David Shaffer

FRCP, FRCPsych
Born
David Percy Shaffer

(1936-04-20)April 20, 1936
Johannesburg, South Africa
DiedOctober 15, 2023(2023-10-15) (aged 87)
Mastic, New York, U.S.
Alma materUniversity College London
Spouses
Serena Millington
​
(div. 1983)​
    ​
    ​
    (m. 1984; div. 1999)​
    Children4
    Scientific career
    FieldsPediatric psychiatry
    Institutions

    David Percy Shaffer (April 20, 1936 – October 15, 2023) was a South African-born British-American physician and pediatrician. He was the Irving Philips Professor of Child Psychiatry in the Departments of Psychiatry and Pediatrics, at Columbia University's College of Physicians and Surgeons in New York City,[1] now the Columbia University Vagelos College of Physicians and Surgeons. Shaffer was also the chief of pediatric psychiatry at New York–Presbyterian Hospital and chief of the Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute. He was the former spouse of renowned British-American journalist Anna Wintour.

    Training

    Shaffer was born in Johannesburg, South Africa, on April 20, 1936,[2] In the late 1940s and early 1950s he attended the International School of Geneva as a boarder, since his father did not want him to be educated in the racist society of South Africa.[3] He subsequently pursued his medical studies in London, England. He qualified as a physician at University College London, undertook his training in paediatrics at Great Ormond Street Hospital for children in London, and trained at the Maudsley Hospital.

    Study of suicide

    At the Maudsley, Shaffer conducted the first epidemiological study of child and early adolescent suicide using the psychological autopsy method.[4] He found that there was a short delay between experiencing a stressor and the act of suicide, youth tended to show elevated levels of aggressive behavior prior to committing suicide, and imitation appeared to play a role in youth suicide. These findings would later be confirmed in his much larger controlled study in New York City and the surrounding area.[5] Other important findings from the New York study included the very high prevalence of alcohol and substance abuse in older male teens who committed suicide and the occurrence of a prior suicide attempt as a predictor of suicide in males, but not females. In females, major depression was especially important predictor of suicide.[5]

    The finding of specific profiles and the almost universal presence of treatable psychiatric disorders among suicide victims suggested that case-finding would be a viable method for preventing suicide. However, one approach to case-finding, suicide-awareness educational programs, was found to offer few benefits and potentially increased risk.[6] This stimulated the development of a screening strategy instead.[7] Ultimately, Shaffer led a team of colleagues in creating the Columbia TeenScreen. The scoring algorithm had a sensitivity of 0.75, specificity 0.83, and positive predictive value 16% with suicidal ideation as the criterion.[8]

    Study of diagnosis

    Other research interests included the development of diagnostic instruments. He was charged by the National Institutes of Health (NIMH) to develop a child version of the Diagnostic Interview Schedule (DIS)[9] for use in large field studies. The NIMH DISC "is a highly structured diagnostic interview, designed to assess more than 30 psychiatric disorders occurring in children and adolescents, and can be administered by "lay" interviewers after a minimal training period."[10] Shaffer led the development of several editions of the DISC, including the version (NIMH DISC-IV), which is based closely on DSM-IV. DISC-IV includes a computerized version of the interview that incorporates voice technology. This greatly reduced the cost of administration, and allowed for self-completion by youth unable to read, obviating the constraining presence of an adult interviewer. The DISC has been translated into nine languages and been used in approximately two hundred child research projects. Elements of the DISC have been employed by large, multi-site studies, such as the Multimodal Treatment Study of Children with ADHD; federally administered regular surveys, such as National Health and Nutrition Examination Survey; and a number of other longitudinal studies. The availability of the instrument allowed, for the first time, careful examination of patterns of psychiatric comorbidity and how this emerges over time, a matter of great importance for the DSM. The American Psychiatric Association funded a grant to Shaffer's group to reexamine DISC data on 26,000 subjects for the purpose of identifying critical questions for DSM-V.

    Shaffer's contribution to psychiatric classification dates back to 1966, when he collaborated with Michael Rutter to explore the benefits of a multi-axial system for the ICD-9. The multi-axial modifications of the ICD-9 subsequently influenced the development of the DSM-III. He served on the Child and Adolescent Work Group for DSM-III and DSM-IIIR and was co-chair of that group for DSM-IV. He was a member of the Child and Adolescent Work Group and the Mood Disorders Work Group for DSM-V and was co-chair of the Disruptive Behaviors Disorder Workgroup for DSM-V.

    Other research

    Building on data collected as part of the Columbia Presbyterian Hospital chapter of the multi-center Collaborative Perinatal Project, Shaffer led a study of the sequelae of age-7 neurological soft signs.[11] In that study, Shaffer and his colleagues found that neurological soft signs diagnosed at age 7 were related to mood and anxiety disorders ten years later.

    Later years

    Shaffer retired as director of the Division of Child and Adolescent Psychiatry at the New York State Psychiatric Institute (NYSPI)[12]/Columbia University (CU) in May 2008, but retained his academic position and was actively engaged in research on DSM-5, the determinants and triggers of suicidal ideation, and the categorization of suicidal ideation and behavior in adolescents. He thus maintained ties with the Division of Child Psychiatry at NYSPI/CU, which, under his leadership, grew from a small department with seven hundred visits a year to one with over 35,000; from one without research grants to one that holds a portfolio of over $30 million per annum; and from one with four child psychiatrists in training to one that is now the largest in the country, with five endowed chairs, over twenty-four clinical trainees, eight research trainees, and junior researchers from all continents.

    Shaffer served as a consultant on suicide prevention for the U.S. Department of Defense, the Indian Health Service, and the New York State Office of Mental Health. He was a member of the Surgeon General’s Advisory Task Force on Suicide Prevention. He was a past president of the American Foundation for Suicide Prevention and of the Society for Research in Child and Adolescent Psychopathology.

    Offices held

    • President of the International Society for Research in Child and Adolescent Psychiatry
    • President of the American Foundation for Suicide Prevention
    • President elect of the International Society for Research in Suicide Prevention.
    • Chairman of the Work Group on Research for the American Academy of Child and Adolescent Psychiatry.

    In addition to these research studies, he contributed to the debate about the relationship between SSRI antidepressants and suicidal behavior for the American Academy of Child and Adolescent Psychiatry, the American Psychiatric Association, and both the American College of Neuropsychopharmacology and the European College of Neuropsychopharmacology.

    Personal life and death

    Shaffer was married and divorced twice. His first wife was the caterer Serena Millington, by whom he had two sons. They divorced in 1983.[2] His second wife, by whom he had a daughter and a son, was Vogue editor-in-chief Anna Wintour.[13]

    David Shaffer died from respiratory failure in Mastic, New York, on October 15, 2023, at the age of 87. He also had Alzheimer’s disease in his later years.[2]

    Awards and honours

    • The American Psychiatric Association awarded him the McGavin Award in 1995 and the Itteleson award in 2000.
    • In 2007, he received lifetime achievement awards from NARSAD and from the American Foundation for Suicide Prevention.
    • He received the American Suicide Foundation's award for research in suicide in 1989 and the American Mental Health Fund Research Award for research on suicide in 1990.
    • The American Academy of Child and Adolescent Psychiatry awarded him the Philips Prize for outstanding contribution to prevention in 1998, the Klingenstein Third-Generation Foundation Award for Research in Depression or Suicide in 2004, and the Catcher in the Rye Award in 2006.
    • In 2009, he received the Joseph Zubin Award from the American Psychopathological Association.

    References

    1. ↑ "David Shaffer, M.D." July 24, 2017.
    2. 1 2 3 Barry, Ellen (October 18, 2023). "David Shaffer, Medical 'Detective' in Suicide of Youths, Dies at 87". The New York Times. Retrieved October 18, 2023.
    3. ↑ "In memoriam of Dr. David Shaffer (La Grande Boissière, 1954)". Ecolint Connect. Retrieved October 30, 2023.
    4. ↑ Shaffer, D (1974). "Suicide in childhood and early adolescence". J Child Psychol Psychiatry. 15 (4): 275–91. doi:10.1111/j.1469-7610.1974.tb01252.x. PMID 4459418.
    5. 1 2 Shaffer, D., Gould, M.S., Fisher, P., Trautman, P., Moreau, D., Kleinman, M., & Flory, M. (1996). Psychiatric Diagnosis in Child and Adolescent Suicide. Archives of General Psychiatry, 53(4), 339-348. doi:10.1001/archpsyc.1996.01830040075012. PMID 8634012.
    6. ↑ Shaffer, D., Garland, A., Vieland, V., Underwood, M., & Busnner, C. (1991). The impact of curriculum-based suicide prevention programs for teenagers. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 588-596. doi:https://doi.org/10.1097/00004583-199107000-0001
    7. ↑ Kaplan, Arline (1 March 2006). "Battling a National Killer: TeenScreen Aims To Prevent Teen Suicide". Psychiatric Times. p. 1.
    8. ↑ Shaffer, D; et al. (January 2004). "The Columbia Suicide Screen: Validity and Reliability of a Screen for Youth Suicide and Prevention" (PDF). J Am Acad Child Adolesc Psychiatry. 43 (1): 71–9. doi:10.1097/00004583-200401000-00016. PMID 14691362.
    9. ↑ Helzer, J. E, Robins, L. N., McEvoy, L.T., Spitznagel, E.L., Stoltzman, R..K., Farmer, A., et al. (1985). A comparison of clinical and diagnostic interview schedule diagnoses. Archives of General Psychiatry, 42, 657-666.
    10. ↑ Shaffer, D; Fisher, P; Lucas, CP; Dulcan, MK; Schwab-Stone, ME (2000). "NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses". J Am Acad Child Adolesc Psychiatry. 39 (1): 28–38. doi:10.1097/00004583-200001000-00014. PMID 10638065.
    11. ↑ Shaffer, D.; Schonfeld, I.; O'Connor, P.A.; Stokman, C.; Trautman, P.; Shafer, S.; Ng, S. (1985). "Neurological soft signs: Their relationship to psychiatric disorder and intelligence in childhood and adolescence". Archives of General Psychiatry. 42 (4): 342–351. doi:10.1001/archpsyc.1985.01790270028003. PMID 3977551.
    12. ↑ (New York State Psychiatric Institute)
    13. ↑ Gray, Kevin (September 20, 1999). "The Summer of Her Discontent". New York Magazine. Archived from the original on January 3, 2003. Retrieved July 9, 2018.
    • Shaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H, Aluwahlia S. A children's global assessment scale (CGAS). Arch Gen Psychiatry. 1983;16(11):1228-1231. PubMed PMID 6639293.
    • Shaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H, Aluwahlia S. A children's global assessment scale (CGAS) (for children 4 to 16 years of age). Psychopharmacol Bull. 1985; 1(4):747-748.
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