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Book Forum: CHILD PSYCHIATRY   |    
Research and Innovation on the Road to Modern Child Psychiatry, vol. 1: Festschrift for Professor Sir Michael Rutter ? Research and Innovation on the Road to Modern Child Psychiatry, vol. 2: Classic Papers by Professor Sir Michael Rutter
LAWRENCE HARTMANN, M.D.
Am J Psychiatry 2003;160:196-197. doi:10.1176/appi.ajp.160.1.196
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Edited by Jonathan Green and Bill Yule. London, Gaskell (Royal College of Psychiatrists), 2001, 166 pp., £25.00 (paper). • Edited by Eric Taylor and Jonathan Green. London, Gaskell (Royal College of Psychiatrists), 2001, 340 pp., £25.00 (paper).

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Michael Rutter, the first professor of child psychiatry in Great Britain, has been astonishing in his sustained thoughtful energy and wide-ranging productivity, and has been one of the great figures in child psychiatry for about a third of a century. With multiple honors, he retired in the late 1990s from many administrative roles in British and international psychiatry, but he remains an active research professor and remains the dean of world child psychiatry to most world child psychiatrists and many colleagues in related fields—even to those of us more centered in the United States and/or with more background and interest than Dr. Rutter has in the psychoanalytic aspects of child psychiatry.

The two volumes under review were jointly published by the Child and Adolescent Faculty of the Royal College of Psychiatrists and the Association for Child Psychology and Psychiatry. The first volume contains papers by friends and colleagues in honor of Dr. Rutter as well as two new papers by Dr. Rutter himself, on the occasion of his retirement from the Medical Research Center Child Psychiatry Unit in 1998. Volume 2 includes a collection of classic papers by Dr. Rutter, some written with collaborators. The scope of these volumes is large, and the contributors are distinguished. The career and achievements of Dr. Rutter are almost exhausting to contemplate.

Fortunately for those who lack years of acquaintance with Dr. Rutter’s ideas and works, volume 1 has a useful brief foreword as well as a useful, longer summarizing afterword, and volume 2 has a fine overview introduction to Dr. Rutter’s scientific contributions, written by Eric Taylor. Also fortunately, Dr. Rutter and a majority of those colleagues who contributed articles generally retain both clarity and skepticism about the work done and the many areas still unclear or unknown.

Child psychiatry is often described as being about 100 years old. Fifty years ago, child psychiatry was still young, heavily psychoanalytic, good-natured, idealistic, inventive, full of social conscience, interested in the environment and psychology far more than biology, spottily insightful, helpful to many, probably lacking in humility, certainly lacking in scientific solidity, and often seen as somewhat marginal. Dr. Rutter has contributed centrally to the growth of child psychiatry into a far more firmly established medical and biopsychosocial specialty with a solid scientific base.

Predominantly a phenomenologist and not at all psychoanalytic (the many long bibliographies refer hardly at all to any psychoanalyst), Dr. Rutter is interested in, and very good at, asking questions and adding social, biological, genetic, and epidemiologic data to child psychiatry. He is usually respectful of biopsychosocial complexity and integration—more so, I think, than some of his followers and admirers, who are sometimes capable of biological or behavioral reductionism.

Dr. Rutter’s work has included early and excellent epidemiologic studies (Isle of Wight, inner London); studies of autism involving a wide range of scientific techniques and disciplines, including DNA study and neuroimaging; links between research and practice; deprivation; influences of families and schools; genetics; reading disorders; biological, social protective, and risk factors; interactions of biological and social factors; stress; longitudinal as well as epidemiologic studies, including childhood and adult experiences and conditions; and continuities and discontinuities in normal and pathological development. Across wide psychiatric areas, I have repeatedly enjoyed his skepticism and his asking good and powerful questions.

Volume 2 begins with two articles on developmental psychopathology: "Pathways From Childhood to Adult Life" (1989), and "Epidemiological Approaches to Developmental Psychopathology"(1988). After an article on genetics, "Opportunities for Psychiatry From Genetic Findings" (1997), there are two articles on assessment: "Classification and Categorization in Child Psychiatry" (1965) (a good paper for all child psychiatry fellows to read) and "Psychiatric Interviewing Techniques, IV: Experimental Study: Four Contrasting Styles" (1981). A section on psychiatric disorders includes "Genetic Influences and Autism" (1997), "The Treatment of Autistic Children" (1985), "Heterogeneity of Antisocial Behavior: Causes, Continuities, and Consequences" (1997), "Syndromes Attributed to ‘Minimal Brain Dysfunction’ in Childhood" (1982), "Psychological Sequelae of Brain Damage in Children" (1981), and "Adolescent Turmoil: Fact or Fiction?" (1976) (Rutter is cautious about, but not wholly dismissive of, such turmoil).

The last section is on psychosocial risks and includes "Maternal Deprivation 1972–1978: New Findings, New Concepts, New Approaches" (1979), "Family and School Influences on Cognitive Development" (1985), "Family and School Influences on Behavioural Development"(1985), and "Why Are London Children So Disturbed?" (1973). Finally, there is an 18-page summary of Dr. Rutter’s principal publications, ending with a reassuring half-page labeled "in press."

Volume 1, full of papers worthy of longer comment than this review can provide, includes papers on longitudinal research by Barbara Maughan; genetic variation by Jim Stevenson; developmental psychopathology by Dante Cicchetti; autism by Dr. Rutter; developmental neuropsychiatry by Eric Taylor; research on autism by Fred Volkmar; classification revisited by David Shaffer; conduct disorder by Lee Robins; psychosocial adversity and child psychopathology by Dr. Rutter; and a summarizing afterword by Ann LeCouteur.

Few future Festschrifts are likely to be published in such a generous two-volume format, but in the case of Dr. Rutter it seems to me justified, educational, and efficient to have many of his seminal papers collected in one volume and many cogent papers in his honor in another.

Most psychiatrists, whether they know it or not, directly or indirectly have learned from Michael Rutter. All psychiatrists who read or even browse in these two volumes will learn more, from a master.

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