Christopher Gillberg

Christopher Gillberg
Born	(1950-04-19) 19 April 1950 (age 74) Gothenburg, Sweden
Nationality	Swedish
Occupation	Professor
Known for	Autism research Research controversy regarding the Gothenburg Study of Children with DAMP Deficits in attention, motor control and perception,

Lars Christopher Gillberg (born 19 April 1950) is a professor of child and adolescent psychiatry at Gothenburg University in Gothenburg, Sweden. He has been a visiting professor at the universities of Bergen, New York, Odense, St George's (University of London), San Francisco, and Glasgow and Strathclyde.[1][2] Gillberg is the founding editor of the journal European Child & Adolescent Psychiatry.

Autism research

In the early 1980s, the concept of an 'autism spectrum' was introduced by Lorna Wing and Gillberg.[3] Gillberg has done extensive research into autism throughout his academic career. In 2003, a French and Swedish research team at the Institut Pasteur and the psychiatry departments at Gothenburg University and University of Paris, led by Thomas Bourgeron, Marion Leboyer and Gillberg, discovered the first precisely identified genetic mutations in individuals with autism.[4] The team identified mutations altering two genes on the X chromosome which seem to be implicated in the formation of synapses (communication spaces between neurons), in two families where several members are affected. Previous studies, such as the Paris Autism Research International Sib-Pair Study (PARIS), coordinated by Gillberg and Marion Leboyer, have more generally associated the X-chromosome regions with autism. The 2003 breakthrough indicated the location of the mutation to be on the NLGN4 gene and the NGLN3 gene. The mutation prevents a complete protein from forming and is inherited from the mother.[5]

Beginning in 2006, Gillberg is involved in a cross-disciplinary project titled "Autism spectrum conditions: the Gothenburg collaborative studies", funded by the Swedish Research Council (Vetenskapsrådet).[6] The project is a collaboration between scientists specialized in child and youth psychiatry, molecular biology and neuroscience and involves a genetic part with an international study team of French, British and U.S. researchers examining various aspects autism. Some of the results were published during 2007.[7][8] The project also includes a genetic study on the Faroe Islands.[6][9]

DAMP, MBD, and ADHD

In the 1970s, Gillberg and co-workers developed the concept Deficits in Attention, Motor control and Perception (DAMP), which was primarily used in Scandinavia.[10][11] The DAMP concept as used in more recent publications, refers to Attention-deficit hyperactivity disorder (ADHD) in combination with Developmental Coordination Disorder (DCD). According to Gillberg, it constitutes a "subgroup of the diagnostic category of ADHD, conceptually similar – but not clinically identical – to the WHO concept of HKD (hyperkinetic disorder)" and is diagnosed on the basis of "concomitant attention deficit/hyperactivity disorder and developmental coordination disorder in children who do not have severe learning disability or cerebral palsy".[12]

Some scholars disagree with the lumping of ADHD and DCD, arguing that they are unrelated.[13] Gillberg stated in 2003 that, although he opines that there is a "very real issue of how to deal with the conflict between splitting (ADHD plus DCD) and lumping (DAMP)", he nevertheless feels that "the DAMP construct has been helpful in identifying a group of children with ADHD and multiple needs that will not be self evident if the diagnosis is just ADHD or just DCD."[12] Before the Scandinavian studies, recognition that individuals with attention problems may also have difficulties with movement, perception, and memory had received little attention in studies.[13] According to various studies, half of the children with ADHD also have DCD.[14]

With the development of the ADHD concept, the previous, less precise, category of Minimal Brain Dysfunction (MBD), "a term almost universally employed in child psychiatry and developmental paediatrics from the 1950s to the early 1980s"[12] was replaced. Gillberg began to study DAMP in the late 1970s, when ADHD was still called MBD and the DAMP concept has been adjusted as the term ADHD was introduced and became internationally used. Around 1990, DAMP had become a generally accepted diagnostic concept in two Nordic countries,[15] but when the DSM-IV appeared in 1994, DAMP became considered a redundant term in many countries, since DAMP is essentially equivalent to ADHD in combination with DCD as defined by DSM-IV.[12][16] Gillberg's four criteria for DAMP are:

• ADHD as defined in DSM-IV
• Developmental coordination disorder as defined in DSM-IV
• Condition not better accounted for by cerebral palsy
• IQ higher than about 50 [Gillberg, 2003: box 1]

According to Gillberg, clinically severe form DAMP (or ADHD + DCD) affects about 1.5% of the general population of school age children; another few per cent are affected by more moderate variants. Boys are overrepresented; girls are currently probably underdiagnosed. There are many overlapping conditions, including conduct disorder, depression/anxiety, and academic failure. There is a strong link with autism spectrum disorders in severe DAMP. Familial factors and pre- and perinatal risk factors account for much of the variance. Psychosocial risk factors appear to increase the risk of marked psychiatric abnormality in DAMP. Outcome in early adult age was psychosocially poor in one study in almost 60% of unmedicated cases. About half of all cases with ADHD have DCD, and conversely, ADHD occurs in about half of all cases of DCD.[12]

As of December 2024^[update], Gillberg has published 780 papers (listed at PubMed) on DAMP, ADHD and related conditions.[12]

Gillberg's criteria for Asperger syndrome

In 1989, Gillberg became instrumental in the publication of the first diagnostic criteria for Asperger syndrome.[17] They are applied in clinical practice due to the adhesion to the original description of Hans Asperger.[18] All of the following six criteria must be met for confirmation of diagnosis:[19]

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

Gillberg's criteria differ from those given in the DSM-IV-TR. Some scholars have therefore criticized them for "making it difficult to compare with other studies."[20] It has been argued that the failure of some research groups to replicate some of Gillberg's findings "may relate primarily to fundamental differences in diagnostic approach".[20]

Awards

Gillberg has received several awards for his research, including:

• Fernström prize,1991^[citation needed]
• Ingvar Award, 1995^[citation needed]
• The Ronald McDonald Major Award for Paediatrics, 1998 ^[citation needed]
• Ågrenska Major Medicine Prize, 2001^[citation needed]
• Philips Nordic Prize in 2004 ^[citation needed]
• Honorary professorship at the UCL Institute of Child Health, University College London in 2008.^[better source needed][21]
• The King's Medal of the Seraphim order, 2009[22]
• Dahlberg award, 2010. ^[citation needed]
• The Söderberg Prize for Medicine, 2012
• In 2010, the Gillberg Neuropsychiatry Centre, named after Gillberg, within the Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, was founded.
• 2016 INSAR Lifetime Achievement Award at the International Meeting for Autism Research^[citation needed]
• Arvid Carlsson Foundation Major Prize (2024)
• The Hilda och Alfred Eriksson Prize from the Royal Academy of Science in Sweden (2024)

See also

• Gothenburg Study of Children with DAMP
• Rapid-onset gender dysphoria controversy

Notes

1. Munk-Jørgensen, P. (2003). "Biographies". Acta Psychiatrica Scandinavica. 108 (2): 160. doi:10.1034/j.1600-0447.2003.00154.x. S2CID 221438541.
2. Modern Approaches in Learning Disabilities Conference Archived 3 December 2008 at the Wayback Machine. Developmental Disabilities Research Group (DDREG) 2005 annual conference, South West Centre for Education, Research & Development. Retrieved 23 May 2008.
3. Gillberg, C. (2006) "Autism Spectrum Disorders". A Clinician's Handbook of Child and Adolescent. Eds. Christopher Gillberg, Richard Harrington and Hans-Christoph Steinhausen. Cambridge University Press, 2006. ISBN 0-521-81936-9, p. 447.
4. Gosline, Anna. "Roadmap to unravelling autism revealed". New Scientist, 28 June 2005. Retrieved 20 August 2006.
5. Betancur, Catalina; et al. (2003). "Mutations of the X-linked genes encoding neuroligins NLGN3 and NLGN4 are associated with autism". Nature Genetics. 34 (1): 27–29. doi:10.1038/ng1136. PMC 1925054. PMID 12669065. Press release: "Two genes associated with autism" Archived 12 September 2006 at the Wayback Machine. Press Office, Institut Pasteur, University of Paris. 31 March 2003. Retrieved 20 August 2006.
6. Vetenskapsrådet. Detaljerad information för diarienr 2006–3449 Archived 24 May 2010 at the Wayback Machine: Gillberg, Christopher "Psychiatric diseases". 8 November 2006 (in Swedish). Retrieved 6 May 2008.
7. Christopher Gillberg Archived 9 February 2012 at the Wayback Machine. Scientific Commons. Retrieved 6 May 2008.
8. Buxbaum JD, Cai G, Nygren G, et al. (2007). "Mutation analysis of the NSD1 gene in patients with autism spectrum disorders and macrocephaly". BMC Med. Genet. 8: 68. doi:10.1186/1471-2350-8-68. PMC 2248565. PMID 18001468.
9. Ellefsen, Asa et al. (2008). "Autism in the Faroe Islands. An Epidemiological Study". Journal of Autism and Developmental Disorders, 37-3 (March 2007), pp. 437–444.
10. Gillberg, C. (2003). "Deficits in attention, motor control, and perception: A brief review". Archives of Disease in Childhood. London: Oct 2003. Vol. 88, Iss. 10; p. 904: "In Scandinavia, the DAMP (deficits in attention, motor control, perception) concept was developed in the 1970s, in an attempt to operationalise the syndrome of MBD, long before the publication of the DSM-III-R (in which ADHD appeared in a formalised fashion for the first time)."
11. Tervo, Raymond C. et al. (2002)."Children with ADHD and motor dysfunction compared with children with ADHD only". Developmental Medicine & Child Neurology 2002; 44, p. 383: "Establishing a diagnosis is often difficult because separately identified disorders such as DCD and attention-deficit-hyperactivity disorder (ADHD) have a substantial overlap (Bax 1999). A child who has problems of attention may have difficulties with movement, perception, and memory (Gillberg and Rasmussen 1982a,b). In Scandinavia these overlapping symptoms and signs are labeled as deficits in attention, motor control, and perception (DAMP)".
12. Gillberg, Christopher (2003). "Deficits in attention, motor control, and perception: a brief review". Archives of Disease in Childhood. 88 (10): 904–910. doi:10.1136/adc.88.10.904. PMC 1719331. PMID 14500312.
13. Tervo Raymond C.; et al. (2002). "Children with ADHD and motor dysfunction compared with children with ADHD only". Developmental Medicine & Child Neurology. 2002 (44): 383–390. doi:10.1111/j.1469-8749.2002.tb00832.x.
14. Martin, Neilson C.; Piek Jan P; Hay, David (February 2006). "DCD and ADHD: A genetic study of their shared aetiology". Human Movement Science. 25 (1). The Association for Child Psychology and Psychiatry: 110–124. doi:10.1016/j.humov.2005.10.006. ISSN 0167-9457. PMID 16442650.
15. Airaksinen E; Bille B; Carlström G; Diderichsen J; Ehlers S; Gillberg C; et al. (1991). "Barn och ungdomar med DAMP/MBD". Läkartidningen. 88: 714.
16. Gillberg, Christopher (1999). "Nordisk enighet om DAMP/ADHD – Aktuellt dokument sammanfattar dagens kunskap". Läkartidningen. 96: 3330–3331.
17. Attwood, Tony (2006). The Complete Guide to Asperger's Syndrome. Jessica Kingsley Publishers, 2006. ISBN 1-84310-495-4, p.36: "One of the results of the discussions [at a small international conference about Asperger's syndrome in London in 1988] was the publication of the first diagnostic criteria in 1989, revised in 1991 (Gillberg 1991; Gillberg and Gillberg 1989)".
18. Attwood, Tony (2006). The Complete Guide to Asperger's Syndrome. Jessica Kingsley Publishers, 2006. ISBN 1-84310-495-4, p.36: "the criteria of Christopher Gillberg, who is based in Sweden and London, remain those that most closely resemble the original descriptions of Asperger. Thus, these are the criteria of first choice for me and many experienced clinicians."
19. Gillberg IC, Gillberg C (July 1989). "Asperger syndrome—some epidemiological considerations: a research note". J Child Psychol Psychiatry. 30 (4): 631–638. doi:10.1111/j.1469-7610.1989.tb00275.x. PMID 2670981.
20. Klin Ami; Pauls, David; Schultz, Robert; Volkmar, Fred (2005). "Three Diagnostic Approaches to Asperger Syndrome: Implications for Research". Journal of Autism and Developmental Disorders. 35 (2): 221–234. doi:10.1007/s10803-004-2001-y. PMID 15909408. S2CID 19076633.
21. Staff list. ICH, Academic units, Neurosciences. Retrieved 23 May 2008.
22. Professor Christopher Gillberg awarded H.M. The King's Medal Archived 24 February 2012 at the Wayback Machine. University of Gothenburg, 30 January 2009. Retrieved 16 June 2009.

• Wärngård M. (17 March 2006), "Villkorligt och böter för Gillbergmedarbetare."^[permanent dead link‍] Dagens Medicin. [In Swedish.]
• White, Caroline (10 July 2004), "Destruction of data prompts calls for Swedish agency to investigate research misconduct." British Medical Journal, 329: 72.
• White C (July 2005). "Swedish court rules against doctor at centre of row over destroyed research data". BMJ. 331 (7510): 180. doi:10.1136/bmj.331.7510.180-f. PMC 1179809. PMID 16037439.

Selected publications by Gillberg

Journal articles

• Steffenburg, Suzanne; Gillberg Christopher; Hellgren Lars; et al. (May 1989). "A Twin Study of Autism in Denmark, Finland, Iceland, Norway and Sweden". Journal of Child Psychology and Psychiatry, and Allied Disciplines. 30 (3). The Association for Child Psychology and Psychiatry: 405–416. doi:10.1111/j.1469-7610.1989.tb00254.x. ISSN 0021-9630. PMID 2745591.

• Baron-Cohen, Simon; Jane Allen; Christopher Gillberg (December 1992). "Can Autism Be. Detected at 18 Months? The Needle, the Haystack and the CHAT". The British Journal of Psychiatry. 161 (6). The Royal College of Psychiatrists: 839–43. doi:10.1192/bjp.161.6.839. ISSN 0007-1250. PMID 1483172. S2CID 196176.

• Ehlers S, Gillberg C (1993). "The epidemiology of Asperger's syndrome. A total population study". J Child Psychol Psychiatry. 34 (8): 1327–50. doi:10.1111/j.1469-7610.1993.tb02094.x. PMID 8294522.
• Happe, Francesca; Ehlers Stefan; Fletcher Paul; et al. (20 December 1996). "'Theory of mind' in the brain. Evidence from a PET scan study of Asperger syndrome". NeuroReport. 8 (1). Rapid Science Publishers: 197–201. doi:10.1097/00001756-199612200-00040. hdl:21.11116/0000-0001-A166-6. ISSN 0959-4965. PMID 9051780. S2CID 2970614.

• Philippe, Anne; Martinez Maria; Guilloud-Bataille Michel; et al. (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. PMID 10196369.

• Jamain, Stéphane; Quach Hélène; Betancur Catalina; et al. (31 March 2003). "Mutations of the X-linked genes encoding neuroligins NLGN3 and NLGN4 are associated with autism". Nature Genetics. 34 (1). Nature Publishing Group: 27–29. doi:10.1038/ng1136. ISSN 1061-4036. PMC 1925054. PMID 12669065.

• Ståhlberg, Ola; Söderström Henrik; Råstam, Maria; et al. (July 2004). "Bipolar disorder, schizophrenia, and other psychotic disorders in adults with childhood onset AD/HD and/or autism spectrum disorders". Journal of Neural Transmission. 111 (7). Springer Wien: 891–902. doi:10.1007/s00702-004-0115-1. ISSN 0300-9564. PMID 15206005. S2CID 7824831.

• Miller, Marilyn T.; Strömland, Kerstin; Ventura Liana; et al. (April–May 2005). "Autism associated with conditions characterized by developmental errors in early embryogenesis: a mini review". International Journal of Developmental Neuroscience. 23 (2–3). Elsevier: 201–219. doi:10.1016/j.ijdevneu.2004.06.007. ISSN 0736-5748. PMID 15749246. S2CID 14248227.

Selected books

• Gillberg, Christopher (1981). Neuropsychiatric aspects of perceptual, motor and attentional deficits in seven-year-old Swedish children. Uppsala: Uppsala University. ISBN 978-91-554-1212-8.

• Coleman, Mary; Gillberg, Christopher (1985). The biology of the autistic syndromes. New York: Praeger. ISBN 978-0-03-000834-4.

• Gillberg, Christopher, ed. (1989). Diagnosis and treatment of autism. New York: Plenum Press. ISBN 978-0-306-43481-5.

• Gillberg, Christopher (1995). Clinical Child Neuropsychiatry. Cambridge University Press. ISBN 978-0-521-54335-4.

• Gillberg, Christopher (1997). Barn, Ungdomar och vuxna med Asperger Syndrom – Normala, geniala, nördar? (in Swedish). Gothenburg: Bokförlaget Cura AB. ISBN 978-91-972641-6-7.

• Gillberg, Christopher; Peeters, Theo (1998). Autism : medical and educational aspects. London: Whurr. ISBN 978-0-521-54335-4.

• Gillberg, Christopher (2002). A Guide to Asperger Syndrome. Cambridge University Press. ISBN 978-0-521-00183-0.

• Gillberg, Christopher; Harrington, Richard; Steinhausen, Hans-Christoph (2006). A clinician's handbook of child and adolescent psychiatry. Cambridge: Cambridge University Press. ISBN 978-0-521-81936-7.
• Coleman M, Gillberg C, The Autisms, Oxford University Press, 2012
• Gillberg C, ADHD and its many associated problems, Oxford University Press, 2014
• Gillberg C, Råstam M, Fernell E (red.) Barn och Ungdomspsykiatri, Natur & Kultur, 2015
• Gillberg C, ESSENCE Om ADHD, autism och andra utvecklingsavvikelser Archived 29 August 2019 at the Wayback Machine, Natur & Kultur, 2018

External links

• Child psychiatric diagnoses – Christopher Gillberg – Iriss, 16 November 2007
• Philips Prize – Information about the Philips Prize
• European Child & Adolescent Psychiatry (journal)
• The Autism Puzzle Archived 14 November 2011 at the Wayback Machine (A BBC documentary featuring Gillberg)
• An interview with Gillberg in Looking Up (an autism newsletter) 3:12, 2005.
• Kärfe, Elinder, and others defend their accusations – "Rapid responses" submitted to British Medical Journal, 2004
• "Various responses to Kärfve". Archived from the original on 22 November 2002. Retrieved 21 July 2006. Gothenburg University, 2001 (in Swedish)
• Riksförbundet Attention supports Gillberg Official web page in Swedish, 21 August 2005. (Riksförbundet Attention is a national Swedish association for people with neuropsychiatric disabilities.)
• Riksföreningen Autism supports Gillberg Press release in Swedish. Undated, 2006. (Riksföreningen Autism is the national Swedish association for people with autism and autism-like disorders.)
• Letter to the Swedish Chancellor of Justice The Swedish Child Neuropsychiatry Science Foundation. Letter detailing the actions by Christopher Gillberg opponents, the involvement of public figures and the media, and the legal process.
• Autism And Pre Tactile Impotency