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Christopher Gillberg

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Christopher Gillberg, born 19 April 1950, is professor of Child and Adolescent Psychiatry at Gothenburg University in Gothenburg, Sweden, and at the medical college St George's, University of London, in Tooting (in south London).

Gillberg is known for his research of autism in children, DAMP, Asperger syndrome and ADHD. He was the founding editor of the journal European Child & Adolescent Psychiatry, and author and editor of several scientific and educational books. He is the recipient of several scientific awards, including the Philips Nordic Prize 2004 for neurological research, and he has authored or co-authored more than 300 scientific papers listed in Medline.

In 2002, Gillberg was accused of having committed scientific fraud for much of his career. In 2004, most of the records of Gillberg's research were deliberately destroyed by Gillberg's wife and other co-workers. The destruction of the potential evidence ended attempts at investigation into misconduct. Gillberg maintains his innocence of misconduct.


Gillberg's Criteria for Asperger's Disorder

Gillberg's criteria are as follows (all six criteria must be met for confirmation of diagnosis) (Gillberg and Gillberg 1989) (Attwood 195-196)

  1. Severe impairment in reciprocal social interaction (at least two of the following)
    1. inability to interact with peers
    2. lack of desire to interact with peers
    3. lack of appreciation of social cues
    4. socially and emotionally inappropriate behavior
  2. All-absorbing narrow interest (at least one of the following)
    1. exclusion of other activities
    2. repetitive adherence
    3. more rote than meaning
  3. Imposition of routines and interests (at least one of the following)
    1. on self, in aspects of life
    2. on others
  4. Speech and language problems (at least three of the following)
    1. delayed development
    2. superficially perfect expressive language
    3. formal, pedantic language
    4. odd prosody, peculiar voice characteristics
    5. impairment of comprehension including misinterpretations of literal/implied meanings
  5. Non-verbal communication problems (at least one of the following)
    1. limited use of gestures
    2. clumsy/gauche body language
    3. limited facial expression
    4. inappropriate expression
    5. peculiar, stiff gaze
  6. Motor clumsiness: poor performance on neurodevelopmental examination

(Note that these criteria are somewhat different than those given in DSM-IV-TR.)

DAMP, MBD, and ADHD

Gillberg played a leading role in developing the concept DAMP (Deficits in Attention, Motor control and Perception) in the 1980s. The new concept was partly based on previous attempts to define diagnostic criteria for MBD (Minimal Brain Dysfunction). Around 1990 DAMP had become a generally accepted diagnostic concept in the Nordic countries. DAMP has sometimes been defined as being similar to ADHD in combination with DCD as defined by DSM-IV. (In the WHO system, it would be a hyperkinetic disorder combined with a developmental disorder of motor function.) About half of the children with ADHD are believed to also have DCD.[1]

Criticism and controversy

Gillberg's research showed that roughly ten percent of all children have either DAMP, or other neurological problems. His results regarding DAMP have been criticised by the sociologist Eva Kärfve at the University of Lund, and the pediatrician Leif Elinder. The two critics accused Gillberg of forging his data. Kärfve and Elinder (as private persons) then demanded access to the research material behind the so-called Gothenburg study about DAMP, but they were denied this, on the grounds of patient confidentiality. They asked for the data to be anonymized (i.e. obfuscated so that individuals cannot be identified: this is a standard practice), but were told that this could not be done.[2] They then took the matter to civil court, where it was decided that they would be allowed to access some of the research material, although the material on patients falls under privacy restrictions.[3]

Gillberg refused to respect the court's decision. Instead, the Gillberg group informally asked Ove Lundgren, the Chairman of the Ethics Committee (and a Professor Emeritus of Physiology at the university), to look at the research material as a private person (i.e. not representing the Committee).[4][5] There was 22 meters (about 100.000 pages) of material.[2][4][6] Lundgren was given four hours to scrutinize all this; he found nothing obviously wrong. Gillberg and the president of the faculty of health sciences (Sahlgrenska Academy) at the university then told the media that Gillberg had been cleared by the Ethics Committee.[4][5][7][8] The Ethics Committee responded to this by publishing a letter stating explicitly that no investigation had been done regarding misconduct in Gillberg's research and that the Committee "never exonerated Gillberg from the allegations".[5]

Lundgren later said the following in a letter to the rector, Gunnar Svedberg (dated 2005-02-21):

I made it perfectly clear to the Gillberg group (C Gillberg, P Rasmussen) that I - based my four hour inspection - never could certify that there had not been a misconduct of research. I have never in my professional life been used in such a way as I have been used in this affair.

In May 2004, three of Gillberg's coworkers deliberately destroyed most of the research material. In June 2005, Gillberg and the rector of Gothenburg University were convicted for not handing the material over to Kärfve and Elinder. Gillberg received a suspended sentence and a fine; the rector received a fine.[3] In March 2006, the three coworkers were convicted for destroying the data. Each of the three received a suspended sentence and a fine: Peder Rasmussen, Carina Gillberg (wife of Christopher Gillberg), and Kerstin Lamberg.[6]

Lamberg is vice-chairman of the Autism (Patients) Society (Riksföreningen Autism).[9] Both the Autism Society and the Attention (Patients) Society (Riksförbundet Attention) have remained strong supporters of Gillberg.[10][11]

The whole affair has been given considerable attention by Swedish newspapers, television, etc.

After the destruction of most of the research material, further attempts at formal investigation into potential misconduct became essentially impossible. It might be noted, though, that Per-Anders Rydelius, Professor of Child Psychiatry at the Karolinska Institute, and Rolf Zetterstrom, past chief editor of Acta Paediatrica, published a somewhat-investigative report in the Swedish journal Dagens Medicin.[12][13] The report pointed out that the Gillberg group, in order to prove their hypothesis, repeatedly changed diagnoses and information in their material: "Accessible articles (from the Gillberg group) reveal that those studied have been managed in an unscientific way - a conclusion which does not need strengthening by what could have been found in the destroyed research material".

Separately, Sir Michael Rutter stated in 2003 that the concept of DAMP (unlike ADHD) was "muddled" and "lacks both internal coherence and external discriminative validity ... it has no demonstrated treatment or prognostic implications".[2] He concluded that the concept should be abandoned.

Bibliography

Books (incomplete list)

  • Gillberg, Christopher (1981). Neuropsychiatric aspects of perceptual, motor and attentional deficits in seven-year-old Swedish children. Uppsala: Uppsala University. ISBN 9155412122.
  • Coleman, Mary; Gillberg, Christopher (1985). The biology of the autistic syndromes. New York: Praeger. ISBN 0030008344.{{cite book}}: CS1 maint: multiple names: authors list (link)
  • Gillberg, Christopher (ed.) (1989). Diagnosis and treatment of autism. New York: Plenum Press. ISBN 0306434814. {{cite book}}: |author= has generic name (help)
  • Gillberg, Christopher (1995). Clinical Child Neuropsychiatry. Cambridge University Press. ISBN 0521543355.
  • Gillberg, Christopher; Peeters, Theo (1998). Autism: medical and educational aspects. London: Whurr. ISBN 0521543355.{{cite book}}: CS1 maint: multiple names: authors list (link)
  • Gillberg, Christopher (2002). A Guide to Asperger Syndrome. Cambridge University Press. ISBN 0521001838.
  • Gillberg, Christopher; Harrington, Richard; Steinhausen, Hans-Christoph (2006). A clinician's handbook of child and adolescent psychiatry. Cambridge: Cambridge University Press. ISBN 9780521819367.{{cite book}}: CS1 maint: multiple names: authors list (link)

Journal articles (selected)

Ehlers, Stefan (Nov, 1993). "The Epidemiology of Asperger Syndrome: A Total Population Study". Journal of Child Psychology and Psychiatry and Allied Disciplines. 34. The Association for Child Psychology and Psychiatry: 1327–1350. ISSN: 0021-9630. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)

Philippe, Anne (May, 1999). "Genome-wide scan for autism susceptibility genes". Human Molecular Genetics. 8 (5). Oxford University Press: 805–812. doi:10.1093/hmg/8.5.805. ISSN: 1460-2083. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)

References

  1. ^ Martin et al., 2006
  2. ^ a b c Gallup et al., 2005
  3. ^ a b White, 2005
  4. ^ a b c Investigate, May 2006, p.52
  5. ^ a b c Lundgren et al., 2005
  6. ^ a b Wärngård, 17 March 2006
  7. ^ White, 2004
  8. ^ Snaprud, 2005
  9. ^ Investigate, May 2006, p.53
  10. ^ Riksföreningen Autism, 2006
  11. ^ Riksförbundet Attention, 2005
  12. ^ Rydelius & Zetterström, 25 May 2005
  13. ^ Investigate, May 2006, p.52

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