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Biomedical subjects

M Rutter

Publications and source records attributed to M Rutter.

At least 181 records · Page 10Linked to original sources

The role of cognition in child development and disorder.

The role of cognition in child development is reviewed with respect to the role of cognitive processing and cognitive deficits. Cognitive processing is discussed with respect to the self-system; the effects of psychosocial experiences; risk, vulnerability and protective mechanisms; vulnerability to depression; aetiology and treatment of depression. Cognitive deficits are discussed with respect to the socio-emotional consequences of language delay and reading difficulties; hyperkinetic/attentional deficit syndromes; schizophrenia; and autism. It is concluded that the ways in which we appraise our life circumstances and the ways in which we react to experiences of all kinds are greatly influenced by how we think about ourselves and our environment. Biases and distortions in such cognitive processing may be associated with social and emotional malfunction. These biases may derive from earlier experiences, from intensive temperamental styles, or from deficits in the ability to process incoming information. The further study of cognitive processing and cognitive deficits is likely to be rewarding and helpful for clinical practice.

Attention Deficit Disorder with Hyperactivity↗

Agreement between teachers' ratings and observations of hyperactivity, inattentiveness, and defiance.

The relationship of directly observed classroom behavior and teacher ratings on questionnaires with a judgemental (Conners Teacher Rating Scale) or operational format was examined for 33 boys aged 6 years 5 months to 7 years 7 months. Results showed a high degree of association between observed and rated behavior. This association did not vary with the format of the rating scales but did vary with the nature of the behavior being rated. Defiance was more reliably rated than hyperactivity or inattentiveness. Several behaviors exerted a halo effect on ratings of hyperactivity, inattentiveness, and behavior problems. In particular, defiance toward a teacher increased the likelihood that a child would be rated as hyperactive or inattentive regardless of his observed level of activity or attentiveness. These results support the validity of behavior rating scales as screening measures for hyperactivity, inattentiveness, and defiance and indicate that a child's defiance and disobedience are significant causes of misclassification.

Attention↗

Child psychiatry: looking 30 years ahead.

The likely developments over the next 30 years in the understanding of disorders and in patterns of clinical practice in child psychiatry are considered in the light of basic biological principles, the current knowledge base and the prevailing trends of change. Attention is paid to possible advances in genetics, biological investigations, cognitive deficits and cognitive processing, psychosocial mechanisms, treatment strategies, classification, theories, patterns of practice and child psychiatric training.

Brain↗

Meyerian psychobiology, personality development, and the role of life experiences.

The psychobiological life history approach to psychiatry is perhaps the most important of Adolf Meyer's contributions to psychiatric thinking. The author outlines the implications of that approach for current concepts and practice. He reviews the literature regarding the causative role of life experiences in the genesis of psychiatric disorder, the extent to which the effects of stressors are situation-specific, the effects of stress on the organism, the reason for individual variations in the response to stress, and the cause of life stressors.

Adaptation, Psychological↗

Conduct disorder and hyperactivity: II. A cluster analytic approach to the identification of a behavioural syndrome.

Sixty boys, aged from 6 to 10 years, were studied after their referral to psychiatric clinics for antisocial or disruptive behaviour. Their scores on reliable measures of hyperactivity, defiant behaviour, emotional disorder and attention deficit were taken for the home, school and clinic settings; and subjected to two techniques of cluster analysis. Both gave a similar set of clusters, one of which had high scores on all measures of hyperactivity and attention deficit. Membership of this cluster was associated with a lower IQ, a younger age of problem onset and referral, an abnormal neurological examination, a history of developmental delay, smaller family size, poor peer relationships and a high rate of accidental injuries; and it predicted a good response to stimulant medication in a controlled trial. Other research on the classification of hyperactivity is discussed, and proposals are made for the criteria of a rather narrow definition of 'hyperkinetic conduct disorder'.

Antisocial Personality Disorder↗

Family and school influences on cognitive development.

Family and school influences on cognitive development are reviewed in terms of the empirical research findings on (i) variations within the ordinary environment; (ii) family intervention studies; (iii) the effects of abnormal environments; (iv) extreme environmental conditions; (v) variations within the ordinary school environment; and (vi) preschool and school intervention studies. It is concluded that environmental effects on IQ are relatively modest within the normal range of environments, but that the effects of markedly disadvantageous circumstances are very substantial. Cognitive development is influenced both by direct effects on cognition and by indirect effects through alterations in self-concept, aspirations, attitudes to learning and styles of interaction with other people.

Achievement↗

Reading retardation and antisocial behaviour: a follow-up into employment.

The implications of the frequent overlap between reading and behavioural disorders in childhood are explored using follow-up findings on the secondary school progress and early work histories of four groups of boys, with an without reading retardation, and with and without behavioural disturbance. While the prognosis for the majority of the retarded readers appeared poor, certain particular features-high rates of early school leaving, unstable work records and especially depressed skill levels-characterized those with associated behavioural problems. The importance of separating out the effects of additional associated disorders and disadvantages in assessing the long-term prognosis for children with learning problems is discussed.

Absenteeism↗

The nature and qualities of parenting provided by women raised in institutions.

A repeated pattern of difficulties in parenting is often found in successive generations of the same families. That finding, together with a concern to identify potential adverse influences upon child behaviour and development, was the focus of this study into the parenting provided by women who were raised within institutions. Relationships with their 2- to 3-year-old infants were assessed using complementary interview and naturalistic observational techniques. Differences in parenting styles between the case and comparison groups were on the whole subtle. Ex-care women were relatively less sensitive to their children's cues and, in response to their demands and opposition, exercised control by confrontation rather than by circumvention.

Affect↗

Family and school influences on behavioural development.

Research findings are reviewed with respect to possible family and school influences on behavioural development, but with special reference to socially disapproved conduct. The hypothesis that statistical associations between environmental variables and children's disorders represent causal connections is considered in terms of the three main alternatives--hereditary influences, the effect of children on their parents, and the operation of some third variable. It is concluded that each has some validity but that nevertheless there are true environmental effects. The mechanisms underlying their operation are discussed with respect to parental criminality, family discord, weak family relationships, ineffective discipline, and peer group influences. Individual differences in response to adversity are discussed in terms of age, sex, temperament, genetic factors, coping processes, patterning of stressors, compensatory good experiences and catalytic factors. The various ways in which environmental effects may persist over time are considered in terms of linkages within the environment as well as within the child. It is concluded that long-term effects are far from independent from intervening circumstances.

Child↗

The treatment of autistic children.

The goals of treatment need to be decided on the basis of knowledge on the nature of autism. As with any developmental disorder, the first goal must be to foster normal development; with autistic children this involves a focus on intellectual, language and social development. The further goals include: the reduction of rigidity/stereotypy; the elimination of non-specific maladaptive behaviours; and alleviation of family distress. Research findings are used to translate these goals into a practical overall therapeutic programme with three main elements: a full diagnostic appraisal, special educational provision and a home-based programme for the family. Finally, the research findings are drawn together to derive inferences on the lessons to be learned and the questions that remain to be answered.

Autistic Disorder↗

Institutional rearing, parenting difficulties and marital support.

A prospective follow-up study was undertaken of two groups of women first studied in the mid 1960s when they were children: 94 girls reared in institutions to which they had been admitted because of a breakdown in parenting, and 51 girls in a general population comparison group. Both groups were interviewed in detail when aged 21-27 years and home observations were undertaken for those with young children. The institution-reared women showed a markedly increased rate of poor psychosocial functioning and of severe parenting difficulties in adult life. However, the support of a non-deviant spouse and of good living conditions in adult life provided a powerful protective effect.

Adult↗

Parental psychiatric disorder: effects on children.

A 4-year prospective study was undertaken of the families of 137 newly referred English speaking psychiatric patients with children at home aged under 15 years. The group comprised a representative sample of such patients living in one inner London borough. Teacher questionnaires were obtained yearly for all children of school age in the families, and for age-, sex- and classroom-matched controls. Detailed standardized interviews were undertaken yearly with parent-patients and with their spouses. A comparison was also made with a control group of families in the general population with 10-year-old children. Patients' families differed in terms of a higher rate of psychiatric disorder in spouses and a much higher level of family discord. Both parental mental disorder and marital discord tended to persist over the 4-year period, but persistence of both was much more marked when the parent had a personality disorder. The children of psychiatric patients had an increased rate of persistent emotional/behavioural disturbance, which tended to involve disorders of conduct. The psychiatric risk to the children was greatest in the case of personality disorders associated with high levels of exposure to hostile behaviour. Boys showing temperamental risk features were most vulnerable to the ill-effects associated with parental mental disorder.

Adolescent↗

Parents with children in care--I. Current circumstances and parenting.

Interview data on a consecutive sample of families with children multiply admitted to residential care by one inner London borough were contrasted with those from a comparison sample from the same geographical area. The in-care group were twice as likely to be experiencing current parenting problems with 5- to 8-year-old children, but were distinguished from the already disadvantaged comparison group as much by other kinds of family difficulties as by parenting problems per se. It was therefore argued that parenting cannot be seen as an attribute of individuals irrespective of their current circumstances.

Child↗