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Biomedical subjects

M Rutter

Publications and source records attributed to M Rutter.

At least 217 records · Page 12Linked to original sources
PubMed1981

A prospective study of children with head injuries: IV. Specific cognitive deficits.

Twenty-five children with a head injury resulting in a posttraumatic amnesia of at least one week were compared with an individually matched group of 25 children with orthopedic injuries. Both groups were studied a few weeks after the accident and the again at 4 months, 1 year and 21/4 years after the injury. The head injury group showed a persistent deficit on the WISC Performance IQ scale; the deficit on the Verbal IQ scale was more transient. An extensive battery of neuropsychological tests was employed to identify specific deficits not shown on the WISC. On the whole, these tests showed a pattern of results similar to that found with the WISC, and in most cases children without deficits on the Performance IQ scale of the WISC also did not show deficits on the battery of specific tests. However, in a few cases, tests of speed of visuo-motor or visuo-spatial functioning picked up deficits attributable to the head injury which occurred in children with normal scores on the WISC.

Adolescent↗
PubMed1981

Psychological sequelae of brain damage in children.

The author reviews the empirical evidence on the psychological sequelae of brain damage in childhood, concluding that brain injury causes a markedly increased risk in both intellectual impairment and psychiatric disorder. The risk is related to the severity of the brain damage, but there is little indication of locus effects. Psychiatric disorder is probably most likely to occur when there is abnormal neurophysiological activity; to some extent it may be influenced by the nature of the basic medical condition. Psychiatric consequences of brain injury are also substantially affected by the child's pre-injury behavior, psychosocial circumstances, and cognitive level. However, there are few psychological sequelae that are specific to brain damage.

Amnesia↗
PubMed1981

Psychiatric interviewing techniques: I. Methods and measures.

An account is given of the overall strategy and measures used in a three-phase study of styles and techniques employed in the initial diagnostic interviews with the parents of children referred to a child psychiatric clinic. The measures of interview style included interviewer activity and talkativeness, directiveness, types of questions and statements, interventions designed to elicit or to respond to feelings, and non-verbal qualities. The informant's response and the interview 'outcome' were assessed through measures of the quantity and quality of factual information obtained, and of the extent of expression of emotional feelings by the informant. Good inter-rater reliability was achieved with most measures. Some difficulties were experienced in achieving comparable thresholds for the recognition of expressed emotions.

Adolescent↗
PubMed1981

Psychiatric interviewing techniques II. Naturalistic study: eliciting factual information.

A naturalistic study was undertaken of 36 video and audio taped interviews made by 7 different psychiatric trainees. The interviews studied were those conducted in the ordinary course of clinic work for diagnostic and therapeutic planning purposes by trainees when first seeing the parent or parents of a child newly referred to a psychiatric clinic. It was found that a directive style with specific probes and requests for detailed descriptions was associated with the obtaining of better-quality factual information than that associated with a more free-style approach. Interviewers who talked less and who made use of open questions and checks tended to have more talkative informants. Double questions were liable to result in ambiguous answers, but multiple-choice questions did not appear to cause distortion and in some circumstances might be helpful.

Adolescent↗
PubMed1981

Psychiatric interviewing techniques. III. Naturalistic study: eliciting feelings.

A naturalistic study was undertaken of 36 video and audio-taped interviews undertaken by 7 different psychiatric trainees. The interviews studied were those conducted in the ordinary course of clinic work for diagnostic and therapeutic planning purposes by trainees when first seeing the parent or parents of a child newly referred to a psychiatric clinic. It was found that a variety of rather different interview techniques seemed to facilitate emotional expression. These included a low level of interview talk with few interruptions, a high rate of open rather than closed questions, direct requests for feelings, interpretations and expressions of sympathy. The issue of how far these associations reflected causal influences is discussed.

Child↗
PubMed1981

Psychiatric interviewing techniques. IV. Experimental study: Four contrasting styles.

The development and definition of four contrasting interview styles is described. The four styles were designed using different permutations of techniques which, on the basis of an earlier naturalistic study, appeared to be most effective in eliciting either factual information or feelings. A 'sounding board' style utilized a minimal activity approach; an 'active psychotherapy' style actively sought to explore feelings and to bring out emotional links and meanings; a 'structured' style adopted an active cross-questioning approach, and a 'systematic exploratory' style aimed to combine a high use of both fact-oriented and feeling-oriented techniques. Quantitative measures based on video-tape and audio-tape analysis showed that two experienced interviewers could be trained to adopt these four very different styles and yet remain feeling and appearing natural. An experimental design to compare the four styles is described.

Attitude↗
PubMed1981

Psychiatric interviewing techniques V. Experimental study: eliciting factual information.

Four experimental interview styles, each recommended by experts in the field, were compared for their efficiency in eliciting factual information during the initial diagnostic interviews with the mothers of children referred to a psychiatric out-patient clinic. If encouraged to talk freely, mothers tended to mention most (but not all) key issues without the need for standardized questioning on a pre-determined range of topics. However, systematic questioning was essential in order to obtain good quality factual data. Better data were obtained when interviewers were sensitive and alert to factual cues and chose their probes with care. Clinically significant factual information, idiosyncratic to the family and outside the range of standard enquiry was common, but was obtained satisfactorily with all four styles. No one style was generally preferred by informants. The advantages of systematic questioning for obtaining factual information were not associated with any disadvantages with respect to the eliciting of emotions and feelings.

Attitude to Health↗
PubMed1981

Psychiatric interviewing techniques. VI. Experimental study: eliciting feelings.

Four experimental interview styles, designed to differ in the extent of their use of active fact-oriented and active feeling-oriented techniques, were compared in relation to their use in the initial diagnostic interviews with the mothers of children referred to a psychiatric clinic. All four styles proved to be effective in eliciting emotions and feelings, but the findings suggested that each was effective for different reasons. It appeared that emotional expression could be encouraged by the interviewer's response to emotional cues, by a reflective style with little factual cross-questioning, by the use of direct requests for self-disclosures, by the optimal (but not necessarily maximal) use of interpretations. and expressions of sympathy, and by direct requests for feelings.

Emotions↗
PubMed1980

A prospective study of children with head injuries: I. Design and methods.

The main unresolved issues with respect to the psychological sequelae of brain damage in childhood are noted, and the previous studies of children suffering head injury are critically reviewed. A new prospective study is described. Three groups of children were studied: (a) 31 children with "severe" head injuries resulting in a post-traumatic amnesia 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 post-traumatic amnesia exceeding 1 hour but less than 1 week. The children were studied as soon as possible after the accident and then again 4 months, 1 year, and 2 1/4 years after the injury. The parents were interviewed, using systematic and standardized interview techniques; both parents and teachers completed behavioural questionnaires; and the children were seen for individual psychological testing the WISC, the Neale Analysis of Reading Ability and a battery of tests of more specific cognitive functions. At the final follow-up, the severe head injury group (but not the other 2 groups) received a systematic neurological examination and the school teacher who knew the child best was personally interviewed. The findings are given on physical handicap, neurological abnormality, school placement and psychiatric referrals. All types of disabilities were both more frequent and more persistent in the children with severe head injuries.

Amnesia↗
PubMed1980

The long-term effects of early experience.

Empirical research findings are reviewed with respect to the long-term effects of early experiences on intellectual and social development. Particular attention is focused on the question of whether adverse experiences in infancy can lead to enduring impairment, even when later experiences are positive and beneficial. It is concluded that, although there are continuities between infancy and maturity, the residual effects of early experiences on adult behaviour tend to be quite slight, both because of the maturational changes that take place during middle and later childhood and because of the effects of beneficial and adverse experiences during all the years after infancy. The long-term effects of early deprivation depend heavily on whether or not the deprivation continues, but there is a suggestion that, in some circumstances, infantile experiences may have some persisting effects in spite of later environmental change. However, there is a lack of critical data to test this hypothesis.

Adolescent↗
PubMed1980

Raised lead levels and impaired cognitive/behavioural functioning: a review of the evidence.

Research findings on the effects of raised lead levels on children's cognitive and behavioural functioning are reviewed. The results are considered separately with respect to clinic-type studies of children with high lead levels, studies of mentally retarded or behaviourally deviant children, chelation studies, smelter studies, and general population studies of dental lead. It is concluded that, although the findings are somewhat contradictory, the evidence suggests that persistently raised blood levels in the range above 40 microgram/100 ml may cause slight cognitive impairment (a reduction of one to five points on average) and less certainly may increase the risk of behavioural difficulties. There are pointers that there may also be psychological risks with lead levels below 40 microgram/100 ml, but the evidence on this point is inconclusive so far. Parallels are drawn with studies of other brain traumata and some suggestions are made with respect to both practical implications and the needs for further research.

Adolescent↗
PubMed1979

Families of autistic and dysphasic children. I. Family life and interaction patterns.

Patterns of parent-child interaction and family functioning were systematically examined in well-matched groups of 15 autistic and 14 dysphasic children. The measures used included the Douglas 24-hour standard day analysis, the Brown and Rutter interview measure of positive interaction, the Ittleson scales (based on a four- to six-hour period of home observation, specially developed time-sampled measures of observed mother-child interaction at home), and the Eysenck Personality Inventory. The findings from all measures agreed in showing that family life and interaction patterns were closely similar in the two groups. The results were compared with those of previous investigations; we concluded that autism is most unlikely to be due to abnormal psychogenic influences in the family.

Activities of Daily Living↗