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 reliability and validity of measures of family life and relationships in families containing a psychiatric patient

Abstract: Several studies have highlighted the burden on the families of mentally ill patients and so emphasised the need to investigate the effects of illness on family life and relationships. — A review of the literature showed that many of the published measures of the family lacked satisfactory reliability and validity. — A methodological study of 30 families in all of which there were children of school age or younger and in which one parent had newly attended a psychiatric facility is reported. For each family there was a 2–3 hour interview with the patient, a 3–4 hour interview with the spouse and a third interview of about an hour with the two of them together. At each interview there were two investigators who made independent ratings. There were different investigators for each of the three interviews so that there were 6 investigators and 6 sets of independent ratings for each family. — A basic distinction was made between concrete happenings or activities in the family, on the one hand and, on the other, feelings, emotions or attitudes concerning these events or the individuals participating in them. An interview designed to measure both types of variables is described. By the use of a particular kind of flexible and detailed questioning about recent events an attempt was made to free the measurement of events and activities from attitudinal biases. A different approach was used for the measurement of emotions. By the use of tape recordings and group discussions, interviewers were trained to recognise and rate differences in tone of voice as shown in the speed, pitch and intensity of speech. The third main type of scale consisted of overall summary ratings of relationships. — Each type of scale is illustrated by a number of examples for which detailed results are given. These are ‘warmth’ and ‘number of critical remarks’ as examples of ‘emotional’ scales, ‘participation of husband and wife in household tasks’ and ‘frequency of irritable acts’ as examples of scales of events or happenings, and ‘overall assessment of the marriage’ as a summary scale. Details are also given on the scale measuring ‘parent preferred by the child’ which does not readily fit into any of these 3 main categories. — High inter-rater reliability was demonstrated for the emotional scales. Respondent and rater biases were not found. By comparison of ratings made in different interviews, it was shown that similar feelings were expressed about the spouse in different situations, suggesting that the ratings were valid as well as reliable. A person's report of someone else's emotions, on the other hand, appeared to have a low level of validity in spite of good reliability. — Inter-rater reliability for the measures of activities and for the overall summary ratings was also high and, more important, it was shown that there was good agreement between the accounts of husbands and wives when interviewed separately. — A detailed examination was made of possible factors influencing husband-wife agreement. Slight biases associated with dissatisfaction and patient status were found but these were not sufficient to influence conclusions in most instances. Ways of reducing such bias are discussed.

A prospective study of children with head injuries: III. Psychiatric sequelae.

Abstract: A 2¼-year prospective study of children suffering head injury is described. Three groups of children were studied: (a) 31 children with ‘severe’ head injuries resulting in a post-traumatic amnesia (PTA) of at least 7 days; (b) an individually matched control group of 28 children with hospital-treated orthopaedic injuries; and (c) 29 children with ‘mild’ head injuries resulting in a PTA exceeding 1 hour but less than 1 week. A retrospective assessment of the children's pre-accident behaviour was obtained by parental interview and teacher questionnaire immediately after the accident and before the behavioural sequelae of the injury could be known. Further psychiatric assessments were undertaken 4 months, 1 year and 21 years after the initial injury. The mild head injury group showed a raised level of behavioural disturbance before the accident but no increase thereafter. It was concluded that head injuries resulting in a PTA of less than I week did not appreciably increase the psychiatric risk. By contrast, there was a marked increase in psychiatric disorders following severe head injury. The high rate of new disorders in children with severe head injuries who were without disorder before the accident, together with the finding of a dose–response relationship with the severity of brain injury, indicated a causal relationship. However, the development of psychiatric disorders in children with severe head injuries was also influenced by the children's pre-accident behaviour, their intellectual level, and their psychosocial circumstances. With the exception of social disinhibition and a slight tendency for the disorders to show greater persistence over time, the disorders attributable to head injury showed no specific features.

Effects of age and pubertal status on depression in a large clinical sample

Abstract: The rate of depression rises overall between childhood and adolescence, and by early adulthood depression is twice as common in women as in men. However, study results are conflicting as to the relative rates of depression in prepubertal boys and girls, and it is not clear whether the rates in adolescent boys rise, fall, or remain steady. It is also uncertain when in adolescence the female preponderance emerges. A number of studies point to effects of the biological developments of puberty as having an important place in these changes. From a developmental point of view, the fact that the hormonal and physical changes of puberty differ in boys and girls, mean that a “biological explanation” fits in well with the gender differentiation in rates of depression across puberty. In a sample of 3,519 8–16-year-old psychiatric patients, both boys and girls shared increasing levels of depression across this age range, but the rate of increase was faster in girls. There was no difference in the rates of depression between boys and girls before the age of 11, but by the age of 16 girls were twice as likely as boys to have significant depressive symptomatology. When age was controlled for, pubertal status had no effect on depression scores. Thus, these results did not support the idea that the biological changes of puberty are a primary motive force in producing the changes in the sex ratio in depression in adolescence. Therefore, further research on this topic needs not only to address the etiology of depression in young people, but also to search for etiologic factors with differential distributions or effects on boys and girls.

Temperament, personality and personality disorder.

Abstract: It is now over 2000 years since Hippocrates put forward his idea that there were four body †̃¿ humours', each associated with a characteristic personality style: black bile with melancholic; blood with sanguine; yellow bile with choleric; and phlegm with phlegmatic (Mora, 1980).The proposition that human beings are constitutionally different in ways that shape their personality style caught on with the lay public. Indeed the notion of body humours determined the very words that we use to describe such styles. Yet the view has not had such a smooth journey in scientific circles. There is a surprising lack of uniformity in both concept and terminology, as is all too evident in the controversies surrounding the terms †̃¿ tempera ment', †̃¿ personality' and †̃¿ personality disorder'. Paradoxically, personality psychology went out of fashion just at the time that the study of temperament was becoming firmly established. But the recent up surge of research and of writing on temperament has not brought general agreement. Kagan et al(1987) see temperament in terms of those behavioural styles that have a strong biological basis; somewhat similarlyBuss & Plomin (1986) defined temperament as inherited personality traits present in early childhood. By contrast, Bates (1980) suggested that much of temperament lay in parental percepts rather than child behaviour; Mischel (1968) argued that situational influences were so strong that the role of personality traits could be ignored; Stevenson-Hinde & Hinde (1986) accepted that there is an individual component to behaviour but pointed out that most behaviour as observed is a property of social interactions rather than just one person; and Graham & Stevenson (1986) maintained that temperament represents only sub clinical manifestations of psychiatric disorder. Where does the truth lie? What value have these concepts for clinical practice if their meaning and basis is in such dispute? My purpose in this paper is to attempt some clarification of the rather complex mesh of ideas that fall under the general rubric of tempera ment, personality and personality disorder. In so doing, I shall seek to provide tentative answers to these difficult questions and, more hesitantly, I shall suggest some possible ways forward. Temperament

A Five to Fifteen Year Follow-up Study of Infantile Psychosis: I. Description of Sample

Abstract: The psychoses of infancy have long been a matter for controversy. The nature of the disorders, their aetiology, relationship to adult forms of psychosis, long-term outcome and response to treatment are still areas of disagreement among clinicians. Follow-up studies should provide information relevant to some of these problems. Unfortunately, the findings of published investigations have been contradictory. To a large extent contradictions appear to be related to differences in diagnostic criteria, but the failure of many writers to describe their cases adequately has made it difficult to assess the significance of possible differences.

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.