IMH Lunchtime Lecture with Dr Ruchika Gajwani

Adverse childhood experiences and neurodevelopmental difficulties: understanding pathways to borderline personality disorder

with Dr Ruchika Gajwani, Research fellow/Honorary Clinical Psychologist, Institute of Health and Wellbeing | Academic CAMHS/North CAMHS

Adverse Childhood Experiences (ACEs), especially child maltreatment, greatly increases the risk of a wide range of poor physical and psychosocial outcomes in a dose-response relationship: the more adversity an individual has experienced in early childhood, the higher the risk of negative health outcomes in adulthood. However, any association between ACE’s and mental health remains to be understood. Longitudinal studies with a genetically sensitive design (Duneden, E-Risk and CATSS) have challenged the idea of a causal association. Neurodevelopmental problems, including cognitive impairment and Attention Deficit Hyperactivity Disorder (ADHD), predate maltreatment in the lifespan. 

Child maltreatment and neurodevelopmental problems often co-exist, as we have demonstrated previously: using a general population twin sample (Study 1). Also, that adolescents are at twice the risk of developing symptoms of severe psychiatric disorder (in this case mania) if they had experiences of both child maltreatment and symptoms of neurodevelopmental disorder(s) (Study 2). In our pilot study in Glasgow, we investigated the pathways to care for young people early in the course of borderline personality pathology- amongst those met criteria for both exposures - to ACE’s and those who met criteria for ADHD/ASD (Study 3).

Dr Ruchika Gajwani is a Clinical psychology research fellow at the Institute of Health and Wellbeing at Glasgow University and an honorary clinical psychologist within specialist children’s services in NHS Greater Glasgow and Clyde. Since moving to Scotland and joining the Adverse Childhood Experiences (ACE) Clinical and Research Centre in 2014, Dr Gajwani has spent tthe last seven years engaging with local services and experienced service providers, as well as researching the gaps in young people’s mental health provision. Engaging substantially in the model of early intervention, Dr Gajwani is interested in clinical research to understand what are the developmental pathways to mental health (both in relation to at-risk and resilience). Her current project as an MQ fellow will be focussing on a feasibility randomised control trial with young people early in the course of Borderline Personality Disorder.