, Volume 24, Issue 2, pp 235-249

The ontogenesis of primary prevention: Lengthy strides and subbed toes

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Abstract

Reviews evolution of the concept of primary prevention in the past 40 years and cites progress in overcoming significant early deterrents (e.g., loosely anchored, overinclusive definitions; weak supporting empirical base) to this development. Highlights the growing trend to define the concept specifically around the yoked notions of risk, and the goal of forestalling major psychological dysfunction. This de facto shift in definitional emphasis has obscured primary prevention's early vision of promoting health and wellness. Stresses need for a comprehensive, multilevel, proactive approach targeted systematically toward the enhancement of psychological wellness in all people, from the start.

This article is based on the Seymour B Sarason Award talk given at the 103rd annual meeting of the American Psychological Association, New York City, August 12, 1995. Although the spoken and written versions are similar, and their intended bottom lines identical, the two differ in several ways. One is that the talk's many references to Sarason'shighly influential contributions to the field, and his unique, thought-stimulating style, do not appear here. They continue, however to be keenly felt. Those views are a matter official record (see “In Honor of Seymour Sarason,”American Journal of Community Psychology, 1976, Vol. 4, pp. 244–246). A second difference between the talk and the article is that the former was more relaxed, breezier, and less jargonesque. Although I have tried to preserve some of that informality, the article is surely stuffier than the talk.