affective Disorders and Schizophrenia; Kaufman et al., 1997). The symptom is met if they describe negative perceptions about themselves or are unable to describe any positive perceptions of themselves. However, we do not know how the adolescent responses should be interpreted or even what the interviewer should be looking for in the responses. Furthermore, a negative view of the future is suggested to be the most important factor that causes and maintains depression (Roepke & Seligman, 2016), and this is the putative target of some psychological therapies developed to treat adolescent depression (e.g. Horwitz et al., 2017). However, these strategies for improving how young people think about their future could be better guided if we knew more about the specific components of how young people describe their future, and which perceptions are most likely to be problematic or useful in adolescent depression. Given the important implications of my research on the assessment and treatment of adolescent depression, dissemination is imperative. The proposed postdoctoral fellowship seeks to enhance my professional development as an early career researcher, allowing me to disseminate my PhD research findings by presenting my research at conferences, special interest research groups, local authorities, local school, writing blogs and also contributing to press releases. Ultimately this will enable me to further my career and access a wide range of audiences including clinicians, researchers and non-academics and therefore build new professional networks and develop grant applications specifically focusing on improving treatment efficacy by improving cognitive models and working to translate these models into treatment and therefore further my career.

Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS;5.6 PSYCHOLOGICAL AND BEHAVIOURAL
Health categories: MENTAL HEALTH