Christopher Gillberg


Lars Christopher Gillberg is a professor of Child and Adolescent Psychiatry at the University of Gothenburg in Gothenburg, Sweden. He has been a visiting professor at the universities of Bergen, New York, Odense, St George's , San Francisco, Glasgow, and Strathclyde. Gillberg is the founding editor of the journal European Child & Adolescent Psychiatry.

Autism research

In the early 1980s, the concept of the 'autism spectrum' was introduced by Lorna Wing and Gillberg. Gillberg has conducted extensive research on autism throughout his academic career. In 2003, a French and Swedish research team at the Institut Pasteur, and the psychiatry departments at University of Gothenburg and the University of Paris, led by Thomas Bourgeron, Marion Leboyer, and Gillberg, discovered the first precisely identified genetic mutations in individuals with autism. The team identified mutations altering two genes on the X chromosome, which appear to play a role in the formation of synapses, in two families where multiple members were diagnosed with autism. Earlier studies, such as the Paris Autism Research International Sib-Pair Study, coordinated by Gillberg and Marion Leboyer, have more generally associated the X-chromosome regions with autism. The 2003 findings 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.
Since 2006, Gillberg has participated in a cross-disciplinary project titled "Autism spectrum conditions: the Gothenburg collaborative studies", funded by the Swedish Research Council. 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 of autism. Some of the results were published in 2007. The project also includes a genetic study on the Faroe Islands.

DAMP, MBD, and ADHD

In the 1970s, Gillberg and colleagues introduced the concept Deficits in Attention, Motor Control and Perception, primarily used in Scandinavia. The DAMP concept as used in more recent publications, refers to Attention-deficit hyperactivity disorder in combination with Developmental Coordination Disorder. 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 ", 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".
Some scholars disagree with the lumping of ADHD and DCD, arguing that they are unrelated. In 2003, Gillberg noted that, although there could be "an issue of how to deal with the conflict between splitting and lumping ", he maintained that "the DAMP construct has helped identify a group of children with ADHD and multiple needs that will not be self-evident if the diagnosis is just ADHD or just DCD." 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. According to various studies, half of the children with ADHD also have DCD.
With the development of the ADHD concept, the previous, less precise, category of Minimal Brain Dysfunction, "a term almost universally employed in child psychiatry and developmental pediatrics from the 1950s to the early 1980s" 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, 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. Gillberg's four criteria for DAMP are:
According to Gillberg, clinically severe form of DAMP affects roughly 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.
, Gillberg has authored 780 papers on DAMP, ADHD and related conditions.

Gillberg's criteria for Asperger syndrome

In 1989, Gillberg created one of the first diagnostic criteria for Asperger syndrome, which was revised in 1991. They are applied in clinical practice due to the adhesion to the original description of Hans Asperger. All of the following six criteria must be met for confirmation of diagnosis:
  1. Severe impairment in reciprocal social interaction
  2. #Inability to interact with peers
  3. #Lack of desire to interact with peers
  4. #Lack of appreciation of social cues
  5. #Socially and emotionally inappropriate behavior
  6. All-absorbing narrow interest
  7. #Exclusion of other activities
  8. #Repetitive adherence
  9. #More rote than meaning
  10. Imposition of routines and interests
  11. #On self, in aspects of life
  12. #On others
  13. Speech and language problems
  14. #Delayed development
  15. #Superficially perfect expressive language
  16. #Formal, pedantic language
  17. #Odd prosody, peculiar voice characteristics
  18. #Impairment of comprehension including misinterpretations of literal/implied meanings
  19. Non-verbal communication problems
  20. #Limited use of gestures
  21. #Clumsy/gauche body language
  22. #Limited facial expression
  23. #Inappropriate expression
  24. #Peculiar, stiff gaze
  25. 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." 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".

Awards

Gillberg has received several awards for his research, including:

Journal articles

Selected books

  • 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 Barn och Ungdomspsykiatri, Natur & Kultur, 2015
  • Gillberg C, , Natur & Kultur, 2018