RESUMEN
BACKGROUND: Autistic-like traits (ALTs), that is restrictions in intuitive social interaction, communication and flexibility of interests and behaviors, were studied in two population-based Swedish twin studies, one in children and one in adults: (1) to examine whether the variability in ALTs is a meaningful risk factor for concomitant attention deficit hyperactivity disorder (ADHD), anxiety, conduct problems, depression and substance abuse, and (2) to assess whether common genetic and environmental susceptibilities can help to explain co-existence of ALTs and traits associated with such concomitant problems. METHOD: Two nationwide twin cohorts from Sweden (consisting of 11 222 children and 18 349 adults) were assessed by DSM-based symptom algorithms for autism. The twins were divided into six groups based on their degree of ALTs and the risk for concomitant mental health problems was calculated for each group. Genetic and environmental susceptibilities common to ALTs and the other problem types were examined using bivariate twin modeling. RESULTS: In both cohorts, even the lowest degree of ALTs increased the risk for all other types of mental health problems, and these risk estimates increased monotonically with the number of ALTs. For all conditions, common genetic and environmental factors could be discerned. Overall, the phenotypic correlation between ALTs and the traits examined were less pronounced in adulthood than in childhood and less affected by genetic compared with environmental factors. CONCLUSIONS: Even low-grade ALTs are relevant to clinical psychiatry as they increase the risk for several heterotypical mental health problems. The association is influenced partly by common genetic and environmental susceptibilities. Attention to co-existing ALTs is warranted in research on a wide range of mental disorders.
Asunto(s)
Trastornos Generalizados del Desarrollo Infantil/epidemiología , Trastornos Generalizados del Desarrollo Infantil/genética , Enfermedades en Gemelos/epidemiología , Enfermedades en Gemelos/genética , Trastornos Mentales/epidemiología , Adolescente , Adulto , Trastornos de Ansiedad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Niño , Estudios de Cohortes , Comorbilidad , Trastorno Depresivo/epidemiología , Femenino , Interacción Gen-Ambiente , Predisposición Genética a la Enfermedad/epidemiología , Humanos , Masculino , Riesgo , Trastornos Relacionados con Sustancias/epidemiología , Suecia/epidemiologíaRESUMEN
OBJECTIVE: The objective was to explore the communication between courts and expert witnesses in legal proceedings concerning child sexual abuse in Sweden. METHOD: A cross professional research team performed a qualitative text analysis of files covering 20 court cases (court report and expert witness statement) from 4 different years (1985, 1989, 1992, and 1997). RESULTS: Expert witnesses applied a wide variety of assessment procedures. Several patterns of communicative difficulties were identified, categorized as "mismatch," "misunderstanding," "misuse," and "missing pieces." Experts and courts sometimes used similar words (e.g., "credibility") but seemed to apply different meanings to them, indicating a lack of a mutual conceptual framework. CONCLUSIONS: The combination of brief expert assignments and diverse assessment procedures turned out to be a specific risk factor for communicative impairment. Alternate strategies for improved communication are discussed.
