Michael Rutter's research while affiliated with The Kings College and other places

Publications (369)

Article
Background Childhood institutional deprivation is associated with growth stunting in childhood but long-term effects in adulthood remain uncertain. Objective To examine the impact of global institutional deprivation experienced in early childhood on subsequent growth with a special focus on final adult height and puberty timing. Participants & se...
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In the last 40 years, there has been a huge increase in autism genetics research and a rapidly growing number of discoveries. We now know autism is one of the most highly heritable disorders with negligible shared environmental contributions. Recent discoveries also show that rare variants of large effect size as well as small effect common gene va...
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Background: Previous findings suggested that associations between childhood hyperactivity and later criminality were mediated mainly by conduct disorders. Method: Information recorded in case notes was used to predict officially recorded criminal convictions later in life among 148 individuals who were seen as child psychiatric patients between 19...
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Beginning in the 1960s, the Isle of Wight studies were among the first to investigate developmental reading problems in representative, population-based samples, using the tools of epidemiology. In this paper, we provide an overview of the contribution of the Isle of Wight studies to research on reading disabilities. We begin with an account of the...
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Background Institutional deprivation in early childhood is associated with neuropsychological deficits in adolescence. Using 20-year follow-up data from a unique natural experiment – the large-scale adoption of children exposed to extreme deprivation in Romanian institutions in the 1980s –we examined, for the first time, whether such deficits are s...
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Significance Millions of children worldwide live in nonfamilial institutions. We studied impact on adult brain structure of a particularly severe but time-limited form of institutional deprivation in early life experienced by children who were subsequently adopted into nurturing families. Institutional deprivation was associated with lower total br...
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Background: Using data from the English & Romanian Adoptees (ERA) study, we recently reported that early time-limited exposure to severe institutional deprivation is associated with early-onset and persistent neurodevelopmental problems and later-onset emotional problems. Here, we examine possible reasons for the late emergence of emotional proble...
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There is an enormous interest in identifying the causes of psychiatric disorders but there are considerable challenges in identifying which risks are genuinely causal. Traditionally risk factors have been inferred from observational designs. However, association with psychiatric outcome does not equate to causation. There are a number of threats th...
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Hypothalamic-pituitary-adrenal (HPA) axis function is disrupted in institutionally-deprived children - reduced morning cortisol, flattened diurnal slope and blunted reactivity persist even after successful adoption into positive family environments. Here we test whether such effects persist into adulthood. Cortisol release across the day (sampled a...
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Background: early life institutional deprivation produces disinhibited social engagement (DSE). Portrayed as a childhood condition, little is known about the persistence of DSE-type behaviours into, presentation during, and impact on, functioning in adulthood. Aims: we examine these issues in the young adult follow-up of the English and Romanian...
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Background: Time-limited, early-life exposures to institutional deprivation are associated with disorders in childhood, but it is unknown whether effects persist into adulthood. We used data from the English and Romanian Adoptees study to assess whether deprivation-associated adverse neurodevelopmental and mental health outcomes persist into young...
Article
Neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder, although most commonly considered in childhood, can be lifelong conditions. In this Personal View that is shaped by clinical experience and research, we adopt a conceptual approach. First, we discuss what disorders are neurodevelopment...
Article
Translational research focuses on innovation in healthcare settings, but this is a two-way process that may have implications for either treatment or prevention. Smoking and lung cancer and the fetal alcohol syndrome are used as examples. Experimental medicine that budges basic and clinical science often constitutes a key way forward. Areas of scie...
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Exposure to adverse rearing environments including institutional deprivation and severe childhood abuse is associated with an increased risk for mental and physical health problems across the lifespan. Although the mechanisms mediating these effects are not known, recent work in rodent models suggests that epigenetic processes may be involved. We s...
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Background Early‐life institutional deprivation is associated with attention‐deficit/hyperactivity disorder (ADHD) later in childhood and adolescence. In this article, we examine, for the first time, the persistence of deprivation‐related ADHD into young adulthood in a sample of individuals adopted as young children by UK families after periods in...
Data
Table S1. Maximum likelihood estimates of the MZ and DZ twin correlations.
Data
Table S2. Maximum likelihood estimates of the genetic and environmental variance components.
Chapter
Concepts of causation are discussed, as are alternative explanations of an association other than causation. Nine types of genetically sensitive natural experiments are described, together with their assumptions and limitations. Social selection biases can be dealt with by designs involving the universal introduction or removal of risks. The use of...
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Background: The etiology of Autism Spectrum Disorder (ASD) has been recently debated due to emerging findings on the importance of shared environmental influences. However, two recent twin studies do not support this and instead re-affirm strong genetic effects on the liability to ASD, a finding consistent with previous reports. This study conduct...
Article
Background: Suggestions have been made that many claims concern false-positive findings in the field of child psychology and psychiatry. Methods: The literature was searched for concepts and findings on the validity of child psychiatry and psychology. Findings: Substantial progress has been made in some, but not all, areas and considerable cha...
Chapter
There is enormous interest in identifying causes of child psychopathology but considerable difficulty in knowing which risks are genuinely causal and in showing how they work. Why is it such a problem and how might we go about testing causal hypotheses? In this chapter we first discuss the threats that clinicians and researchers face in making caus...
Chapter
In this chapter we consider why grouping different neurodevelopmental disorders might be useful for clinical and research purposes and also discuss findings that support this clustering. We then go on to highlight the heterogeneity among them and the implications this has for understanding the meaning of neurodevelopmental impairment.
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Background: Conduct Disorder (CD) is a markedly heterogeneous psychiatric condition. Moffitt (1993) proposed that subclassification of CD should be according to age of onset. Our goals were to compare childhood-onset and adolescent-onset CD in terms of differences in phenotypic risk factors, genetic analyses, and factors associated with the persis...
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The English & Romanian Adoptees (ERA) study follows children who spent their first years of life in extremely depriving Romanian institutions before they were adopted by families in the UK. The ERA study constitutes a "natural experiment" that allows the examination of the effects of radical environmental change from a profoundly depriving institut...
Article
Data on psychiatric problems in adults with autism are inconsistent, with estimated rates ranging from around 25% to over 75%. We assessed difficulties related to mental health in 58 adults with autism (10 females, 48 males; mean age 44 years) whom we have followed over four decades. All were of average non-verbal intelligence quotient when diagnos...
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Clinical genetic studies confirm the broader autism phenotype (BAP) in some relatives of individuals with autism, but there are few standardized assessment measures. We developed three BAP measures (informant interview, self-report interview, and impression of interviewee observational scale) and describe the development strategy and findings from...
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The English & Romanian Adoptees (ERA) study follows children who spent their first years of life in extremely depriving Romanian institutions before they were adopted by families in the UK. The ERA study constitutes a “natural experiment” that allows the examination of the effects of radical environmental change from a profoundly depriving institut...
Article
To identify the broader autism phenotype (BAP), the Family History Interview subject and informant versions and an observational tool (Impression of Interviewee), were developed. This study investigated whether the instruments differentiated between parents of children with autism, and parents of children with Down syndrome (DS). The BAP scores of...
Article
Little is known about adult siblings of individuals with autism. We report on cognitive, social and mental health outcomes in 87 adult siblings (mean age 39 years). When younger all had been assessed either as being "unaffected" by autism (n = 69) or as meeting criteria for the "Broader Autism Phenotype" (BAP, n = 18). As adults, all scored within...
Article
The accompanying Practitioner Review by Munafò et al. (2014) presents two main arguments: (1) that there are few (if any) examples of G × E in psychiatry so it cannot aid gene discovery, and (2) that genome-wide association studies (GWAS) are already yielding important findings. With respect to the supposed weakness of G × E research, they fail to...
Article
This article is a commentary on Fearon et al. (2014, Genetic and environmental influences on adolescent attachment) published in this issue.
Chapter
Recent research has shown that the traditional concept that each diagnosis is separate from all others is mistaken. The evidence shows the high level of overlap. Molecular genetic studies have shown that many genetic influences are pleiotropic and probabilistic, as well as having limited diagnostic specificity. Both common polymorphic variations an...
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A general assumption is that science is just organised commonsense. It is noted that translation involves a two-way pathway between basic laboratory science and patient care, and that some scientific findings have implications for prevention rather than treatment. A succinct critique follows on the key features that differentiate science and common...
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The recent release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association has led to much debate. For this forum article, we asked BMC Medicine Editorial Board members who are experts in the field of psychiatry to discuss their personal views on how the changes in DSM-5 migh...
Article
It is well established that very few individuals with autism spectrum disorders (ASD) and an IQ below 70 are able to live independently as adults. However, even amongst children with an IQ in the normal range, outcome is very variable. Childhood factors that predict later stability, improvement or decline in cognitive functioning remain uncertain a...
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Attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) often co-occur. Factor analyses of ASD traits in children with and without ASD indicate the presence of social and restrictive-repetitive behaviour (RRB) factors. This study used exploratory factor analyses to determine the structure of ASD traits (assessed using the...
Article
Objective: To describe current social functioning in a clinical sample of 60 adults with autism (mean age = 44 years) who were all of average nonverbal IQ (70+) when first diagnosed (mean age = 6.75 years). Method: Outcome measures included standardized diagnostic and cognitive assessments and questionnaires on social functioning. Child and adul...
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A 20 item observational measure of social functioning, the Impression of Interviewee rating scale, is one of three measures devised to assess the broader autism phenotype. The sample studied included families containing at least two individuals with autism spectrum disorder; observations were undertaken by the researcher who interviewed the subject...
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Abstract To examine whether and how the classification of mental disorders can be based on research, we evaluate the relevance of psychiatric science to the major questions in classification. We conclude that most studies cannot inform the validity of diagnostic categories because they are constrained by the classification through a top-down diagno...
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Abstract The major advances that have taken place over the last half century are reviewed with a focus on those that are particularly important with respect to classification issues in the field of child and adolescent psychopathology. Attention is paid to the conceptual issues in DSM and ICD development and differences between the two classificati...
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New research findings provide major challenges regarding our understanding of the concept of autism. These are critically discussed in relation to research relevant to classification, genetics, environmental risk factors, gene-environment interplay, animal models, biomarkers, clinical features, neuropathology, pharmacotherapy, behavioral treatments...
Article
The starting point for the study of adverse experiences is that some have enduring consequences that continue after the period of exposure to the adversity. That raises four basic issues: whether social adversities can be considered homogeneous, whether the crucial effect lies in the "objective" or subjectively perceived "effective" environment, wh...
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Background: It is a universal finding that there is huge heterogeneity in people's responses to all kinds of stress and adversity. Resilience is an interactive phenomenon that is inferred from findings indicating that some individuals have a relatively good outcome despite having experienced serious adversities. Methods: Resilience can only be i...
Chapter
The author distinguishes resilience from concepts of positive psychology and competence by showing that there is heterogeneity in how humans respond to environmental hazards, whether those are physical or psychological. His goal is to explore these different responses in order to discover the causal processes that relate to resilience. His chapter...
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To summarize the advantages and limitations of general population, high-risk and "natural experiment" longitudinal studies for studying psychological change. The English and Romanian Adoptees study is used as an example of a "natural experiment," and detailed findings are provided. What is new is a focus on the young people who spent the whole of t...
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While it is apparent that rare variation can play an important role in the genetic architecture of autism spectrum disorders (ASDs), the contribution of common variation to the risk of developing ASD is less clear. To produce a more comprehensive picture, we report Stage 2 of the Autism Genome Project genome-wide association study, adding 1301 ASD...
Article
Current classification of eating disorders is failing to classify most clinical presentations; ignores continuities between child, adolescent and adult manifestations; and requires frequent changes of diagnosis to accommodate the natural course of these disorders. The classification is divorced from clinical practice, and investigators of clinical...
Article
The concept of resilience has as its starting point the recognition that there is huge heterogeneity in people's responses to all manner of environmental adversities. Resilience is an inference based on evidence that some individuals have a better outcome than others who have experienced a comparable level of adversity; moreover, the negative exper...
Article
There is a debate over whether disruptive behaviour should be regarded as a central component of, or rather as an epiphenomenon with little diagnostic value for, psychopathy. To test whether callous-unemotional traits and conduct disorder can be dissociated in the English and Romanian Adoptee Study, a prospective longitudinal study of adopted indiv...
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Social benefits and quality of group daycare vary greatly across countries; the effects on children may depend on the social context. This study used the prospective Norwegian cohort of 24,259 (MoBa; Norwegian Mother and Child Cohort Study) to examine predictors of group daycare, and the effects of family risk and group daycare on child behaviour a...
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Autism spectrum disorder (ASD) is a highly heritable disorder of complex and heterogeneous aetiology. It is primarily characterized by altered cognitive ability including impaired language and communication skills and fundamental deficits in social reciprocity. Despite some notable successes in neuropsychiatric genetics, overall, the high heritabil...
Article
This study presents follow-up findings on the reading progress of black and white children from an inner London sample between the ages of 10 and 14. At 10, mean scores for black children of West Indian origin were well below those of whites. By 14, black girls had maintained comparable levels of progress with white girls, but there was some eviden...
Article
This study explores the examination attainments of black pupils of West Indian origin and their white peers attending the same inner London secondary schools. At 16, black pupils were underrepresented in the highest exam pass grades, but more likely than whites to have achieved at least some graded results. Viewed against the background of earlier...
Article
This study aimed to establish whether or not young children and young people with autism can understand the mental state of intention. Participants were exposed to personal experience of unintended outcomes, to test if they could distinguish intended vs. unintended actions. Recognizing accidental outcomes was more difficult for normal 4-year-olds t...
Book
Autism is an emerging area of basic and clinical research, and has only recently been recognized as a major topic in biomedical research, and is now an intense growth area in behavioral and educational treatments. This resource provides a comprehensive summary of all current knowledge related to the behavioral, experiential, and biomedical features...
Article
Epilepsy occurs in a significant minority of individuals with autism, but few long-term follow-up studies have been reported, so the prevalence, features (type of seizures, age at onset and severity, etc.) and correlates (IQ history of regression, family history) have only partially been identified. To undertake a long-term follow-up study of indiv...
Article
The characteristics of early developmental regression (EDR) were investigated in individuals with ASD from affected relative pairs recruited to the International Molecular Genetic Study of Autism Consortium (IMGSAC). Four hundred and fifty-eight individuals with ASD were recruited from 226 IMGSAC families. Regression before age 36 months occurred i...
Article
The conceptual issues are briefly noted with respect to the distinctions between classification and diagnosis; the question of whether mental disorders can be considered to be 'diseases'; and whether descriptive psychiatry is outmoded. The criteria for diagnosis are reviewed, with the conclusion that, at present, there are far too many diagnoses, a...
Article
Scientific progress is discussed in relation to clinical issues; genetic issues; environmental issues; and the state of play on psychological treatments. It is concluded that substantial gains in knowledge have been achieved during the last 3 years, and there have been some unexpected findings, but major puzzles remain. We should be hopeful of ever...
Article
Amaral, David Rogers, Sally J Baron-Cohen, Simon Bourgeron, Thomas Caffo, Ernesto Fombonne, Eric Fuentes, Joaquin Howlin, Patricia Rutter, Michael Klin, Ami Volkmar, Fred Lord, Catherine Minshew, Nancy Nardocci, Franco Rizzolatti, Giacomo Russo, Sebastiano Scifo, Renato van der Gaag, Rutger Jan Letter United States J Am Acad Child Adolesc Psychiatr...
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Children growing up in disharmonious families with anxious/depressed mothers are at risk for emotional and behavioral difficulties, however whether these associations reflect postnatal environment, prenatal exposure, or an overall liability is still unclear. This study used prospectively collected data from 24,259 participants of the Norwegian Moth...
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Although autism spectrum disorders (ASDs) have a substantial genetic basis, most of the known genetic risk has been traced to rare variants, principally copy number variants (CNVs). To identify common risk variation, the Autism Genome Project (AGP) Consortium genotyped 1558 rigorously defined ASD families for 1 million single-nucleotide polymorphis...
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The autism spectrum disorders (ASDs) are a group of conditions characterized by impairments in reciprocal social interaction and communication, and the presence of restricted and repetitive behaviours. Individuals with an ASD vary greatly in cognitive development, which can range from above average to intellectual disability. Although ASDs are know...
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The worldwide history of scientific achievements in child and adolescent psychopathology is reviewed from the mid-twentieth century onwards. Attention is drawn, e.g., to diagnostic distinctions, measures of psychopathology, the several roles of epidemiological longitudinal studies, temperament and personality, developmental psychopathology, the use...
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This monograph is concerned with the mid adolescent follow-up of a group of adoptees from Romania and from within the United Kingdom who were first assessed at the age of 4 years (or 6 years in the case of the oldest children). After describing the structure of this monograph, this chapter provides the background as it applied at the time that the...
Article
In this monograph, we have brought the findings of the English and Romanian Adoptee (ERA) study up to age 15 years and, in so doing, have focused especially on the question of whether there are deprivation-specific psychological patterns (DSPs) that differ meaningfully from other forms of psychopathology. For this purpose, our main analytic strateg...
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Throughout this monograph, there has been frequent reference to levels of risk, inference of causation, testing for mediating variables, and the need to consider possible moderating influences. In this chapter, we review what is meant by these concepts, and then seek to pull together the findings from the English and Romanian Adoptee (ERA) studies...
Article
A common polymorphism in the serotonin transporter gene (SLC6A4, 5HTT) has been repeatedly shown to moderate the influence of childhood adversity and stressful life events on the development of psychopathology. Using data from the English and Romanian Adoptee Study, a prospective-longitudinal study of individuals (n = 125) exposed to severe early i...