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Biomedical subjects

M Rutter

Publications and source records attributed to M Rutter.

At least 55 records · Page 3Linked to original sources
PubMed2000

The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism.

The Autism Diagnostic Observation Schedule-Generic (ADOS-G) is a semistructured, standardized assessment of social interaction, communication, play, and imaginative use of materials for individuals suspected of having autism spectrum disorders. The observational schedule consists of four 30-minute modules, each designed to be administered to different individuals according to their level of expressive language. Psychometric data are presented for 223 children and adults with Autistic Disorder (autism), Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS) or nonspectrum diagnoses. Within each module, diagnostic groups were equivalent on expressive language level. Results indicate substantial interrater and test-retest reliability for individual items, excellent interrater reliability within domains and excellent internal consistency. Comparisons of means indicated consistent differentiation of autism and PDDNOS from nonspectrum individuals, with some, but less consistent, differentiation of autism from PDDNOS. A priori operationalization of DSM-IV/ICD-10 criteria, factor analyses, and ROC curves were used to generate diagnostic algorithms with thresholds set for autism and broader autism spectrum/PDD. Algorithm sensitivities and specificities for autism and PDDNOS relative to nonspectrum disorders were excellent, with moderate differentiation of autism from PDDNOS.

Autistic Disorder↗
PubMed1999

The influence of genetic factors and life stress on depression among adolescent girls.

BACKGROUND: The possible causes of greater depression among adolescent girls were investigated by examining variation in the influence of genetic and environmental risk factors among 182 prepubertal female, 237 prepubertal male, 314 pubertal female, and 171 pubertal male twin pairs from the Virginia Twin Study of Adolescent Behavioral Development. OBJECTIVES: To compare the trajectory of depressive symptoms among boys and girls from childhood to adolescence; to analyze the role of genetic, shared, and unique environmental factors in depression among prepubertal and pubertal male and female twins; and to investigate a possible link between liability to depression and one salient index of the child's environment: past-year life events. METHODS: Child-reported depression was assessed using the Child and Adolescent Psychiatric Interview and ratings of past-year life events and pubertal status obtained by maternal questionnaire and interview, respectively. RESULTS: The impact of life events on depression was particularly evident in the adolescent girls. The results from model fitting indicate increased heritability for depression in this group, and its long-term consistency was mediated primarily by latent genetic factors. Model fitting also showed that at least part of the liability to depression and to life events can be linked to a common set of genes in the adolescent girls, and there is a notable developmental increase in the genetic variance for life events. CONCLUSIONS: The greater heritability for depression in pubertal girls, its genetic mediation over time, and the increase in genetic variance for life events may be one possible explanation for the emergence of increased depression among pubertal girls and its persistence through adolescence.

Adolescent↗
PubMed1999

Colonoscopy aided by magnetic 3D imaging: assessing the routine use of a stiffening sigmoid overtube to speed up the procedure.

There are not enough trained colonoscopists to cope with the present recommended number of examinations required for diagnostic and surveillance purposes. If colorectal cancer screening is to be introduced, endoscopic examination of the large bowel needs to be easier to learn and significantly quicker to carry out. The 'Bladen system', first described in 1993, is a non-radiological method of visualising the path of the endoscope, using magnetic drive coils under the patient and a chain of sensors along the biopsy channel of the instrument. In 1998, results were published using a novel computer graphics system (the RMR system), in which a much more realistic image of the endoscope could be produced using the stored positional data from the Bladen system. The RMR system has been further refined to allow, for the first time ever, accurate measurement of the effect of the passage of a colonoscope along the bowel on the lengths of different segments of the large intestine. The results obtained in 232 patients undergoing colonoscopy are analysed. In 77 of the patients, a stiffening overtube is used to splint the sigmoid colon once the endoscope is at or beyond the splenic flexure. The mean time taken to pass the colonoscope across the transverse colon is significantly shorter (p < 0.001) when an overtube is used, despite it resulting in significant lengthening of the transverse colon. The routine use of a stiffening overtube can be expected to reduce the total procedure time by between 10 and 20%.

Adult↗
PubMed1999

Children's recall of medical experiences: the impact of stress.

OBJECTIVE: The study compared children's reports of two medical events, to assess the effects of the type of event on children's recall. Additionally, the study examined the effect of props on children's event reports. METHOD: Twenty children between the ages of 37 and 67 months were interviewed following either a voiding cysto-urethrogram (VCUG) or a pediatric assessment (PA) at a hospital. Interviews were conducted between 6 and 8 days after the event and included a doll and prop items. RESULTS: Ratings of stress were significantly higher for children who underwent the VCUG than those who underwent the PA. Children who experienced the VCUG procedure reported more correct information than the children who experienced the PA. Age was correlated with the total amount of correct information reported. Stress levels were correlated with both errors and accuracy of information. CONCLUSIONS: Children who experienced a stressful medical procedure remembered more than children who experienced a neutral medical event, although this increase in amount recalled was at the expense of accuracy. These findings suggest that stress impacts negatively on recall: however, the unique and structured nature of the VCUG procedure compared to the PA, and the familiarity of the PA prop items to the children who experienced the VCUG procedure, may also have contributed to differences in recall of the two events.

Child, Preschool↗
PubMed1999

Effects of qualities of early institutional care on cognitive attainment. E.R.A. Study Team. English and Romanian Adoptees.

The adoption of children reared in poor quality Romanian institutions provided a "natural experiment" to determine whether psychological privation is the cause of later deficits. Low IQ at six years was strongly related to the duration of institutional care, with malnutrition having a weaker effect. After taking both into account, there was an additional effect of a particularly marked lack of individualized care.

Child Care↗
PubMed1999

Autism screening questionnaire: diagnostic validity.

BACKGROUND: Good interview and diagnostic measures for autism and other pervasive developmental disorders (PDDs) are available but there is a lack of a good screening questionnaire. AIMS: To develop and test a screening questionnaire based on items in the best available diagnostic interview--the Autism Diagnostic Interview--Revised (ADI-R). METHOD: A 40-item scale, the Autism Screening Questionnaire (ASQ), was developed and tested on a sample of 160 individuals with PDD and 40 with non-PDD diagnoses. RESULTS: The ASQ has good discriminative validity with respect to the separation of PDD from non-PDD diagnoses at all IQ levels, with a cut-off of 15 proving most effective. The differentiation between autism and other varieties of PDD was weaker. CONCLUSIONS: The ASQ is an effective screening questionnaire for PDD.

Adolescent↗
PubMed1999

Tobacco, alcohol and drug use in eight- to sixteen-year-old twins: the Virginia Twin Study of Adolescent Behavioral Development.

OBJECTIVE: This study reports prevalences of lifetime and current alcohol, tobacco and drug use in adolescents; examines associations between substance use and a number of putative risk factors; and estimates the contribution of genetic, shared and unique environmental influences on substance use. METHOD: Substance use data were collected using the Child and Adolescent Psychiatric Assessment on a population sample of 1,412 male and female monozygotic and dizygotic twin pairs, aged 8 through 16, from the Virginia Twin Study of Adolescent Behavioral Development. RESULTS: Heritabilities were estimated to be 84% and 82% for liability to lifetime and current tobacco use, respectively. For alcohol use the role of genes and environment varied according to the context of reporting. Liability to lifetime alcohol use was estimated to be under environmental control, with 71% of the variation shared by members of a twin pair and 29% unique to individual twins. Lifetime alcohol use without the permission of a parent or guardian and current use of alcohol were predominantly explained by genetic factors (h2 = 72% and 74%). The role of genetic factors increased and that of unique environmental factors decreased with increasing severity of alcohol use. Lifetime use of any drug showed a heritability of 45%, with the shared environment accounting for 47% of the variation. Shared environmental factors explained most of the variation in marijuana use. CONCLUSIONS: Genetic factors explained a significant proportion of the variation in the use of tobacco, alcohol and other drugs. Shared environmental factors contributed significantly to lifetime alcohol use and other drug use.

Adolescent↗
PubMed1999

Genetics and child psychiatry: I Advances in quantitative and molecular genetics.

Advances in quantitative psychiatric genetics as a whole are reviewed with respect to conceptual and methodological issues in relation to statistical model fitting, new genetic designs, twin and adoptee studies, definition of the phenotype, pervasiveness of genetic influences, pervasiveness of environmental influences, shared and nonshared environmental effects, and nature-nurture interplay. Advances in molecular genetics are discussed in relation to the shifts in research strategies to investigate multifactorial disorders (affected relative linkage designs, association strategies, and quantitative trait loci studies); new techniques and identified genetic mechanisms (expansion of trinucleotide repeats, genomic imprinting, mitochondrial DNA, fluorescent in-situ hybridisation, behavioural phenotypes, and animal models); and the successful localisation of genes.

Adolescent↗
PubMed1999

Genetics and child psychiatry: II Empirical research findings.

Key substantive findings from quantitative and molecular genetic research are reviewed in relation to affective disorder, schizophrenia, autism, hyperkinetic/attention deficit disorder, oppositional and conduct disorders, drug/alcohol problems, and Tourette's syndrome/chronic tics.

Adolescent↗
PubMed1999

The Emanuel Miller Memorial Lecture 1998. Autism: two-way interplay between research and clinical work.

The two-way interplay between research and clinical practice in relation to autism is reviewed with respect to: (1) diagnosis and syndrome delineation; (2) the nature of the disorder: (3) intervention studies; and (4) aetiology, as manifest during four time periods; (a) the 1950s and 1960s; (b) the 1970s into the mid 1980s; (c) the late 1980s and early 1990s; and (d) the late 1990s. It is concluded that clinical practice has changed out of all recognition during the last 50 years and that research findings have been crucial in bringing about that change. It has not, however, been a one-way traffic. Many key advances were prompted by astute clinical observations and some extravagant research claims were given a more balanced perspective through the light of clinical experience. Crucial research and clinical tasks remain but the means to meet them are there if the opportunities are taken and attention is paid to the lessons of the past.

Autistic Disorder↗
PubMed1999

Quasi-autistic patterns following severe early global privation. English and Romanian Adoptees (ERA) Study Team.

Six per cent of child in a sample of 111 children who were adopted into U.K. families from Romania, and who were systematically assessed at the ages of 4 and 6 years, showed autistic-like patterns of behaviour. A further 6% showed milder (usually isolated) autistic features. Such autistic characteristics were not found in a similarly studied sample of 52 children adopted in the first 6 months of life within the U.K. The children from Romania with autistic patterns showed clinical features closely similar to "ordinary" autism at 4 years but they differed with respect to the improvement seen by age 6 years, to an equal sex ratio, and to a normal head circumference. The children from Romania with autistic features tended to differ from the other Romanian adoptees with respect to a greater degree of cognitive impairment and a longer duration of severe psychological privation.

Adoption↗
PubMed1998

Autism, affective and other psychiatric disorders: patterns of familial aggregation.

BACKGROUND: The liability to autism confers a risk for a range of more subtle autistic-like impairments, but it remains unclear whether it also confers a risk for other psychiatric disturbances. METHODS: To investigate this, we studied the pattern of familial aggregation of psychiatric disorders in relatives of 99 autistic and 36 Down's probands, using family history and direct interview measures. RESULTS: Family history data showed that motor tics, obsessive-compulsive (OCD) and affective disorders were significantly more common in relatives of autistic probands and that individuals with OCD were more likely to exhibit autistic-like social and communication impairments. Direct interview data confirmed the increased rate of affective disorders (especially major depressive disorder) in the first-degree relatives. There was no evidence to indicate significant co-morbidity between affective disorders and the broadly defined phenotype of autism. Moreover, the characteristics of the probands' and the relatives' that were associated with the liability to familiarity of the broader phenotype of autism differed from those that predicted the liability to the familiarity of affective disorders. Examination of the onset of affective disorders suggested that the increased risk was not confined to the period following the birth of the child with autism. CONCLUSIONS: Overall, the results indicated that OCD, but not affective disorders, may index an underlying liability to autism. They also indicated that the increased risk of affective disorders was not solely the consequence of the stress of raising a child with autism and that further research will be required to clarify the mechanisms involved.

Adolescent↗
PubMed1998

Genetic influences on childhood hyperactivity: contrast effects imply parental rating bias, not sibling interaction.

BACKGROUND: Previous twin studies of hyperactivity have supported a 'contrast effect', whereby the more hyperactive the rating of one twin, the less the rating of the other. It has not been clear whether contrast effects occur in the twins' behaviour or in the ratings made of their behaviour but the implications for hyperactivity are different under the two models. METHOD: We use hyperactivity ratings from mothers and teachers for 1644 twin pairs in the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) to explore the origin of contrast effects, making use of independent teacher reports in a proportion of twins. Models were fitted separately for the two informants and jointly to ratings combined through a latent variable, using structural equation modelling. RESULTS: Models for maternal data confirm the contrast effect previously reported. Teacher ratings show a different form of bias, with both twin confusion and correlated errors representing alternative but not mutually exclusive explanations of the data. Latent variable modelling of the joint responses allowed comparison of a model in which the contrast effect was placed on maternal ratings, representing bias, versus one in which the contrast occurred in the underlying 'true' phenotype. The fit of the former model was significantly better. CONCLUSIONS: Support is provided for the notion of contrast effects as a form of rater bias in maternal hyperactivity ratings. Different bias in teacher reports highlight that no one report can be considered a gold standard. The extent to which such biases may distort information for other data sources such as sib-pair studies of concordance/discordance is discussed.

Adolescent↗
PubMed1998

Assortative mating for major psychiatric diagnoses in two population-based samples.

BACKGROUND: Previous studies on assortment for psychiatric disorders have reported discrepant findings. We aimed to test whether there is a significant association for psychiatric diagnoses, including alcoholism, generalized anxiety disorder, major depressive disorder, panic disorder and phobias between husbands and wives in two population-based samples. We further evaluated whether marital resemblance occurs primarily within or across psychiatric disorders and if assortment for psychopathology is primary or secondary to assortment for correlated variables. METHODS: A model for mate selection addressed whether the correlation between mates for psychiatric disorders arises from direct assortment (primary homogamy) or through correlation with other variables for which assortment occurs (secondary homogamy) or through cross-variable assortment. The model accounted for within-person co-morbidity as well as across-spouse data. RESULTS: Findings suggested that a moderate degree of assortment exists both within and across psychiatric diagnoses. Only a small amount of the observed marital resemblance for mental illness could be explained by assortment for correlated variables such as age, religious attendance and education. Similar results were obtained for the two samples separately and confirmed in their joint analysis, revealing that the co-morbidity and assortment findings, except for the marital correlation for age, religious attendance and education, replicate across samples. CONCLUSIONS: Significant but moderate primary assortment exists for psychiatric disorders. The bias in twin studies that have ignored the small amount of assortment is negligible.

Adolescent↗
PubMed1998

Genotype-environment correlations in late childhood and early adolescence: antisocial behavioral problems and coercive parenting.

A key question for understanding the interplay between nature and nurture in development is the direction of effects in socialization. A longitudinal adoption design provides a unique opportunity to investigate this issue in terms of genotype-environment correlations for behavioral problems. As part of the Colorado Adoption Project, adopted children were classified as being at genetic risk (N = 38) or not at genetic risk (N = 50) for antisocial behavior based on their biological mothers' self-report history of antisocial behavior collected prior to the birth of the child. From age 7 through age 12, adoptive parents reported on the negative control, positive parenting, and inconsistent parenting they use in managing their child's behavior. Repeated measures analysis of variance indicated that children at genetic risk were consistently more likely to receive negative parenting from their adoptive parents than children not at genetic risk, indicating an evocative genotype-environment correlation. However, the findings also showed that most of the association between negative parenting and children's externalizing behavior was not explicable on the basis of an evocative gene-environment correlation and that an additional environmentally mediated parental effect on children's behavior was plausible.

Adolescent↗
PubMed1998

Some research considerations on intergenerational continuities and discontinuities: comment on the special section.

Research into intergenerational continuities should pay attention to 9 key considerations: both sides of the family are involved, secular change will affect continuities, discontinuities outweight continuities, societal as well as family influences may be involved, variations in the meaning of traits must be considered, small differences may be misleading, risks may derive from either person characteristics or experiences, identification of mediating mechanisms is a priority, and such mechanisms may include genetic factors.

Humans↗