Showing papers by "Michael Rutter published in 1994"

Autism Diagnostic Interview-Revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders

Abstract: Describes the Autism Diagnostic Interview-Revised (ADI-R), a revision of the Autism Diagnostic Interview, a semistructured, investigator-based interview for caregivers of children and adults for whom autism or pervasive developmental disorders is a possible diagnosis. The revised interview has been reorganized, shortened, modified to be appropriate for children with mental ages from about 18 months into adulthood and linked to ICD-10 and DSM-IV criteria. Psychometric data are presented for a sample of preschool children.

A case-control family history study of autism

Abstract: Family history data on 99 autistic and 36 Down's syndrome probands are reported. They confirmed a raised familial loading for both autism and more broadly defined pervasive developmental disorders in siblings (2.9% and 2.9%, respectively, vs 0% in the Down's group) and also evidence for the familial aggregation of a lesser variant of autism, comprising more subtle communication/social impairments or stereotypic behaviours, but not mental retardation alone. Between 12.4 and 20.4% of the autism siblings and 1.6% and 3.2% of the Down's siblings exhibited this lesser variant, depending on the stringency of its definition. Amongst autistic probands with speech, various features of their disorder (increased number of autistic symptoms; reduced verbal and performance ability) as well as a history of obstetric complications, indexed an elevation in familial loading. No such association was seen in the probands without speech, even though familial loading for the lesser variant in this subgroup, was significantly higher than in the Down's controls. The findings suggest that the autism phenotype extends beyond autism as traditionally diagnosed; that aetiology involves several genes; that autism is genetically heterogeneous; and that obstetric abnormalities in autistic subjects may derive from abnormality in the foetus.

Field trial for autistic disorder in DSM-IV.

Abstract: OBJECTIVE This project focused on the development of the definition of autism for DSM-IV. METHOD Multiple sites were involved in obtaining information regarding 977 patients with the following clinician-assigned diagnoses: autism (N = 454), other pervasive developmental disorders (N = 240), and other disorders (N = 283). A standard coding system was used, and the raters (N = 125) had a range of experience in the diagnosis of autism. Patterns of agreement among existing diagnostic systems were examined, as was the rationale for inclusion of other disorders within the class of pervasive developmental disorders. RESULTS The DSM-III-R definition of autism was found to be overly broad. The proposed ICD-10 definition most closely approximated the clinicians' diagnoses. Inclusion of other disorders within pervasive developmental disorders appeared justified. Partly on the basis of these data, modifications in the ICD-10 definition were made; this and the DSM-IV definition are conceptually identical. CONCLUSIONS The resulting convergence of the DSM-IV and ICD-10 systems should facilitate both research and clinical service.

Autism and Known Medical Conditions: Myth and Substance

Abstract: There is general agreement that autism has an organic basis but there is less agreement on the frequency with which it is associated with known medical conditions. The evidence in the literature on the latter point is reviewed and it is concluded that the rate of known medical conditions in autism is probably about 10%; however the rate appears to be higher in cases of autism associated with profound mental retardation and in cases of atypical autism.

Development through life : a handbook for clinicians

Abstract: 1. Continuities, Transitions and Turning Points in Development 2. Genetic Influences on Behavioural Development 3. Brain Development 4. Individual Characteristics as a Force in Development 5. Family Influences 6. School Influences 7. Cultural and Community Influences 8. Development and Psychopathology of Attention 9. Language Development 10. Cognition In and Out of Context: a Tale of Two Paradigms 11. Psychometric and Everyday Intelligence: Synonyms, Antonyms and Anonyms 12. Development of Reading and Spelling Skills 13. Development of a Theory of Mind: Where would we be without the Itentional Stance 14. Character Development 15. Developmental Perspective on Gender Differences and Similarities 16. Attachment: Theory and Evidence 17. Emotional Development 18. Peer Relations 19. Developmental Approaches to Aggression and Conduct Problems 20. Sleeping and Feeding Across the Lifespan 21. Psychosexual Development Across the Lifespan 22. Psychological Ageing in Lifespan Perspective

Beyond Longitudinal Data: Causes, Consequences, Changes, and Continuity.

Abstract: Longitudinal data have very important advantages for both measurement and the testing of causal hypotheses on the causes or course of psychopathology, but cross-sectional studies should usually be used first. The investigation of causes needs to encompass the several different types of causal question. The study of within-individual change constitutes a most important research strategy to test causal hypotheses, but it is not the only approach. Their testing requires specification of possible mechanisms, together with attention to the differential impact of risk experiences, of the possible role of person-environment interactions and protective mechanisms. This article addresses several strategies needed in using longitudinal data to test cause-and-effect relationships, including natural experiments, testing of competing hypotheses on mechanisms, study of reversal effects, multiple replications in different circumstances, use of designs to dissociate possible mechanisms, testing for dose-response relationships, examination of effect-specificity, considering biological plausibility, and assessing the strength of effects.

Adult outcomes of childhood and adolescent depression. III. Links with suicidal behaviours.

Abstract: This study followed up into adulthood a group of child psychiatric patients suffering from depressive disorders and a closely matched nondepressed child psychiatric control group. Depression in childhood was a strong predictor of attempted suicide in adulthood. This predictive power was not due to the association between childhood depression and other childhood risk factors such as conduct disorder or suicidality. Rather, it seemed mostly to reside in the association between depression in childhood and major depression in adult life. These findings suggest that the pathways from childhood psychopathology to adult outcomes can be complex, and depend crucially on what happens later.

The application of structural equation modeling to maternal ratings of twins' behavioral and emotional problems.

Abstract: The application of structural equation modeling to twin data is used to assess the impact of genetic and environmental factors on children's behavioral and emotional functioning. The models are applied to the maternal ratings of behavior of a subsample of 515 monozygotic and 749 dizygotic juvenile twin pairs, ages 8 through 16, obtained through mailed questionnaires as part of the Medical College of Virginia Adolescent Behavioral Development Twin Project. The importance of genetic, shared, and specific environmental factors for explaining variation is reported for both externalizing and internalizing behaviors, as well as significant differences in the causes of variation in externalizing behaviors among young boys and girls. The usefulness of applying structural equation models to data on monozygotic and dizygotic twins and the potential implications for addressing clinically relevant questions regarding the causes of psychopathology are discussed.

Survival models for developmental genetic data: Age of onset of puberty and antisocial behavior in twins

Abstract: The use of survival analysis for developmental genetic data is discussed. The main requirements for models based on the decomposition of frailty distributions into shared and unshared components are outlined for the simple case of twins. Extending the earlier work of Clayton, Oakes, and Hougaard, among others, three forms of hazard model are presented, all of which can be applied to pedigree data with flexible baseline hazards without the use of numerical integration. The first two models use an additive decomposition of frailty, with either gamma or positive stable law distributed (PSL) components. The third model previously described by Hougaard involves a multiplicative PSL decomposition. The models are applied to data on the onset of puberty in male twins and illustrate the importance of correct specification of the baseline hazard for correct inference about genetic effects. The difficulty of assessing model specification using information only on the margins is also noted. Overall, the new model with additive PSL components appeared to fit these data best. A second application illustrates the use of a time-varying covariate in examining the impact of puberty on the onset of conduct disorder symptomotology. © 1994 Wiley-Liss, Inc.

Poor readers in secondary school

Abstract: A follow-up of a representative sample of poor readers through secondary schooling confirmed persisting reading problems for most children. As a group, poor readers fell further behind a normal-reading comparison group during their early teens. Later reading progress was unrelated to gender, SES background, behavior problems or non-school attendance, though these factors did influence wider school attainments. Poor readers were more likely to leave school early, and had much depressed educational qualifications. There were no differences in the reading progress or academic attainments of specifically retarded (IQ-discrepant) and generally backward poor readers.

Psychiatric genetics: Research challenges and pathways forward

Abstract: Lessons from past psychiatric genetic research, together with key issues in psychiatry requiring genetic investigation, are reviewed in order to consider the implications for the ways forward. It is argued that traditional quantitative genetics needs to use a combination of twin, adoptee, and family strategies, to examine continuities and discontinuities in psychopathology between childhood and adult life, to compare dimensions and categories, to employ adequate conceptualization and measurement of disorders, to use statistical techniques based on latent constructs, to use biological trait indicators where possible, to examine risk factors as well as diseases, to include good measures of postulated environmental risk variables, to study the interplay between genes and environment, and to study the key assumptions underlying genetic strategies. Molecular cytogenetics needs to consider both the general and specific psychopathological risks associated with chromosome abnormalities and to examine the mechanism involved, to examine the role of submicroscopic chromosomal deletions and of mitochondrial disorders, and to investigate the mechanisms involved in trinucleotide repeat amplifications that take place during intergenerational transmission. Molecular genetics needs to make greater use of smaller pedigrees in view of the concerns over phenotypic definition and genetic heterogeneity in very large extended dense pedigrees, to use sib-pair designs in view of the likelihood that most psychiatric disorder will prove to be multifactorial, to combine association strategies with linkage analyses, to pay careful attention to the definition of phenotypes in probands, to remain in close touch with other branches of biological psychiatry, and to make effective use of collaboration between centers. To date, transgenic models have had a rather limited application in psychiatry but, despite their difficulties, they are likely to provide an underpinning for gene therapy in disorders where that seems feasible. © 1994 Wiley-Liss, Inc.

Abnormal psychosocial situations. Preliminary results of a WHO and a German multicenter study

Abstract: The World Health Organization (WHO) provided instructions for field trials with the completely revised psychosocial axis of the MAS (Multiaxial classification scheme in child and adolescent psychiatry). A description is given of the purpose, the stages and the procedures of the field trials, the participating centres and the samples. The results of the studies concerning applicability and reliability are given and discussed, as well as those of a quasi validity study, in a comparison of anxiety disorders and disruptive behaviour disorders. In general the applicability is very satisfactory, especially when the diagnostic guidelines are followed strictly. The preliminary results of the reliability studies are rather inconsistent. The difference in training apparently played a very important role. The quasi validity study yielded indications that there are not only differences in quantity but in particular in quality of the psychosocial situations, as outlined in the categories of the axis, of different psychiatric disorders.