Showing papers by "Michael Rutter published in 2004"

Validity of adult retrospective reports of adverse childhood experiences: review of the evidence.

Abstract: Background: Influential studies have cast doubt on the validity of retrospective reports by adults of their own adverse experiences in childhood. Accordingly, many researchers view retrospective reports with scepticism. Method: A computer-based search, supplemented by hand searches, was used to identify studies reported between 1980 and 2001 in which there was a quantified assessment of the validity of retrospective recall of sexual abuse, physical abuse, physical/emotional neglect or family discord, using samples of at least 40. Validity was assessed by means of comparisons with contemporaneous, prospectively obtained, court or clinic or research records; by agreement between retrospective reports of two siblings; and by the examination of possible bias with respect to differences between retrospective and prospective reports in their correlates and consequences. Medium- to long-term reliability of retrospective recall was determined from studies in which the test–retest period extended over at least 6 months. Results: Retrospective reports in adulthood of major adverse experiences in childhood, even when these are of a kind that allow reasonable operationalisation, involve a substantial rate of false negatives, and substantial measurement error. On the other hand, although less easily quantified, false positive reports are probably rare. Several studies have shown some bias in retrospective reports. However, such bias is not sufficiently great to invalidate retrospective case-control studies of major adversities of an easily defined kind. Nevertheless, the findings suggest that little weight can be placed on the retrospective reports of details of early experiences or on reports of experiences that rely heavily on judgement or interpretation. Conclusion: Retrospective studies have a worthwhile place in research, but further research is needed to examine possible biases in reporting.

Adult outcome for children with autism

Abstract: Background: Information on long-term prognosis in autism is limited. Outcome is known to be poor for those with an IQ below 50, but there have been few systematic studies of individuals with an IQ above this. Method: Sixty-eight individuals meeting criteria for autism and with a performance IQ of 50 or above in childhood were followed up as adults. Their mean age when first seen was 7 years (range 3–15 years); at follow-up the average age was 29 years (range 21–48 years). Outcome measures included standardised cognitive, language and attainment tests. Information on social, communication and behavioural problems was obtained from the Autism Diagnostic Interview (ADI). Results: Although a minority of adults had achieved relatively high levels of independence, most remained very dependent on their families or other support services. Few lived alone, had close friends, or permanent employment. Communication generally was impaired, and reading and spelling abilities were poor. Stereotyped behaviours or interests frequently persisted into adulthood. Ten individuals had developed epilepsy. Overall, only 12% were rated as having a ‘Very Good’ outcome; 10% were rated as ‘Good’ and 19% as ‘Fair’. The majority was rated as having a ‘Poor’ (46%) or ‘Very Poor’ (12%) outcome. Individuals with a childhood performance IQ of at least 70 had a significantly better outcome than those with an IQ below this. However, within the normal IQ range outcome was very variable and, on an individual level, neither verbal nor performance IQ proved to be consistent prognostic indicators. Conclusions: Although outcome for adults with autism has improved over recent years, many remain highly dependent on others for support. This study provides some information on prognostic indicators, but more fine-grained research is needed into the childhood variables that are associated with good or poor outcome.

Maternal expressed emotion predicts children's antisocial behavior problems: using monozygotic-twin differences to identify environmental effects on behavioral development.

Abstract: If maternal expressed emotion is an environmental risk factor for children's antisocial behavior problems, it should account for behavioral differences between siblings growing up in the same family even after genetic influences on children's behavior problems are taken into account. This hypothesis was tested in the Environmental Risk Longitudinal Twin Study with a nationally representative 1994-1995 birth cohort of twins. The authors interviewed the mothers of 565 five-year-old monozygotic (MZ) twin pairs and established which twin in each family received more negative emotional expression and which twin received more warmth. Within MZ pairs, the twin receiving more maternal negativity and less warmth had more antisocial behavior problems. Qualitative interviews were used to generate hypotheses about why mothers treat their children differently. The results suggest that maternal emotional attitudes toward children may play a causal role in the development of antisocial behavior and illustrate how genetically informative research can inform tests of socialization hypotheses.

Sex Differences in Developmental Reading Disability: New Findings From 4 Epidemiological Studies.

Abstract: ContextAn influential article published in 1990 claimed that the increased rate of reading disability in boys was a consequence of referral biasObjectivesTo summarize the history of research on sex differences in reading disability and to provide new evidence from 4 independent epidemiological studies about the nature, extent, and significance of sex differences in reading disabilityDesign, Setting, and ParticipantsThe Dunedin Multidisciplinary Health and Development Study comprised 989 individuals (521% male) in a cohort born between April 1972 and March 1973 in Dunedin, New Zealand, and followed up from age 3 years; reading performance and IQ were assessed at ages 7, 9, and 11 years using the Burt Word Reading Test and the Wechsler Intelligence Scale for Children–Revised (WISC-R), respectively The Christchurch Health and Development Study comprised 895 individuals (50% male) in a prospectively studied cohort born in the Christchurch, New Zealand, region during a 4-month period in 1977; reading performance and IQ were assessed at ages 8 to 10 years using the Burt Word Reading Test and the WISC-R The Office for National Statistics (ONS) Study comprised a UK nationally representative sample of 5752 children (501% male) aged 9 to 15 years in 1999; reading was assessed on the British Ability Scales II and IQ on the British Picture Vocabulary Scales II The Environmental Risk Longitudinal Twin Study (E-Risk) comprised 2163 twin children from England and Wales (491% male) identified at birth in 1994 and 1995 and included administration of the Test of Word Reading Efficiency at age 7 years and the Wechsler Preschool and Primary Scale of Intelligence–Revised as a test of IQ at age 5 yearsMain Outcome MeasureReading performance by sex in the lowest 15% of the distribution for all 4 studies, with and without taking IQ into accountResultsIn all 4 studies, the rates of reading disability were significantly higher in boys For non–IQ-referenced reading disability: Dunedin study, 216% in boys vs 79% in girls (odds ratio [OR], 319; 95% confidence interval [CI], 215-417); Christchurch study, 206% in boys vs 98% in girls (OR, 238; 95% CI, 162-350); ONS study, 176% in boys vs 130% in girls (OR, 143; 95% CI, 123-165); and E-Risk, 180% in boys vs 130% in girls (OR, 139; 95% CI, 104-186) The rates for IQ-referenced reading disabilities were similarConclusionReading disabilities are clearly more frequent in boys than in girls

Are there biological programming effects for psychological development? Findings from a study of Romanian adoptees.

Abstract: Associations between experiences and outcomes could be due to (a) continuation of adversity or (b) organismic changes, including experience-expectant and experience-adaptive developmental programming. The adoption into British families of children who had been reared in profoundly depriving institutions in Romania presented an opportunity to test mechanisms. Romanian children reared from infancy in very depriving institutions for periods up to 42 months were compared with 52 nondeprived UK-born children placed into adoptive families before the age of 6 months. The results at 6 years of age showed substantial normal cognitive and social functioning after the provision of family rearing but also major persistent deficits in a substantial minority. The pattern of findings suggests some form of early biological programming or neural damage stemming from institutional deprivation, but the heterogeneity in outcome indicates that the effects are not deterministic.

Predictors of antisocial personality. Continuities from childhood to adult life.

Abstract: Background Antisocial behaviour in adult life has its roots in childhood. Aims To explore the independent and joint effects of childhood characteristics on the persistence of antisocial behaviour into adult life. Method A clinical sample of twins who were systematically ascertained in childhood was followed up 10–25 years later. A total of 225 twins were interviewed regarding childhood and adult psychiatric disorder, psychosocial functioning, and psychosocial and cognitive risk factors. Results Inunivariate analyses, childhood hyperactivity and conduct disorder showed equally strong prediction of antisocial personality disorder (ASPD) and criminality in early and mid-adult life. Lower IQ and reading problems were most prominent in their relationships with childhood and adolescent antisocial behaviour. In multivariate modelling childhood conduct disorder and hyperactivity predicted adult ASPD even when intervening risk factors were accounted for. The number of hyperactive and conduct symptoms also predicted adult outcome. Conclusions Childhood disruptive behaviour has powerful long-term effects on adult antisocial outcomes, which continue into middle adulthood. The importance of number of symptoms, the presence of disruptive disorder, and intermediate experiences highlight three areas where interventions might be targeted.

Institutional care: associations between overactivity and lack of selectivity in social relationships.

Abstract: BACKGROUND: The behaviour of children raised in institutional care in their early years is typified by heightened levels of inattention and overactivity irrespective of the quality of the care. There is some evidence that this behaviour may be specifically associated with forms of attachment disorder behaviours, but to date studies have been restricted to institutions characterised by high levels of malnutrition and lack of active experiences. METHODS: Nineteen primary school age children admitted to good quality residential group care before the age of 1 year were compared with 19 children of the same gender reared in a foster family from the same age. A combination of observational, questionnaire, interview and psychometric measures was employed. RESULTS: A fifth of the institutional children but none of the foster-family children showed a marked lack of selective attachment relationships with their caregivers. The same proportions were found for a lack of selectivity in friendships with their peers but the children showing these features were not identical. A lack of selectivity in relationships was strongly associated with inattention/overactivity, both as observed and reported. The pattern of a marked lack of selectivity and inattention/overactivity was evident only in the boys in the institution-reared group. CONCLUSIONS: It is concluded that the pattern represents a relatively specific response to some feature of an institutional rearing; nevertheless, it occurred in only just over a third of the institutional children, so that it is a far from universal consequence.

Early Childcare and Physical Aggression: Differentiating Social Selection and Social Causation.

Abstract: Background: Some research findings have suggested that group day-care may be associated with an increased risk for physical aggression. Methods: Cross-sectional maternal questionnaire data from a representative sample of 3431 Canadian 2- to 3-year-olds were used to compare rates of physical aggression shown by children looked after by their own mothers and those attending group day-care. A family risk index (using occupational level, maternal education, size of sibship, and family functioning) was created to test whether any difference in physical aggression might reflect social selection rather than social causation. Results: Aggression was significantly more common in children looked after by their own mothers than in those attending group day-care. Strong social selection associated with family risk was found, not only in the sample as a whole, but even within the high-risk subsample. However, after taking social selection into account, physical aggression was significantly more common in children from high-risk families looked after by their own parents. No such difference was evident in the majority (84%) of children from low-risk families. Conclusion: Insofar as there are any risks for physical aggression associated with homecare they apply only to high-risk families. Keywords: Physical aggression, family, risk, homecare, day-care, toddlers, social selection, social causation, age, gender.

Pathways of genetic influences on psychopathology

Abstract: Quantitative genetics, using data from twin and adoptee studies, has shown substantial genetic influences on all forms of psychiatric disorder; however, with just a few exceptions, the evidence indicates that the disorders are multifactorial, with influences that are both genetic and environmental. In recent years, molecular genetics has begun to identify individual susceptibility genes; examples are given for schizophrenia, attention deficit/hyperactivity disorder, and Alzheimer's disease. Both quantitative and molecular genetics have shown the importance of gene-environment interplay with respect to the commoner disorders of emotions and behaviour. In particular, it has been found that genetic influences moderate people's vulnerability to environmental risks. Five main alternative routes by which genes indirectly (via their effects on proteins) lead to multifactorial psychiatric disorders are described. Four main research issues are highlighted: the fuller delineation of the mechanisms involved in nature–nurture interplay and its role in aetiology; determination of how genes play a role in the neural underpinning of psychiatric disorders; identification of the ways in which genes suggest a dissection of disorders; and an understanding of the role of risk dimensions and disorder dimensions.

Informant Disagreement for Separation Anxiety Disorder

Abstract: Objective To characterize informant disagreement for separation anxiety disorder (SAD). Method The sample comprised 2,779 8- to 17-year-old twins from a community-based registry. Children and their parents completed a personal interview about the child's psychiatric history. Parents completed a personal interview about their own psychiatric history and a questionnaire about their marital relationship. Results Informant agreement for SAD ranged between chance and extremely poor. Most cases of SAD were diagnosed by interview with only one informant. SAD diagnosed only by child interview was associated with an increased odds of father-rated oppositional defiant disorder, and vice versa. SAD diagnosed only by parent interview was predicted by the parental informant's history of antisocial personality disorder. SAD diagnosed only by paternal interview was also predicted by mother-rated marital conflict and dissatisfaction. Conclusions Parents and children rarely agree about the presence of any level of child separation anxiety. A symptom “or-rule” mostly indexes diagnoses based on interview with only one informant, but the relative validity of such diagnoses remains unclear.

Risks for conduct disorder symptoms associated with parental alcoholism in stepfather families versus intact families from a community sample.

Abstract: BACKGROUND: It is not known if the prevalence of parental psychiatric disorders is higher in stepfather than intact families, or if parental alcoholism is differentially associated with risk for conduct disorder (CD) symptoms in stepfather families versus intact families. METHOD: The sample comprised 839 girls and 741 boys from 792 intact families and 99 girls and 67 boys from 83 stepfather families from a population-based registry of twins aged between 8 and 17 years. Children's current psychiatric symptoms were assessed at personal interview with the child, mother and father. Parental histories of psychiatric disorder were assessed at personal interview with each residential parent. Associations between CD symptoms and parental alcoholism were characterized using both linear and Poisson regression, and results are presented with and without adjustment for maternal drug use during pregnancy, parental conflict, and estimated socioeconomic status (SES) based on census tract data. RESULTS: Mothers from stepfather families had a higher lifetime prevalence of alcoholism, antisocial personality disorder, depression and social phobia than mothers from intact families. Stepfathers had a higher lifetime prevalence of alcoholism and depression than biological fathers from intact families. Children from stepfather families had more externalizing (CD/ODD) symptoms than children from intact families. Girls who lived with an alcoholic stepfather had significantly more CD symptoms than girls who lived with an alcoholic biological father. Boys who lived with an alcoholic stepfather had significantly fewer CD symptoms than boys who lived with an alcoholic biological father. This sex difference was statistically significant. Adjustment for maternal drug use during pregnancy, parental conflict, and estimated SES based on census tract data did not change these findings. CONCLUSIONS: Children living in stepfather families are exposed to more parental psychiatric risk factors than children from intact families. The increased risk for CD symptoms in girls (but not boys) from stepfather families is partly mediated by or associated with the stepfather's history of alcoholism.

The Social, Genetic and Developmental Psychiatry Centre: its origins, conception and initial accomplishments.

Abstract: Background. The Social, Genetic and Developmental Psychiatry Centre was established by the Medical Research Council, in partnership with the Institute of Psychiatry, King's College London, in 1994. Method and Results. The paper describes the origins of the Centre; the reasons why a new initiative was needed in the early 1990s; the thinking that led to the proposal for a major interdisciplinary research centre that integrated social, genetic and developmental research perspectives; the approach to international recruitment of world leaders; and the initial research accomplishments with respect to the basic goal of understanding nature-nurture interplay. Conclusions. The structure and interdisciplinary approach of the Centre have proved a success and the initial accomplishments have begun to meet the objectives of showing how nature-nurture interplay is involved in the development of psychiatric disorders.