Michael Rutter

Bio: Michael Rutter is an academic researcher from King's College London. The author has contributed to research in topics: Autism & Conduct disorder. The author has an hindex of 188, co-authored 676 publications receiving 151592 citations. Previous affiliations of Michael Rutter include VCU Medical Center & Center for Advanced Study in the Behavioral Sciences.

The Role of Pre- and Postnatal Timing of Family Risk Factors on Child Behavior at 36 months

Abstract: Children growing up in disharmonious families with anxious/depressed mothers are at risk for emotional and behavioral difficulties, however whether these associations reflect postnatal environment, prenatal exposure, or an overall liability is still unclear. This study used prospectively collected data from 24,259 participants of the Norwegian Mother and Child Cohort Study (MoBa). Mothers reported on anxiety/depression and family disharmony twice in pregnancy and twice post pregnancy, as well as on their child’s physical aggression and crying behavior at age 36 months. First, results from an autoregressive cross-lagged model showed a substantial stability in both maternal anxiety/depression and family disharmony from pregnancy to 18 months postnatal, but there was no indication that family disharmony led to maternal anxiety/depression, or the other way around. Second, structural equation models further suggests that the main risk derived from an overall liability, that is, a lasting effect of family risks that spanned the two time periods.

Developments in Child and Adolescent Psychiatry Over the Last 50 Years

Abstract: The development of child and adolescent psychiatry in the first half of the 20th century was well described by Achenbach (1974), Cameron (1956), Kanner (1959), Parry-Jones (1989) and Warren (1974) with respect to both its strengths and limitations. The establishment of community child guidance clinics, much influenced by the Mental Hygiene movement, had the value of viewing psychopathology in the context of young people’s real-life circumstances. The cost, however, was that there was both geographical and professional isolation from general psychiatry, pediatrics and academic research. Most treatment tended to be very open-ended and prolonged, usually without a well-defined focus (Rutter, 1982a). There tended, also, to be a rigid separation in the functioning of the unholy trinity of the psychiatrist, the psychologist and the psychiatric social worker. In addition, there was a tendency to blame parents for the disorders of their children – as indexed by concepts of the schizophrenogenic mother (Jackson, 1960) and “refrigerator” parents (Bettelheim, 1967), in relation to schizophrenia and autism, respectively. The dominant theories were the several varieties of psychoanalysis (Eisenberg, 2001), clinical practice was mostly not evidence-based, and there was a paucity of specific treatments (Chess, 1988). Furthermore, very little attention was paid to diagnosis. The prevailing terminology concerned “maladjustment” and official classifications referred only to “behavior disorders of childhood.” However, very important changes were afoot (Rutter, 1998). Although systematic diagnosis was not yet in fashion, Kanner (who wrote the first definitive English-language textbook in 1935) had already done much to foster critical thinking about different patterns of psychopathology and to encourage a questioning approach (as exemplified by his 1969 paper on differential diagnosis). Also, his first description of autism (Kanner, 1943) not only provided a model of top-level clinical observation, but established the reality of a disorder that was distinctively different from others. Similarly, approaching diagnosis psychometrically rather than clinically, Hewitt and Jenkins (1946) wrote a pioneering monograph identifying different patterns of psychopathology. The tide was beginning to turn with respect to both diagnosis and classification in both child and adult psychopathology (Meehl, 1954). Although biological causes had only a very limited role in clinical thinking at that time, Pasamanick and Knobloch (1966), in relation to their concept of a continuum of reproductive casualty, postulated the importance of prenatal and perinatal risk factors. Studies of children with epilepsy as, for example, by Pond (1961) and by Ounsted (1955) were also influential in pointing to the interplay between biological and psychosocial risk factors. The concept of so-called “minimal brain dysfunction” was beginning to be established. It did not stand the test of empirical investigation (Rutter, 1982b) but, nevertheless, it did force people to pay attention to biological risk factors. In the realm of treatment, the value of stimulants in the treatment of children with hyperkinetic disorders was beginning to be appreciated and, in adult psychiatry, neuroleptics were starting to be developed for the treatment of schizophrenia. At about the same time, there was the birth of behavioral therapies (Wolpe, 1958). At first, these were largely considered in relation to adults, rather than children, but the application to children soon followed (Rachman, 1962; Yule & Berger, 1972). Academic child and adolescent psychiatry scarcely existed in the 1950s although there were some chairs in the subject in North America and mainland Europe and there were the beginnings of systematic clinical research (Hersov, 1986; Remschmidt & van Engeland, 1999; Schowalter, 2000). However, the report that probably did most to change the field in a radical fashion was Bowlby’s (1951) review of “maternal deprivation” for the World Health Organization. Spitz and Goldfarb had previously drawn attention to the damaging effects of institutional care but Bowlby drew on a much wider range of evidence and did most to pull together the ideas. For quite a while, his views were treated with extreme hostility by both academic psychologists and by psychoanalysts. The former pointed to the weakness of much of the research and the latter to the heresy that the causal factors lay in real-life experiences rather than internal conflict. Despite the controversies, Bowlby’s observations on young children’s responses to separation from their parents led to enduring changes in hospital practice. Professionals, almost for the first time, were forced to become aware of young

Complementary approaches to the assessment of personality disorder. The Personality Assessment Schedule and Adult Personality Functioning Assessment compared.

Abstract: Background Current concepts and measures of personality disorder are in many respects unsatisfactory. Aims To establish agreement between two contrasting measures of personality disorder, and to compare subject-informant agreement on each. To examine the extent to which trait abnormality can be separated from interpersonal and social role dysfunction. Method Fifty-six subjects and their closest informants were interviewed and rated independently. Personality functioning was assessed using a modified Personality Assessment Schedule (M-PAS), and the Adult Personality Functioning Assessment (APFA). Results Subject-informant agreement on the M-PAS was moderately good, and agreement between the M-PAS and the APFA, across and within subjects and informants, was comparable to that for the M-PAS. This was equally the case when M-PAS trait plus impairment scores and trait abnormality scores were used. Conclusions The M-PAS and the APFA are probably assessing similar constructs. Trait abnormalities occur predominantly in an interpersonal context and could be assessed within that context.

Developmental pathways in depression : multiple meanings, antecedents, andendpoints

Abstract: This article presents an overview of work conducted at the Institute of Psychiatry over the past 30 years on childhood depression. The work began with the basic question of definition and measurement. Epidemiological studies showed that depressive symptoms were quite common in children and were a good, if nonspecific, indicator of psychological disturbance. Further work in both epidemiological and clinical samples provided some evidence for the validity of a depressive syndrome . However, this work also showed that these depressive syndromes represented a heterogeneous group of phenomena. The validity of major depressive disorder in children was therefore tested further in longitudinal and family-genetic studies. These studies supported the validity of the concept but confirmed that there was heterogeneity in respect to both developmental stage at the time of onset and comorbidity with conduct disorder. We concluded that there are probably several different kinds of depressive syndromes in children. Some are strongly linked with depressive disorders in adulthood, but others are probably better conceptualized as part of another psychopathological problem altogether.

Adult disinhibited social engagement in adoptees exposed to extreme institutional deprivation: Examination of its clinical status and functional impact

Abstract: Background Early-life institutional deprivation produces disinhibited social engagement (DSE). Portrayed as a childhood condition, little is known about the persistence of DSE-type behaviours into, presentation during, and their impact on, functioning in adulthood. Aims We examine these issues in the young adult follow-up of the English and Romanian Adoptees study. Method A total of 122 of the original 165 Romanian adoptees who had spent up to 43 months as children in Ceausescu's Romanian orphanages and 42 UK adoptees were assessed for DSE behaviours, neurodevelopmental and mental health problems, and impairment between ages 2 and 25 years. Results Young adult DSE behaviour was strongly associated with early childhood deprivation, with a sixfold increase for those who spent more than 6 months in institutions. However, although DSE overlapped with autism spectrum disorder and attention-deficit hyperactivity disorder symptoms it was not, in itself, related to broader patterns of mental health problems or impairments in daily functioning in young adulthood. Conclusions DSE behaviour remained a prominent, but largely clinically benign, young adult feature of some adoptees who experienced early deprivation.

The need to belong: Desire for interpersonal attachments as a fundamental human motivation.

Abstract: A hypothesized need to form and maintain strong, stable interpersonal relationships is evaluated in light of the empirical literature. The need is for frequent, nonaversive interactions within an ongoing relational bond. Consistent with the belongingness hypothesis, people form social attachments readily under most conditions and resist the dissolution of existing bonds. Belongingness appears to have multiple and strong effects on emotional patterns and on cognitive processes. Lack of attachments is linked to a variety of ill effects on health, adjustment, and well-being. Other evidence, such as that concerning satiation, substitution, and behavioral consequences, is likewise consistent with the hypothesized motivation. Several seeming counterexamples turned out not to disconfirm the hypothesis. Existing evidence supports the hypothesis that the need to belong is a powerful, fundamental, and extremely pervasive motivation.

The Strengths and Difficulties Questionnaire: A Research Note

Abstract: A novel behavioural screening questionnaire, the Strengths and Difficulties Questionnaire (SDQ), was administered along with Rutter questionnaires to parents and teachers of 403 children drawn from dental and psychiatric clinics. Scores derived from the SDQ and Rutter questionnaires were highly correlated; parent-teacher correlations for the two sets of measures were comparable or favoured the SDQ. The two sets of measures did not differ in their ability to discriminate between psychiatric and dental clinic attenders. These preliminary findings suggest that the SDQ functions as well as the Rutter questionnaires while offering the following additional advantages: a focus on strengths as well as difficulties; better coverage of inattention, peer relationships, and prosocial behaviour; a shorter format; and a single form suitable for both parents and teachers, perhaps thereby increasing parent-teacher correlations.

Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication

Abstract: Background Little is known about the general population prevalence or severity of DSM-IV mental disorders. Objective To estimate 12-month prevalence, severity, and comorbidity of DSM-IV anxiety, mood, impulse control, and substance disorders in the recently completed US National Comorbidity Survey Replication. Design and Setting Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using a fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Participants Nine thousand two hundred eighty-two English-speaking respondents 18 years and older. Main Outcome Measures Twelve-month DSM-IV disorders. Results Twelve-month prevalence estimates were anxiety, 18.1%; mood, 9.5%; impulse control, 8.9%; substance, 3.8%; and any disorder, 26.2%. Of 12-month cases, 22.3% were classified as serious; 37.3%, moderate; and 40.4%, mild. Fifty-five percent carried only a single diagnosis; 22%, 2 diagnoses; and 23%, 3 or more diagnoses. Latent class analysis detected 7 multivariate disorder classes, including 3 highly comorbid classes representing 7% of the population. Conclusion Although mental disorders are widespread, serious cases are concentrated among a relatively small proportion of cases with high comorbidity.

Human biochemical genetics

Abstract: So far in this course we have dealt entirely with the evolution of characters that are controlled by simple Mendelian inheritance at a single locus. There are notes on the course website about gametic disequilibrium and how allele frequencies change at two loci simultaneously, but we didn’t discuss them. In every example we’ve considered we’ve imagined that we could understand something about evolution by examining the evolution of a single gene. That’s the domain of classical population genetics. For the next few weeks we’re going to be exploring a field that’s actually older than classical population genetics, although the approach we’ll be taking to it involves the use of population genetic machinery. If you know a little about the history of evolutionary biology, you may know that after the rediscovery of Mendel’s work in 1900 there was a heated debate between the “biometricians” (e.g., Galton and Pearson) and the “Mendelians” (e.g., de Vries, Correns, Bateson, and Morgan). Biometricians asserted that the really important variation in evolution didn’t follow Mendelian rules. Height, weight, skin color, and similar traits seemed to

Adolescence-limited and life-course-persistent antisocial behavior: A developmental taxonomy.

Abstract: This chapter suggests that delinquency conceals two distinct categories of individuals, each with a unique natural history and etiology: A small group engages in antisocial behavior of one sort or another at every life stage, whereas a larger group is antisocial only during adolescence. According to the theory of life-course-persistent antisocial behavior, children's neuropsychological problems interact cumulatively with their criminogenic environments across development, culminating m a pathological personality. According to the theory of adolescence-limited antisocial behavior, a contemporary maturity gap encourages teens to mimic antisocial behavior in ways that are normative and adjustive. There are marked individual differences in the stability of antisocial behavior. The chapter reviews the mysterious relationship between age and antisocial behavior. Some youths who refrain from antisocial behavior may, for some reason, not sense the maturity gap and therefore lack the hypothesized motivation for experimenting with crime.