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.

Epidemiological methods to tackle causal questions

Abstract: It is a dull day when there is not at least one media report of a claim that research has identified some new environmental cause of disease. Such claimed causes concern a wide range of supposed hazards including medical interventions such as the measlesmumps-rubella (MMR) vaccine, the thimerasol (mercury) preservative in other vaccines, dietary factors of many different kinds (coffee, alcohol, food additives, etc.), prenatal stresses or the intra-uterine exposure to the effects of maternal smoking or ingestion of alcohol, use of mobile phones, and living near radiation sources—to mention just a few examples. It is problematic, however, that many of these claims are not confirmed by other research and some are even reversed. Unsurprisingly both professionals and the lay public have developed a scepticism about claims on environmental causes of disease. Because much of the evidence derives from epidemiological studies of one kind or another, epidemiological science itself has come under scrutiny both within and outside the profession. Some have argued that only laboratory experiments and randomized controlled trials (RCT) can provide acceptable evidence on causation. That cannot be a solution, however, because so many of the putative environmental causes are ones that cannot be manipulated in humans—for a mixture of both ethical and practical reasons. Because the identification of environmental causes is of such importance, and because the solution of the causal inference problem has no obvious single, simple solution, the Academy of Medical Sciences set up a working party (made up of clinical scientists, epidemiologists, statisticians, policy leaders and scientific media specialists) to answer the key questions of ‘how should we decide what to believe and when to take action?’ The report emphasized the need to focus on individual components in the causal process and not on some misleading abstract notion of a single basic cause. It also notes the many reasons why an observed association or correlation might not reflect an environmentally mediated causal effect. Such reasons include genetic mediation of the causal risk effect, social selection (allocation bias), and reverse causation to mention but three out of a much longer list of possibilities. It was also noted that the main problem in moving from an observed association to a causal inference did not lie in the effect of known, measured confounders, but rather in the effect of unknown, unmeasured confounders.

Do high threat life events really provoke the onset of psychiatric disorder in children

Abstract: Studies on adults have suggested important effects of stressful life events in provoking onset of psychiatric disorder. Only a few comparable studies on children exist, and their results are inconsistent in relation to definite timing effects. Meeting some important methodological challenges overlooked in the past research, this study set out to examine whether the onset of psychiatric disorder in children was more likely to occur shortly after a severe event, as compared with other times. The sample consisted of 99 consecutive, newly referred patients, aged 8-16 years, from a child psychiatry service in London. PACE (Psychosocial Assessment of Childhood Experiences), an investigator-based, standardized interview was used to assess the timing and impact of life events over the preceding 18 months. CAPA (Child and Adolescent Psychiatric Assessment), a standardized diagnostic assessment, was used to establish the presence, timing, and consequential impairment of child and adolescent psychiatric symptoms. In a within-subject, over-time design, conditional logistic regression techniques were employed to examine whether risk of onset was greater in the 9 weeks following a high-threat life event than at other times. There was a small but statistically significant association between child-reported events and child-reported onset; the associations with parent-reported onset were inconsistent. Parent-reported events failed to relate to onset by either source. The study offers only quite limited support to the notion of negative life events provoking onset of psychiatric disorder in children and young people. The possible reasons for this are discussed, together with important conceptual and methodological issues to problems of defining onset, and the choice of appropriate designs for data analysis.

Prevalence and developmental course of 'secret language'

Abstract: The prevalence and developmental course of supposed 'secret language' was examined in a cohort of twins and closely spaced singletons pairs, with systematic assessments at 20 months and again at 36 months. Two forms of apparent 'secret language' were examined: (1) shared understanding--speech directed generally but unintelligible to the parent, although apparently clearly understood within the child pair, and (2) private language directed exclusively to the other twin/sibling--not intelligible to the parent, but apparently clearly understood and used only within the child pair. Both occurred in singleton pairs, but the rate was much higher in twins. In most cases it seemed to be a developmental phenomenon occurring in the second year of life with the emergence of immature speech, and decreasing considerably over the next 16 months. A small group of children, primarily male twins, was reported to use a private language at 36 months. This group had poorer cognitive and language functioning, and was characterized by highly dependent relationships. Some aspects of the twins' home environment were less stimulating and less responsive, most probably reflecting the abilities and relationships of the children. A follow-up of these children when they were approximately 6 years of age showed that language outcome was poor for the subgroup (n = 4) who did not develop normal language alongside the use of a private language.

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.