Table Of ContentHandbook of
Prevention
Handbook of
Prevention
Edited by
Barry A. Edelstein
Wesl Virginia University
Morganlown, Wesl Virginia
and
Larry Michelson
Weslern Psychiatric Institule and Clinic
University of Piltsburgh School of Medicine
Pills burgh, Pennsylvania
PLENUM PRESS • NEW YORK AND LONDON
Library of Congress Cataloging in Publication Data
Handbook of prevention.
Includes bibliographies and index.
1. Mental illness-Prevention. 2. Medicine, Preventive. I. Edelstein, Barry A, 1945-
. II. Michelson, Larry, 1952- . [DNLM: 1. Primary Prevention. WA 108 H236]
RA790.H335 1986 616.89'05 86-15114
ISBN-13: 978-1-4684-5046-0 e-ISBN-13: 978-1-4684-5044-6
DOl: 10.1007/978-1-4684-5044-6
© 1986 Plenum Press, New York
Softcover reprint ofthe hardcover 1st edition 1986
A Division of Plenum Publishing Corporation
233 Spring Street, New York, N.Y. 10013
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical. photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
BE
To my mother, Lee Edelstein, for her unflagging intellectual and emotional support
LM
To my loving and much loved grandparents, Esther and Joseph Karlin
Contributors
Joseph P. Allen, Department of Psychology, Yale University, New Haven, Connecticut
James A. Blumenthal, Departments of Psychiatry and Medicine, Duke University
Medical Center, Durham, North Carolina
Matthew M. Burg, Departments of Psychiatry and Medicine, Duke University Medical
Center, Durham, North Carolina
Joseph Cullen, Division of Cancer Prevention and Control, National Cancer Institute,
National Institutes of Health, Bethesda, Maryland
Laurie U. de Bettencourt, Learning Resource and Development Cel1ter, University of
Pittsburgh, Pittsburgh, Pennsylvania
L. Erlenmeyer-Kimling, Division of Developmental Behavioral Studies, Medical
Genetics, New York State Psychiatric Institute, New York, New York
Teresa Ficula, Department of Psychology, University of Utah, Salt Lake City, Utah
P. Jean Frazier, Department of Health Ecology, School of Dentistry, University of
Minnesota, Minneapolis, Minnesota
Donna M. Gelfand, Department of Psychology, University of Utah, Salt Lake City,
Utah
E. Scott Geller, Department of Psychology, Virginia Polytechnic Institute and State
University, Blacksburg, Virginia
Peter Greenwald, Division of Cancer Prevention and Control, National Cancer Institute,
National Institutes of Health, Bethesda, Maryland
Marybeth Harris, Department of Psychology, West Virginia University, Morgantown,
West Virginia
Melissa J. Himelein, Department of Psychology, University of Kentucky, Lexington,
Kentucky
Alice M. Horowitz, Health Promotion and Science Transfer Section, Office of Planning,
Evaluation, and Communications, National Institutes of Health, Bethesda, Maryland
vii
viii Leonard A. Jason, Department of Psychology, De Paul University, Chicago, Illinois
CONTRIBUTORS Luciano L'A bate, Department of Psychology, Georgia State University, University
Plaza, Atlanta, Georgia
John Wills Lloyd, Ruffner Hall, University of Virginia, Charlottesville, Virginia
Kathleen A. McCluskey-Fawcett, Department of Psychology, Children's Rehabili-
tation Unit, University of Kansas, Lawrence, Kansas
Nancy Meek, Department of Psychology, West Virginia University, Morgantown, West
Virginia
Gail G. Milgram, Center of Alcohol Studies, Smithers Hall, Rutgers, The State Uni-
versity, Busch Campus, New Brunswick, New Jersey
Peter E. Nathan, Center of Alcohol Studies, Smithers Hall, Rutgers, The State Uni-
versity, Busch Campus, New Brunswick, New Jersey
Susan E. Nicol, Department of Psychiatry, Hennepin County Medical Center, Min-
neapolis, Minnesota
Michael T. Nietzel, Department of Psychology, University of Kentucky, Lexington,
Kentucky
Edward M. Ornitz, UCLA Neuropsychiatric Institute, 760 Westwood Plaza, Los Ange-
les, California
Sleven F. Roark, Departments of Psychiatry and Medicine, Duke University Medical
Center, Durham, North Carolina
Leon S. Robertson, Nanlee Research, 2 Montgomery Parkway, Branford, Connecticut
Thomas Rose, Department of Psychology, De Paul University, Chicago, Illinois
David Thompson, Department of Psychology, De Paul University, Chicago, Illinois
Norman F. Watt, Department of Psychology, Child Study Center, University of Denver,
Denver, Colorado
Roger P. Weissberg, Department of Psychology, Yale University, New Haven,
Connecticut
Lynne Zarbatany, Department of Psychology, University of Western Ontario, London,
Ontario
Preface
Americans are "healing themselves" (Heckler, 1985) and prevention has taken root
(McGinnis, 1985a). We are altering our lifestyle to reduce physical and mental health
risks. Perhaps as important is the fact that the science of prevention is beginning to catch
up with the practices of prevention, although some might argue that the popularity of
these practices far outstrips sound theoretical and empirical foundations. The chapter
authors in this volume examine the theoretical and empirical foundations of many current
prevention practices and, where data exist, discuss the status of prevention efforts. Where
substantial prevention is not yet on the horizon, the authors attempt to point us in the
right direction or at least share with the reader some of the risk factors that should be
addressed in our research. We hope that readers will be stimulated to discuss the issues
raised, advance the current research, and, where possible, adopt the prevention and health
promotion strategies that are supported by sound theoretical and empirical work. This
volume can in no way be comprehensive with respect to the current work in prevention;
however, we hope that we have provided a sampling of prevention activities and issues
that appear together in one volume for perhaps the first time.
The primary intent of this volume is modest, and the reader should not attempt to
find continuity among the various chapters. The only binding among these contributions
is their focus on prevention. We sincerely hope that the reader finds the volume as
interesting, informative, and exciting as we have.
No volume is created without the contributions of many individuals. We extend
our gratitude first to Eliot Werner, our Plenum editor for this volume. Eliot was either
foolish or foresighted when he encouraged us to pursue this project. He was unrelenting
in his efforts to keep the chapters on schedule, offered sympathies when deadlines were
postponed, and finally facilitated the final stages of manuscript preparation.
Appreciation is also expressed to Steve Goldston and George Albee, two pioneers
in primary prevention of psychopathology, for their encouragement and assistance in the
early stages of the development of this volume. Finally, gratitude is extended to the many
talented and dedicated professionals working for the National Institute of Mental Health's
Prevention Branch, whose support (MH39642) has made this volume possible.
BARRY A. EDELSTEIN
LARRY MICHELSON
ix
x References
Heckler, M. (1985). Preface: Prevention 84/85. Office of Disease Prevention and Health Promotion. (DHHS
PREFACE
Publication No. 1985-474-512). Washington, DC: U.S. Government Printing Office.
McGinnis, 1. M. (1985). Forward: Prevention 84/85. Office of Disease Prevention and Health Promotion.
(DHHS Publication No. 1985-474-512). Washington, DC: U.S. Government Printing Office.
Contents
Introduction xxi
Chapter 1
Methodological Issues in Prevention 1
LEONARD A. JASON, DAVID THOMSON, AND THOMAS ROSE
I. Introduction ..................................................... .
I. I. Theoretical Issues ............................................. 1
1.2. Entry ....................................................... 3
2. Methodological Issues .............................................. 3
2. 1. Goals...................................................... 3
2.2. Assessment Issues ............................................ 4
2.3. Screening:.................................................. 6
2.4. Experimental and Quasi-Experimental Designs ............. . . . . . . . . 7
2.5. Control Group Issues ......................................... 8
2.6. Generalization and Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
2.7. Cost-Benefit Analysis ....................... . . . . . . . . . . . . . . . . .. 10
2.8. Meta-analysis................................................ II
2.9. Social Validation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . II
2.10. Monitoring Treatment Integrity ................................. 12
3. Future Directions .................................................. 13
4. References ....................................................... 14
Chapter 2
Genetic Factors in Psychopathology: Implications for Prevention 21
SUSAN E. NICOL AND L. ERLENMEYER-KIMLING
I. Introduction ...................................................... 21
2. Review of the Literature on the Genetics of Psychopathology .............. 21
2.1. Schizophrenia ................................................ 22
2.2. Affective Disorders ............................................ 26
xi
xii 3. Genetic Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 26
3.1. Linkage Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 27
CONTENTS
3.2. Restriction Enzyme Techniques .................................. 28
4. Biological Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 29
4.1. Computerized Tomography and Enlarged Ventricles ................. 29
4.2. Cholinergic-induced REM Sleep ................................. 30
5. Biobehavioral Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 30
5. 1. Attention and Information Processing ............................. 31
5.2. Pursuit Eye Movements ........................................ 32
6. Genetic Markers and Prevention ...................................... 33
7. Genetics and Prevention/Intervention in Psychiatric Disorders .............. 34
7.1. DrugUse .................................................... 34
7.2. Stress....................................................... 35
7.3. Family Communication. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 36
8. Conclusion....................................................... 37
9. References ....................................................... 37
Chapter 3
Prevention during Prenatal and Infant Development 43
KATHLEEN A. McCLUSKEY-FAWCETT, NANCY MECK, AND
MARYBETH HARRIS
1. Introduction ...................................................... 43
2. Historical Foundations ...................................... . . . . . . .. 45
3. Current Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 46
3. 1. Prevention during the Prenatal Period ............................. 46
3.2. Prevention during the Perinatal Period. . . . . . . . . . . . . . . . . . . . . . . . . . . .. 53
3.3. Prevention during the Postnatal Period ............................ 61
4. Summary ........................................................ 66
5. References ....................................................... 66
Chapter 4
Prevention of Developmental Disorders 75
EDWARD M. ORNITZ
1. Introduction ...................................................... 75
2. Infantile Autism ................................................... 77
2.1. Differential Diagnosis .......................................... 79
2.2. Prenatal, Perinatal, and Neonatal Factors .......................... 82
2.3. Family Background ............................................ 82
2.4. Prognosis .................................................... 83
2.5. Problems in Early Recognition ................................... 84
2.6. Intervention .................................................. 0 86
3. Developmental Dysphasia ........................................... 89
3. 1. Differential Diagnosis .......................................... 90
3.2. Family Background ............................................ 91
