Multidimensional household poverty in Ireland: child and maternal psychopathology outcomes

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dc.check.chapterOfThesisPlease redact chapter 5, and 6 as they are currently under review by a publisher.en
dc.check.date2028-09-30
dc.check.infoControlled Access
dc.contributor.advisorKhashan, Ali
dc.contributor.advisorKiely, Elizabeth
dc.contributor.advisorO'Keeffe, Linda
dc.contributor.authorO'Driscoll, David
dc.date.accessioned2025-05-16T13:10:09Z
dc.date.available2025-05-16T13:10:09Z
dc.date.issued2024en
dc.date.submitted2024
dc.descriptionControlled Access
dc.description.abstractBackground and aims: There is evidence that children and mothers exposed to poverty have an increased likelihood of developing mental health problems. Despite this, there is a dearth of literature that informs policy on the timing, and type of poverty experienced during childhood to better understand in turn the subsequent development of psychopathology. Most poverty related studies are cross-sectional in nature and do not take into account a life-course approach. As such, there is a need to consider a broader definition of poverty (i.e., multidimensional household poverty (MHP)) to capture as many households at risk and their subsequent psychopathology outcomes. The aim of this thesis was to evaluate the association between MHP and child and maternal psychopathology using a large contemporary nationally representative prospective longitudinal cohort study in Ireland. Structure and methods: Chapter 1 contains a description of the thesis rationale, theoretical framework, aims and objectives, and hypothesis. In Chapter 2, the existing published literature relating to MHP and child and maternal psychopathology was critically evaluated and synthesised to identify major research gaps. The Growing Up in Ireland study, a nationally representative, prospective longitudinal study was used in each of the four studies ( i.e., Chapter 4-7). A range of statistical analytic approaches were used including logistic and Poisson regression. Multiple imputation was used to examine missing data. Interaction and stratification analysis was employed. In Study 1 (Chapter 4), group based multi-trajectory cluster modelling was used to classify trajectories of poverty from 9-months(m) to 9-years(y). Confounder-adjusted logistic regression was used to understand the association of poverty trajectories from 9m to 9y with child outcomes (overweight, any longstanding illness and psychopathology) at age 9y and the same poverty trajectories over the same 9y period with mother outcomes (overweight, any longstanding illness and depression) using the Infant cohort. In Study 2 (Chapter 5), MHP was derived from monetary, subjective and material poverty questionnaires completed by mothers before 3y using latent-class-analysis. Confounder-adjusted linear spline multilevel modelling was employed to understand the association between MHP prior to 3y and psychopathology trajectories in child (3-to-13y) and mother (34-to-46y) using the Infant cohort. In Study 3 (Chapter 6), latent-class-analysis was used to derive a MHP variable and confounder-adjusted logistic regression modelling was used to understand the association between transitioning into MHP (9m-to-9y and 9y-to-17/18y) and child and maternal psychopathology (when child was 13y and 20y) using both GUI cohorts. In Study 4 (Chapter 7), household energy poverty (EP) was derived using a composite of two relative measures of energy poverty. Confounder-adjusted linear spline multilevel modelling was used to examine the association between (1) EP (9m or 3y) and trajectories of emotional and behavioural difficulties from 3 to 9y in the Infant cohort and (2) EP at 9 y and the same trajectories from 9 to 18y in the Child cohort. The final chapter (Chapter 8) discusses the main findings of each study, including limitations, strengths, policy and research recommendations. Results: Study 1: Of 11,134 participants, four trajectories were identified: never-in-poverty (43.1%), material/subjective>monetary-poverty (16.1%), monetary>material-poverty (25.6%), and persistent-poverty (15.2%). Children in persistent-poverty compared with never in poverty experienced higher odds of being overweight at 9y (adjusted odds ratio aOR 1.70,95% CI 1.34, 2.16), having a longstanding illness (aOR 1.51,95% CI 1.20, 1.91) and psychopathology (aOR 2.06,95% CI 1.42, 2.99). The outcomes for primary parent (99.7% were mothers) had higher odds of being overweight (aOR 1.49,95% CI 1.16, 1.92), having a longstanding illness (aOR 2.13,95% CI 1.63, 2.79), and depression (aOR 3.54,95% CI 2.54, 4.94). Study 2: In adjusted analyses, MHP before 3y was associated with a higher mean difference (MD) (MD:0.67, 95% CI 0.41,0.92) in child psychopathology at 3y and this was broadly similar at age 13y (MD:0.87, 95% CI 0.57,1.17). MHP prior to 3y was associated with a higher mother psychopathology when her child was age 3y (MD:1.07, 95% CI 0.90,1.23) and this persisted albeit with a slight reduction in magnitude at age 13y of the child (MD:0.72, 95% CI 0.53,0.90). Study 3: In the child sample (i.e., Infant cohort) (9m-to-9y), 22.9%(n=1766) households transitioned into MHP, and 6.7%(n=514) lived in persistent MHP. In the adolescent sample (i.e., Child cohort) (9y-to-17/18y), 10.2%(n=791) households transitioned into MHP, and 9.5%(n=734) lived in persistent MHP. In adjusted analyses, transitioning into MHP from 9m-to-9y was associated with higher child (aOR,2.06CI-95%,1.49,2.84) and maternal (aOR,2.59,CI-95%,1.90,3.53) psychopathology when child was 13y. Transitioning into MHP from 9y-to-17/18y was associated with higher adolescent (aOR,1.24,CI-95%,1.00,1.63) and maternal (aOR,1.99,CI-95%,1.34,2.95) psychopathology at 20y. Being in persistent MHP was associated with higher psychopathology than having transitioned into MHP. Study 4: In adjusted analyses, EP at 9m or 3y of age was associated with higher total difficulties score at 3y (0.66, 95% CI 0.41, 0.91) and 5y (0.77, 95% CI 0.48, 1.05) but not at 7y or 9y. EP at 9y was associated with higher total difficulties score at 9y (1.73, 95% CI 1.28, 2.18), with this difference reducing over time leading to 0.68 (95% CI 0.19, 1.17) at 17/18y. Conclusion: This thesis highlighted that different multidimensional household poverty trajectories, early life multidimensional household poverty prior to 3 years of age in the child and transitioning into multidimensional household poverty during childhood was associated with poorer child and mother psychopathology outcomes. Moreover, household energy poverty showed a potential association with subsequent child psychopathology. All in all, while these findings are specific to Ireland and require replication in other cohorts, they highlight the need for early anti-poverty policy interventions in the hope to alleviate and improve a child’s and mother’s psychopathology over time.en
dc.description.statusNot peer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationO'Driscoll, D. 2024. Multidimensional household poverty in Ireland: child and maternal psychopathology outcomes. PhD Thesis, University College Cork.
dc.identifier.endpage306
dc.identifier.urihttps://hdl.handle.net/10468/17513
dc.language.isoenen
dc.publisherUniversity College Corken
dc.rights© 2024, David O'Driscoll.
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectPoverty
dc.subjectMultidimensional household poverty
dc.subjectMental health
dc.subjectPsychopathology
dc.subjectChild
dc.subjectMother
dc.titleMultidimensional household poverty in Ireland: child and maternal psychopathology outcomesen
dc.typeDoctoral thesisen
dc.type.qualificationlevelDoctoralen
dc.type.qualificationnamePhD - Doctor of Philosophyen
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