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Biomedical subjects

M Rutter

Publications and source records attributed to M Rutter.

At least 145 records · Page 8Linked to original sources
PubMed1991

Reliability and validity of a psychosocial axis in patients with child psychiatric disorder.

The interrater reliability of a classification scheme of psychosocial stressors was assessed among 52 child psychiatrists in rating exercises with 28 case histories. Validity was evaluated in a field study of 377 cases rated by 39 of the same child psychiatrists. The impact of glossary descriptions on reliability and validity was also determined. Reliability was low with most Kappa values being in the range of 0.20 to 0.40. The glossary did not affect interrater reliability, but it significantly decreased the use of abnormal codes. The discriminant validity of the codes was supported in that the most commonly used codes were used with differential frequency in a pattern that conforms with the known psychosocial correlates of the different psychiatric conditions of childhood.

Child↗
PubMed1991

Adult outcomes of childhood and adolescent depression: II. Links with antisocial disorders.

Sixty-three child and adolescent patients meeting operational criteria for depression and 68 non-depressed child psychiatric controls were followed into adulthood. Twenty-one percent of the depressed group had had conduct disorder (CD) in conjunction with their index depression. Depressed children with comorbid CD did not differ from depressed children without conduct problems with respect to depressive symptom presentation or demographic characteristics. However, depressives with CD had a worse short-term outcome and a higher risk of adult criminality than depressed children without conduct problems. There was a strong trend for depressives with CD to have a lower risk of depression in adulthood than depressed children without conduct problems. The outcomes of depressives with CD were very similar to those of nondepressed children with CD. The findings are discussed in the context of current classification schemes.

Adolescent↗
PubMed1991

Comorbidity in child psychopathology: concepts, issues and research strategies.

Epidemiological data show that the co-occurrence of two or more supposedly separate child (and adult) psychiatric conditions far exceeds that expected by chance (clinic data cannot be used for this determination). The importance of comorbidity is shown and it is noted that it is not dealt with optimally in either DSM-III-R or ICD-9. Artifacts in the detection of comorbidity are considered in terms of referral and screening/surveillance biases. Apparent comorbidity may also arise from various nosological considerations; these include the use of categories where dimensions might be more appropriate, overlapping diagnostic criteria, artificial subdivision of syndromes, one disorder representing an early manifestation of the other, and one disorder being part of the other. Possible explanations of true comorbidity are discussed with respect to shared and overlapping risk factors, the comorbid pattern constituting a distinct meaningful syndrome, and one disorder creating an increased risk for the other. Some possible means of investigating each of these possibilities are noted.

Adult↗
PubMed1990

Adult outcomes of childhood and adolescent depression. I. Psychiatric status.

The present study was based on the clinical data summaries ("item sheets") of children who attended the Maudsley Hospital, London, England, during the late 1960s and early 1970s. These summaries were used to identify a group of 80 child and adolescent psychiatric patients with an operationally defined depressive syndrome. The depressed children were individually matched with 80 nondepressed psychiatric controls on demographic variables and nondepressive childhood symptoms by a computer algorithm. At follow-up, on average 18 years after the initial contact, information was obtained on the adult psychiatric status of 82% of the total sample. Adult assessments were made "blind" to case/control status. The depressed group was at an increased risk for affective disorder in adult life and had elevated risks of psychiatric hospitalization and psychiatric treatment. They were no more likely than the control group to have nondepressive adult psychiatric disorders. These findings suggested that there is substantial specificity in the continuity of affective disturbances between childhood and adult life.

Adolescent↗
PubMed1989

Autism diagnostic observation schedule: a standardized observation of communicative and social behavior.

The Autism Diagnostic Observation Schedule (ADOS), a standardized protocol for observation of social and communicative behavior associated with autism, is described. The instrument consists of a series of structured and semistructured presses for interaction, accompanied by coding of specific target behaviors associated with particular tasks and by general ratings of the quality of behaviors. Interrater reliability for five raters exceeded weighted kappas of .55 for each item and each pair of raters for matched samples of 15 to 40 autistic and nonautistic, mildly mentally handicapped children (M IQ = 59) between the ages of 6 and 18 years. Test-retest reliability was adequate. Further analyses compared these groups to two additional samples of autistic and nonautistic subjects with normal intelligence (M IQ = 95), matched for sex and chronological age. Analyses yielded clear diagnostic differences in general ratings of social behavior, specific aspects of communication, and restricted or stereotypic behaviors and interests. Clinical guidelines for the diagnosis of autism in the draft version of ICD-10 were operationalized in terms of abnormalities on specific ADOS items. An algorithm based on these items was shown to have high reliability and discriminant validity.

Adolescent↗
PubMed1989

Infantile autism and developmental receptive dysphasia: a comparative follow-up into middle childhood.

An interim follow-up study of a group of "higher functioning" boys with infantile autism and control group of boys with severe (receptive) developmental language disorder (or dysphasia) is reported. The boys were compared both initially and at follow-up for overall functioning in the areas of language, peer relationships, stereotyped behaviors, and disruptive public behaviors, as well as for the presence of a number of specific symptoms. In some respects, the behaviors that differentiated the groups initially did so also at follow-up, although there were important differences. Very few of the autistic boys had good language skills at follow-up, whereas nearly half of the dysphasic group were communicating well, a difference that is striking in view of the initial general similarity between the groups in terms of poor language functioning. However, some of the dysphasic children had developed greater difficulties in peer relationships. The implications for concepts of the nature of the deficit in severe receptive developmental language disorders are considered.

Autistic Disorder↗
PubMed1989

Autism diagnostic interview: a standardized investigator-based instrument.

The development of a new standardized investigator-based interview for use in the differential diagnosis of pervasive developmental disorders is described, together with a diagnostic algorithm (using ICD-10 criteria) based on its use. Good interrater reliability for algorithm items was shown between four raters, two in Canada and two in the UK, who rated 32 videotaped interviews. The items also significantly discriminated between 16 autistic and 16 nonautistic mentally handicapped subjects. The algorithm based on ICD-10 identified all 16 autistic individuals and none of the 16 nonautistic subjects.

Adolescent↗
PubMed1989

Isle of Wight revisited: twenty-five years of child psychiatric epidemiology.

Child psychiatric epidemiology over the last 25 years is reviewed in terms of conceptual and methodological issues arising out of substantive findings. The Isle of Wight surveys undertaken in the mid-1960s are briefly described to establish a starting point, and progress since then is reviewed in terms of topics not originally covered--especially problems in preschool children and specific psychiatric disorders. The use of epidemiology to study causal hypotheses is considered, methodological advances are noted, and challenges for the future are discussed.

Child↗
PubMed1989

Mothers' speech to autistic children: a preliminary causal analysis.

Changes over time in the language patterns of autistic children and their parents were examined during the course of a home-based intervention programme. Although the language used by parents to their autistic children was not deficient, language modification procedures were found to lead to rapid changes in the verbal interaction between parents and children. Parents in the non-intervention, control group showed little change in their communication style. In the experimental group, but not in the control group, a close relationship was found between increases in the use of language-eliciting utterances by their mothers and improvements in children's socialized language. The pattern of association between parent and child language suggested that the main effect was of the parent on the child but that the extent of the child's language handicap constrained what could be achieved by treatment.

Autistic Disorder↗