REDUCING RISKS FOR Mental Disorders -- Copyright -- Preface -- Acknowledgments -- Abstract -- BUILDING THE INFRASTRUCTURE -- EXPANDING THE KNOWLEDGE BASE -- CONDUCTING WELL-EVALUATED INTERVENTIONS -- Contents -- OVERVIEW -- 1 Introduction -- A NEW EMPHASIS ON PREVENTION: OPPORTUNITIES AND STRENGTHS -- OBSTACLES TO PROGRESS -- LOOKING FORWARD -- ORGANIZATION OF THIS REPORT -- REFERENCES -- 2 New Directions in Definitions -- CLASSIFYING PREVENTIVE INTERVENTIONS FOR PHYSICAL ILLNESS -- CLASSIFYING INTERVENTIONS FOR MENTAL DISORDERS -- The Mental Health Intervention Spectrum for Mental Disorders -- Preventive Interventions for Mental Disorders -- MENTAL HEALTH PROMOTION -- THE CLASSIFICATION SYSTEM IN PRACTICE -- REFERENCES -- LESSONS FROM HEALTH RESEARCH -- 3 Prevention of Physical Illness -- CARDIOVASCULAR DISEASE -- SMOKING -- INJURIES -- FINDINGS AND LEADS -- REFERENCES -- 4 The Core Sciences: Contributions and Frontiers -- NEUROSCIENCE -- GENETICS -- EPIDEMIOLOGY -- DEVELOPMENTAL PSYCHOPATHOLOGY -- FINDINGS AND LEADS -- REFERENCES -- 5 Description of Five Illustrative Mental Disorders -- DATA SOURCES, CONCEPTS, AND METHODOLOGIES USED IN THE DISORDER DESCRIPTIONS -- Epidemiologic Catchment Area Study -- Conceptualization of Onset -- Methods for Analyzing Onset -- ILLUSTRATIVE DISORDERS -- Conduct Disorder -- Depressive Disorders -- Alcohol Abuse and Dependence -- Schizophrenia -- Alzheimer's Disease -- GAPS IN OUR KNOWLEDGE -- Age-Specific Prevalence in Children -- Child Psychiatric Nosology -- Empirical Search for Prodromes -- Co-morbidity -- Transition to Adulthood -- FINDINGS AND LEADS -- REFERENCES -- 6 Risk and Protective Factors for the Onset of Mental Disorders -- ALZHEIMER'S DISEASE -- Biological Risk Factors -- Genetic Vulnerability -- History of Head Trauma -- Medical Risk Factors, Including Thyroid Disorders.

Maternal Age at Time of Birth -- Psychosocial Risk and Protective Factors -- Educational Level -- Smoking -- Environmental Triggers -- Future Directions in Identification of Risk and Protective Factors -- Family Burden -- Findings and Leads -- SCHIZOPHRENIA -- Biological Risk Factors -- Genetic Vulnerability -- Pregnancy and Birth Complications, Winter Births, and Viral Exposure -- Biological Markers -- Psychosocial Risk Factors -- Low Socioeconomic Status -- Disturbed Family Environment and Family Communicative Problems -- Serious Behavioral and Emotional Problems in Childhood -- Social Dysfunction -- Substance Abuse -- Caregiver Burden -- Findings and Leads -- ALCOHOL ABUSE AND DEPENDENCE -- Biological Risk Factors -- Genetic Vulnerability -- Biological Markers -- Psychosocial Risk Factors -- Personality -- Contextual Factors -- Psychosocial Aspects of Parental Alcoholism -- Protective Factors -- Positive Group Norms -- Strong Attachments -- Genetic Factors Modifying Expression of the Disorder -- Findings and Leads -- DEPRESSIVE DISORDERS -- Biological Risk Factors -- Genetic Vulnerability -- Disease and Medication -- Brain Injury -- Psychosocial Risk Factors -- Severe and Traumatic Life Events -- Accumulation of Stresses at a Time of Transition -- Sociodemographic Factors -- Protective Factors -- Findings and Leads -- CONDUCT DISORDER -- Biological Risk Factors -- Genetic Vulnerability -- Physiological Abnormalities -- Gender -- Early Temperamental Difficulties -- Hyperactivity -- Cognitive and Neuropsychological Deficits -- Chronic Ill Health -- Psychosocial Risk Factors -- Precursor Symptoms in the Child -- Family Adversity -- Community Risk Factors -- Accumulation of Risk Factors -- Protective Factors -- Findings and Leads -- RISK AND PROTECTIVE FACTORS COMMON TO MANY DISORDERS -- MODELS FOR UNDERSTANDING RISK AND PROTECTIVE FACTOR INTERACTION.

MAJOR FINDINGS AND PROMISING LEADS -- REFERENCES -- 7 Illustrative Preventive Intervention Research Programs -- CRITERIA FOR EXAMINING PREVENTIVE INTERVENTION PROGRAMS DESCRIBED IN THE LITERATURE -- Description of the Risk and Protective Factors Addressed -- Description of the Targeted Population Group -- Description of the Intervention Program -- Description of the Research Methodologies -- Description of the Evidence Concerning the Implementation -- Description of the Evidence Concerning the Outcomes -- A DEVELOPMENTAL PERSPECTIVE -- INTERVENTIONS FOR INFANTS -- Physical Health Interventions with Applications to Mental Health -- High-Quality Prenatal and Perinatal Care -- Immunization -- Programs Aimed at Improving Parenting and Reducing Risks for Infants -- Evidence from a Quasi-Experimental Study -- An Example from Prevention Services -- Findings and Leads -- INTERVENTIONS FOR YOUNG CHILDREN -- Programs Aimed at Improving Parenting and Enhancing Child Development -- Programs Aimed at Enhancing Social Competence -- Findings and Leads -- INTERVENTIONS FOR ELEMENTARY-AGE CHILDREN -- Programs Aimed at Enhancing Parenting Skills and Family Functioning -- An Example from Prevention Services: Family Preservation Services -- Programs Aimed at Enhancing Social Competence -- Programs Aimed at Enhancing Academic Achievement -- An Example from Prevention Services: School Reorganization -- Evidence from Quasi-Experimental Studies -- Findings and Leads -- INTERVENTIONS FOR ADOLESCENTS -- Program Aimed at Enhancing Academic Achievement and School Behavior -- Programs Aimed at Preventing Substance Abuse -- Enhancing Social Competence -- Providing Social Influence Resistance Training and Promoting Norms Against Drug Use -- Multicomponent Interventions -- Policy Initiatives -- Evidence from a Quasi-Experimental Study.

Programs Aimed at Preventing Conduct Disorder -- Evidence from Quasi-Experimental Studies: Altering School Organization and Social Environments -- Evidence from a Quasi-Experimental Study: Programs Aimed at Violence Prevention -- Findings and Leads -- INTERVENTIONS FOR ADULTS -- Programs Aimed at the Marital Relationship -- Enhancing Marital Relationships -- Coping with Separation and Divorce -- Programs Aimed at the Challenges of Childbearing and Childrearing -- Coping with the Stresses of Caesarean Childbirth -- Enhancing Personal Development of New Mothers -- Programs Aimed at Occupational Stress and Job Loss -- Occupational Stress and Coping -- Coping with Job Loss and Reemployment -- Programs Aimed at Preventing Depressive Disorders Among Adults at Risk Because of Poverty and Minority Status -- Program Aimed at Supporting Adult Children Providing Care for Ill Parents -- Findings and Leads -- INTERVENTIONS FOR THE ELDERLY -- Evidence from a Quasi-Experimental Study: Relieving Caregiver Burden -- Programs Aimed at Enhancement of Coping with Widowhood and Bereavement -- Evidence from a Quasi-Experimental Study: Mutual-Help Groups for Widowed Persons -- Findings and Leads -- A NEW GENERATION OF DEVELOPMENTAL STUDIES -- MAJOR FINDINGS AND PROMISING LEADS -- REFERENCES -- 8 Treatment Research and Prevention Research: A Collaborative Frontier -- INTERVENTION PROGRAM DESIGN -- Risk and Protective Factors and Etiological Chains -- Co-morbidity of Disorders -- Progressive Course of Maladaptive Behavior -- Individual Differences -- Multimodal Interventions -- Timing, Duration, and Environment of Interventions -- Intervention Effects on Family Members -- METHODOLOGICAL RESEARCH ISSUES -- ETHICAL AND CULTURAL CONSIDERATIONS -- DISSEMINATION ISSUES -- FINDINGS AND LEADS -- REFERENCES -- 9 Mental Health Promotion -- CONCEPTUAL UNDERPINNINGS.

HEALTH PROMOTION PROGRAMS -- GAPS IN OUR KNOWLEDGE -- FINDINGS AND LEADS -- REFERENCES -- AN AGENDA FOR THE NEXT DECADE -- 10 Designing, Conducting, and Analyzing Programs Within the Preventive Intervention Research Cycle -- THE PREVENTIVE INTERVENTION RESEARCH CYCLE -- Identification of the Problem or Disorder(s) and Review of Information Concerning Its Extent -- Review of Risk and Protective Factors and Relevant Information from the Knowledge Base -- Pilot Studies and Confirmatory and Replication Trials -- Choosing a Theoretical Model to Guide the Intervention Program -- Designing the Form of the Intervention Program -- Recruiting and Training Interveners -- Identifying and Securing Cooperation from Appropriate Participants -- Large-Scale Field Trials -- Facilitation of Large-Scale Implementation of the Preventive Intervention Program in the Community -- METHODOLOGICAL ISSUES -- Structure and Duration of the Trial and Follow-up Period -- Structure of the Trial -- Duration of the Trial and Follow-up -- Sampling -- Measurement -- What to Measure -- When and How Often to Measure -- Which Measuring Techniques and Instruments to Use -- How Many Measures and Instruments to Use -- How to Ensure Reliability and Validity of Measures -- Statistics and Analysis -- Strategies for Data Analysis -- The Unit of Analysis and Statistical Power Consideration -- DOCUMENTATION ISSUES -- ISSUES OF CULTURE, ETHNICITY, AND RACE -- ETHICAL ISSUES -- ECONOMIC ISSUES -- CONCLUSION -- REFERENCES -- 11 The Knowledge Exchange Process: From Research into Practice -- THE ROLE OF THE COMMUNITY -- Defining the Problem and Assessing the Needs -- Ensuring the Readiness of the Host Organization -- Selecting a Model Program -- Criteria to Use in Examining Programs -- Information Sources to Use in Examining Programs -- Balancing Fidelity and Adaptability While Implementing the Program.

Evaluating the Program's Effectiveness.