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Biomedical subjects

Michael Rutter

Publications and source records attributed to Michael Rutter.

At least 37 records · Page 2Linked to original sources

Are there biological programming effects for psychological development? Findings from a study of Romanian adoptees.

Associations between experiences and outcomes could be due to (a) continuation of adversity or (b) organismic changes, including experience-expectant and experience-adaptive developmental programming. The adoption into British families of children who had been reared in profoundly depriving institutions in Romania presented an opportunity to test mechanisms. Romanian children reared from infancy in very depriving institutions for periods up to 42 months were compared with 52 nondeprived UK-born children placed into adoptive families before the age of 6 months. The results at 6 years of age showed substantial normal cognitive and social functioning after the provision of family rearing but also major persistent deficits in a substantial minority. The pattern of findings suggests some form of early biological programming or neural damage stemming from institutional deprivation, but the heterogeneity in outcome indicates that the effects are not deterministic.

Adoption↗

Maternal expressed emotion predicts children's antisocial behavior problems: using monozygotic-twin differences to identify environmental effects on behavioral development.

If maternal expressed emotion is an environmental risk factor for children's antisocial behavior problems, it should account for behavioral differences between siblings growing up in the same family even after genetic influences on children's behavior problems are taken into account. This hypothesis was tested in the Environmental Risk Longitudinal Twin Study with a nationally representative 1994-1995 birth cohort of twins. The authors interviewed the mothers of 565 five-year-old monozygotic (MZ) twin pairs and established which twin in each family received more negative emotional expression and which twin received more warmth. Within MZ pairs, the twin receiving more maternal negativity and less warmth had more antisocial behavior problems. Qualitative interviews were used to generate hypotheses about why mothers treat their children differently. The results suggest that maternal emotional attitudes toward children may play a causal role in the development of antisocial behavior and illustrate how genetically informative research can inform tests of socialization hypotheses.

Antisocial Personality Disorder↗

Informant disagreement for separation anxiety disorder.

OBJECTIVE: To characterize informant disagreement for separation anxiety disorder (SAD). METHOD: The sample comprised 2,779 8- to 17-year-old twins from a community-based registry. Children and their parents completed a personal interview about the child's psychiatric history. Parents completed a personal interview about their own psychiatric history and a questionnaire about their marital relationship. RESULTS: Informant agreement for SAD ranged between chance and extremely poor. Most cases of SAD were diagnosed by interview with only one informant. SAD diagnosed only by child interview was associated with an increased odds of father-rated oppositional defiant disorder, and vice versa. SAD diagnosed only by parent interview was predicted by the parental informant's history of antisocial personality disorder. SAD diagnosed only by paternal interview was also predicted by mother-rated marital conflict and dissatisfaction. CONCLUSIONS: Parents and children rarely agree about the presence of any level of child separation anxiety. A symptom "or-rule" mostly indexes diagnoses based on interview with only one informant, but the relative validity of such diagnoses remains unclear.

Adolescent↗

Adult outcome for children with autism.

BACKGROUND: Information on long-term prognosis in autism is limited. Outcome is known to be poor for those with an IQ below 50, but there have been few systematic studies of individuals with an IQ above this. METHOD: Sixty-eight individuals meeting criteria for autism and with a performance IQ of 50 or above in childhood were followed up as adults. Their mean age when first seen was 7 years (range 3-15 years); at follow-up the average age was 29 years (range 21-48 years). Outcome measures included standardised cognitive, language and attainment tests. Information on social, communication and behavioural problems was obtained from the Autism Diagnostic Interview (ADI). RESULTS: Although a minority of adults had achieved relatively high levels of independence, most remained very dependent on their families or other support services. Few lived alone, had close friends, or permanent employment. Communication generally was impaired, and reading and spelling abilities were poor. Stereotyped behaviours or interests frequently persisted into adulthood. Ten individuals had developed epilepsy. Overall, only 12% were rated as having a 'Very Good' outcome; 10% were rated as 'Good' and 19% as 'Fair'. The majority was rated as having a 'Poor' (46%) or 'Very Poor' (12%) outcome. Individuals with a childhood performance IQ of at least 70 had a significantly better outcome than those with an IQ below this. However, within the normal IQ range outcome was very variable and, on an individual level, neither verbal nor performance IQ proved to be consistent prognostic indicators. CONCLUSIONS: Although outcome for adults with autism has improved over recent years, many remain highly dependent on others for support. This study provides some information on prognostic indicators, but more fine-grained research is needed into the childhood variables that are associated with good or poor outcome.

Activities of Daily Living↗

Validity of adult retrospective reports of adverse childhood experiences: review of the evidence.

BACKGROUND: Influential studies have cast doubt on the validity of retrospective reports by adults of their own adverse experiences in childhood. Accordingly, many researchers view retrospective reports with scepticism. METHOD: A computer-based search, supplemented by hand searches, was used to identify studies reported between 1980 and 2001 in which there was a quantified assessment of the validity of retrospective recall of sexual abuse, physical abuse, physical/emotional neglect or family discord, using samples of at least 40. Validity was assessed by means of comparisons with contemporaneous, prospectively obtained, court or clinic or research records; by agreement between retrospective reports of two siblings; and by the examination of possible bias with respect to differences between retrospective and prospective reports in their correlates and consequences. Medium- to long-term reliability of retrospective recall was determined from studies in which the test-retest period extended over at least 6 months. RESULTS: Retrospective reports in adulthood of major adverse experiences in childhood, even when these are of a kind that allow reasonable operationalisation, involve a substantial rate of false negatives, and substantial measurement error. On the other hand, although less easily quantified, false positive reports are probably rare. Several studies have shown some bias in retrospective reports. However, such bias is not sufficiently great to invalidate retrospective case-control studies of major adversities of an easily defined kind. Nevertheless, the findings suggest that little weight can be placed on the retrospective reports of details of early experiences or on reports of experiences that rely heavily onjudgement or interpretation. CONCLUSION: Retrospective studies have a worthwhile place in research, but further research is needed to examine possible biases in reporting.

Child↗

Early childcare and physical aggression: differentiating social selection and social causation.

BACKGROUND: Some research findings have suggested that group day-care may be associated with an increased risk for physical aggression. METHODS: Cross-sectional maternal questionnaire data from a representative sample of 3431 Canadian 2- to 3-year-olds were used to compare rates of physical aggression shown by children looked after by their own mothers and those attending group day-care. A family risk index (using occupational level, maternal education, size of sibship, and family functioning) was created to test whether any difference in physical aggression might reflect social selection rather than social causation. RESULTS: Aggression was significantly more common in children looked after by their own mothers than in those attending group day-care. Strong social selection associated with family risk was found, not only in the sample as a whole, but even within the high-risk subsample. However, after taking social selection into account, physical aggression was significantly more common in children from high-risk families looked after by their own parents. No such difference was evident in the majority (84%) of children from low-risk families. CONCLUSION: Insofar as there are any risks for physical aggression associated with homecare they apply only to high-risk families.

Age Factors↗

Risks for conduct disorder symptoms associated with parental alcoholism in stepfather families versus intact families from a community sample.

BACKGROUND: It is not known if the prevalence of parental psychiatric disorders is higher in stepfather than intact families, or if parental alcoholism is differentially associated with risk for conduct disorder (CD) symptoms in stepfather families versus intact families. METHOD: The sample comprised 839 girls and 741 boys from 792 intact families and 99 girls and 67 boys from 83 stepfather families from a population-based registry of twins aged between 8 and 17 years. Children's current psychiatric symptoms were assessed at personal interview with the child, mother and father. Parental histories of psychiatric disorder were assessed at personal interview with each residential parent. Associations between CD symptoms and parental alcoholism were characterized using both linear and Poisson regression, and results are presented with and without adjustment for maternal drug use during pregnancy, parental conflict, and estimated socioeconomic status (SES) based on census tract data. RESULTS: Mothers from stepfather families had a higher lifetime prevalence of alcoholism, antisocial personality disorder, depression and social phobia than mothers from intact families. Stepfathers had a higher lifetime prevalence of alcoholism and depression than biological fathers from intact families. Children from stepfather families had more externalizing (CD/ODD) symptoms than children from intact families. Girls who lived with an alcoholic stepfather had significantly more CD symptoms than girls who lived with an alcoholic biological father. Boys who lived with an alcoholic stepfather had significantly fewer CD symptoms than boys who lived with an alcoholic biological father. This sex difference was statistically significant. Adjustment for maternal drug use during pregnancy, parental conflict, and estimated SES based on census tract data did not change these findings. CONCLUSIONS: Children living in stepfather families are exposed to more parental psychiatric risk factors than children from intact families. The increased risk for CD symptoms in girls (but not boys) from stepfather families is partly mediated by or associated with the stepfather's history of alcoholism.

Adolescent↗

Institutional care: associations between overactivity and lack of selectivity in social relationships.

BACKGROUND: The behaviour of children raised in institutional care in their early years is typified by heightened levels of inattention and overactivity irrespective of the quality of the care. There is some evidence that this behaviour may be specifically associated with forms of attachment disorder behaviours, but to date studies have been restricted to institutions characterised by high levels of malnutrition and lack of active experiences. METHODS: Nineteen primary school age children admitted to good quality residential group care before the age of 1 year were compared with 19 children of the same gender reared in a foster family from the same age. A combination of observational, questionnaire, interview and psychometric measures was employed. RESULTS: A fifth of the institutional children but none of the foster-family children showed a marked lack of selective attachment relationships with their caregivers. The same proportions were found for a lack of selectivity in friendships with their peers but the children showing these features were not identical. A lack of selectivity in relationships was strongly associated with inattention/overactivity, both as observed and reported. The pattern of a marked lack of selectivity and inattention/overactivity was evident only in the boys in the institution-reared group. CONCLUSIONS: It is concluded that the pattern represents a relatively specific response to some feature of an institutional rearing; nevertheless, it occurred in only just over a third of the institutional children, so that it is a far from universal consequence.

Caregivers↗

Predictors of antisocial personality. Continuities from childhood to adult life.

BACKGROUND: Antisocial behaviour in adult life has its roots in childhood. AIMS: To explore the independent and joint effects of childhood characteristics on the persistence of antisocial behaviour into adult life. METHOD: A clinical sample of twins who were systematically ascertained in childhood was followed up 10-25 years later. A total of 225 twins were interviewed regarding childhood and adult psychiatric disorder, psychosocial functioning, and psychosocial and cognitive risk factors. RESULTS: In univariate analyses, childhood hyperactivity and conduct disorder showed equally strong prediction of antisocial personality disorder (ASPD) and criminality in early and mid-adult life. Lower IQ and reading problems were most prominent in their relationships with childhood and adolescent antisocial behaviour. In multivariate modelling childhood conduct disorder and hyperactivity predicted adult ASPD even when intervening risk factors were accounted for. The number of hyperactive and conduct symptoms also predicted adult outcome. CONCLUSIONS: Childhood disruptive behaviour has powerful long-term effects on adult antisocial outcomes, which continue into middle adulthood. The importance of number of symptoms, the presence of disruptive disorder, and intermediate experiences highlight three areas where interventions might be targeted.

Adolescent↗

Maternal smoking during pregnancy and risk to boys' conduct disturbance: an examination of the causal hypothesis.

BACKGROUND: We undertook this study to determine whether the widely replicated link between maternal smoking and conduct disturbance (Cd) is better explained by a model of direct causation or of mother-offspring transmission of a latent Cd variable. METHODS: Family data collected on 538 adolescent twin boys from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) was used to compare two alternative models: 1) a model composed of a latent transmissible factor that influences mother's juvenile conduct symptoms, smoking during pregnancy, and subsequent Cd and smoking in her adolescent boys; and 2) a model specifying a direct causal path from mother's smoking to child Cd. RESULTS: The maternal-offspring transmission model fit the data as well as a model specifying a direct causal path from maternal smoking to child Cd. CONCLUSIONS: Our results suggest that the association between maternal smoking during pregnancy and boys' Cd symptoms may be attributed to the transmission of a latent Cd factor and not to a direct effect of the smoking. Our results challenge previous findings of a direct effect of prenatal smoke exposure on risk to Cd once other etiologic factors are considered.

Adolescent↗

Brief measure of expressed emotion: internal consistency and stability over time.

The study examined three methodological aspects of expressed emotion (EE) as assessed in the course of PACE (Psychosocial Assessment of Childhood Experiences) interviews with a parent. In a sample of 87 children, aged 6 13 years, enrolled in a prospective study examining the role of stress on the course of asthma, EE was assessed at three time points, 9 months apart. A high degree of agreement was found among the three concurrent measures of negative and positive EE (kappas from 0.74 to 0.97, and from 0.45 to 0.88, respectively; p < or = 0.0001 in all instances). The temporal stability of all measures was lower, although statistically significant in all but 2 instances (kappas from 0.19 to 0.59, and from 0.11 to 0.39, respectively). The temporal stability across measures, as well as across interviewers and over time, was broadly similar (kappas from 0.21 to 0.56 for negative EE, and from 0.09 to 0.38 for positive EE, with all but three of the 36 statistically significant). The findings provide support for the underlying assumptions of the PACE-EE and show the utility of measures based on just very brief periods of non-directive interviewing, making them practical in a wide range of studies with EE just one of a larger set of measures.

Adolescent↗

Child-parent attachment following early institutional deprivation.

Child-parent attachment quality with an adoptive caregiver at age 4 years was examined in a sample of 111 children adopted into the United Kingdom following early severe deprivation in Romania and a comparison group of 52 nondeprived within-United Kingdom adoptees. Findings indicated that, compared with nondeprived adoptees, children who experienced early severe deprivation were less likely to be securely attached and more likely to show atypical patterns of attachment behavior; ordinary forms of insecure attachment were not associated with deprivation. Within the sample of deprived adoptees, there was a dose-response association between duration of deprivation and disturbances in attachment behavior. In addition, a minority of children who experienced severe early deprivation were classified as avoidant, secure, or dependent using conventional classification strategies, despite also exhibiting atypical patterns of attachment behaviors, and this was also more likely among children exposed to prolonged deprivation. The results raise both theoretical and methodological implications for attachment research on very deprived children.

Adoption↗

Commentary: causal processes leading to antisocial behavior.

Conceptual, and empirical, questions are raised regarding the notion that physical aggression is the main individual risk factor for antisocial behavior, that language impairment also constitutes a risk factor, the meaning of the male preponderance for antisocial behavior, the findings on environmentally mediated risk; the role of biosocial interplay; social context effects; the construct of antisocial behavior, developmental trends; processing of experiences; and transactional effects. The main blocks to using research to develop policy are the lack of evidence on (a) the mediators of the causal processes, (b) what is needed to bring about change, (c) ways to ensure that individuals who need interventions actually receive them, and (d) differences in levels of antisocial behavior.

Adolescent↗

Twins as a natural experiment to study the causes of mild language delay: I: Design; twin-singleton differences in language, and obstetric risks.

BACKGROUND: Twins tend to lag behind singletons in their language development, but the causes were unknown. The possibilities suggested include obstetric complications, twin-specific features, and postnatal differences in family interaction. The present study was designed to pit these alternatives against one another as possible causal influences. METHOD: The Avon Longitudinal Study of Parents and Children (ALSPAC) was used to identify the 116 twin pairs (of whom 96 participated) and 114 pairs of singletons (of whom 98 participated) whose ages were no more than 30 months apart. The McArthur Communicative Development Inventory was completed at 20 months, and the Pre-School Language Scales (PLS-3), and the McCarthy Scales of Children's Abilities at 36 months. Obstetric and perinatal complications were assessed on the basis of detailed systematic parental reports, together with a systematic coded abstraction of all medical records dealing with pregnancy and the neonatal period. Family background details were assessed from parental reports, and the primary carer's verbal functioning was assessed by the Mill Hill Vocabulary Scale. Congenital anomalies were assessed using the method of Waldrop and Halverson. RESULTS: The language of twins was 1.7 months below that of singletons at 20 months and 3.1 months at 3 years. The verbal cognitive score of twins was about half a standard deviation lower than that of singletons. The twin-singleton differences in language level were found tobe unassociated with obstetric/perinatal features as assessed from both parental reports and medical records, to birthweight or gestation, to birthweight discrepancy within the twin pair, or to congenital anomalies. CONCLUSION: It is concluded that obstetric/perinatal features do not account for the slower language development in twins as compared with singletons, within a sample born after at least 33 weeks gestation.

Case-Control Studies↗

Twins as a natural experiment to study the causes of mild language delay: II: Family interaction risk factors.

BACKGROUND: Twins tend to lag behind singletons in their language development, but the causes were unknown. METHOD: Ninety-six twin pairs from the Avon Longitudinal Study of Parents and Children (ALSPAC), for whom birth was after at least 33 weeks of gestation, were compared with 98 pairs of singletons, no more than 30 months apart in age. Parental qualities and family interaction were assessed through standardised questionnaires and interviews and both structured and unstructured observations in the home at 20 months and 36 months. The possible causal role of postnatal family influences was assessed through five criteria: i) the feature had to differ between twins and singletons; ii) individual differences in that feature had to relate to individual differences in language level within the sample of singletons and of twins; iii) the feature as measured at 20 months had to predict language as assessed at 36 months; iv) that had to apply after controlling for language level at 20 months; and v) introduction of the predictive feature into an overall model had to obliterate the twin-singleton difference in language level. RESULTS: Patterns of parent-child interaction and communication met these five criteria. The maternal factors all concerned aspects of interaction that were broadly concerned with communication: encouraging the child to speak, providing elaborating comments, engaging in reading to the child and talking about the story and its illustrations. The HOME inventory findings provided similar findings with respect to responsiveness, involvement and level of experiences involved. Family features that might have been influential, but which were not, included parental depression, breast-feeding, family size, and style of sibling interaction. CONCLUSION: Patterns of parent-child interaction and communication within the normal range have environmentally mediated effects on language and account for twin-singleton differences in language developmently. The results indicate the value of a natural experiment in testing competing causal hypotheses, and show the role of environmental factors as influences on language variations within the normal range, for both twins and singletons.

Breast Feeding↗

Genetic and environmental risk factors in adolescent substance use.

BACKGROUND: The present study was undertaken with the goal of understanding the causes of association between substance use and both conduct disturbance (CD) and depression in adolescent boys and girls. METHOD: Multivariate genetic structural equation models were fitted to multi-informant, multi-wave, longitudinal data collected in extensive home interviews with parents and children with respect to 307 MZ male, 392 MZ female, 185 DZ male, and 187 DZ female, same-sex twin pairs aged 12-17 years from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD). RESULTS: Although conduct disturbance and depression were moderately associated with substance use, the pattern of genetic and environmental risk differed for males and females and across the two disorders. Genetic factors were predominant in girls' substance use whereas boys' use was mediated primarily by shared environmental factors reflecting family dysfunction and deviant peers. The patterns of correlations across the two waves of the study were consistent with conduct disturbance leading to substance use in both males and females, but depression leading to smoking, drug use and, to a lesser extent, alcohol use in girls. CONCLUSIONS: The comorbidity between substance use and depression, and between substance use and conduct disturbance in childhood/adolescence, probably reflects rather different mediating mechanisms--as well as a different time frame, with conduct disturbance preceding substance use but depression following it. In both, the co-occurrence partially reflected a shared liability but, in girls, genetic influences played an important role in the comorbidity involving depression, whereas in both sexes (but especially in boys) environmental factors played a substantial role. The extent to which these differences reflect genuine differences in the causal mechanisms underlying substance use and CD/depression in boys and girls revealed in the present analysis awaits replication from studies of other general population samples.

Adolescent↗