A Developmental Epidemiological Framework for Clinical Child and Pediatric Psychology Research

  • Nicholas S. Ialongo
  • Sheppard G. Kellam
  • Jeanne Poduska
Part of the Issues in Clinical Child Psychology book series (ICCP)

Abstract

In this chapter we elaborate on the principles and theoretical perspectives that have formed the foundation for the Johns Hopkins University Prevention Intervention Research Center’s (JHU-PIRC) work over the last decade. During this time, we fielded two sets of classroom-based, universal preventive intervention trials in 28 Baltimore City schools with three cohorts of first graders. We also fielded a universal, or primary, preventive intervention trial, along with a nested mental health services intervention, in three Baltimore Head Start centers. In each trial, the focus was on the early risk behaviors of poor academic readiness and aggressive and shy behavior and their distal correlates of antisocial behavior, substance abuse, and anxious and depressive symptoms and disorders. We believe the principles and perspectives that have guided our preventive and services interventions work are equally applicable to researchers in the child clinical and pediatric psychology arenas. As will become apparent, we advocate an interdisciplinary approach to mental health research, which requires an integration of the life course developmental, public health, community epidemiological, and experimental trials perspectives. We provide the reader with examples from our own research as well as that of others that we hope will highlight the strengths of our developmental epidemiological framework and its applicability to the challenges faced by child clinical and pediatric psychology researchers. Among the topics addressed are: (1) the need for grounding our clinical and basic research in developmental theory (Coie et al., 1993; Kellam & Rebok, 1992; Reid, 1993; Sandler et al., 1992); (2) the use of intervention trials as tests of our etiologic models of development and psychopathology (Coie et al., 1993; Kellam & Rebok, 1992; Reid, 1993; Sandler et al, 1992); (3) the benefits of a public health perspective with respect to the dissemination and acceptance of interventions found to be efficacious in research settings (Kellam & Rebok, 1992); (4) the pitfalls associated with the use of clinic samples and samples of convenience in clinical research and research on development and psychopathology (Greenley & Mechanic, 1976; Greenley, Mechanic, & Clearly, 1987); and (5) economically and logistically feasible methods for defining and selecting research populations in accord with epidemiological principles (Gordis, 1996).

Keywords

Mental Health Service Antisocial Behavior Head Start Public Health Perspective Baltimore City 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Anthony, J. C. (1990). Prevention research in the context of epidemiology, with a discussion of public health models. In P. Muehrer (Ed.), Conceptual research models for preventing mental disorders (pp. 1–32) (DHHS Publication No. (ADM) 90-1713). Washington, DC: US Government Printing Office.Google Scholar
  2. Berkson, J. (1946). Limitations of the application of the fourfold contingency table. Biometrics Bulletin, 2, 47–53.PubMedCrossRefGoogle Scholar
  3. Bird, H., Gould, M., Yager, T., Staghezza, B., & Canino, G. (1989). Risk factors for maladjustment in Puerto Rican children. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 847–850.PubMedCrossRefGoogle Scholar
  4. Bronfenbrenner, V. (1979). The ecology of human development. Cambridge, MA: Harvard University Press.Google Scholar
  5. Brook, J. S., Nomura, C., & Cohen, P. (1989). A network of influences on adolescent drug involvement: Neighborhood, school, peer, and family. Genetic, Social, and General Psychology Monographs, 115, 125–145.Google Scholar
  6. Caron, C., & Rutter, M. (1991). Comorbidity in child psychopathology: Concepts, issues, and research strategies. Journal of Child Psychology and Psychiatry, 32,1063–1080.PubMedCrossRefGoogle Scholar
  7. Cicchetti, D., & Schneider-Rosen, K. (1984). Toward a transactional model of childhood depression. In D. Cicchetti & K. Schneider-Rosen (Eds.), Childhood depression: A developmental perspective (pp. 5–28). San Francisco: Jossey-Bass.Google Scholar
  8. Coie, J., Watt, N. F., West, S. G., Hawkins, D., Asarnow, J. R., Markman, H. J., Ramey, S. L., Shure, M. B., & Long, B. (1993). The science of prevention: A conceptual framework and some directions for a national research program. American Psychologist, 48, 1013–1022.PubMedCrossRefGoogle Scholar
  9. Crum, R. L., Lillie-Blanton, M., & Anthony, J. C. (1996). Neighborhood environment and opportunity to use cocaine and other drugs in late childhood and early adolescence. Drug and Alcohol Dependence, 43,155–161.PubMedCrossRefGoogle Scholar
  10. Goldsmith, H., Lee, A. S., & Rosen, B. M. (1984). Small area social indicators. Publication No. (ADM) 82–1189. Washington, DC: US Government Printing Office.Google Scholar
  11. Gordis, L. (1996). Epidemiology. Philadelphia, PA: W. B. Saunders.Google Scholar
  12. Greenley, J. R., & Mechanic, D. (1976). Social selection in seeking help for psychological problems. Health and Social Behavior, 17, 249–262.CrossRefGoogle Scholar
  13. Greenley, J. R., Mechanic, D., & Cleary, P. (1987). Seeking help for psychologic problems: A replication and extension. Medical Care, 25, 1113–1128.PubMedCrossRefGoogle Scholar
  14. Ialongo, N., Reider, E., & Kellam, S. (submitted). A further look at the prognostic power of young children’s reports of depressed mood and feelings.Google Scholar
  15. Ialongo, N., Werthamer, L., Brown, H. B., Kellam, S., & Wai, S. B. (in press). Proximal impact of two first grade preventive interventions on the early risk behaviors for later substance abuse, depression, and antisocial behavior. American Journal of Community Psychology.Google Scholar
  16. Jason, L. A. (1982). Community-based approaches in preventing adolescent problems. School Psychology Review, 11(4), 417–424.Google Scholar
  17. Johnston, L. D., O’Malley, P., Bachman, J. G. (1995). National survey results on drug use from the monitoring the future study, 1975–1994: Vol. 1, Secondary School Students (DHHS, PHS, NIH, Publication No. 95–4026). Washington, DC: US Government Printing Office.Google Scholar
  18. Kellam, S. G. (1990). Developmental epidemiologic framework for family research on depression and aggression. In G. R. Patterson (Ed.), Depression and aggression in family interaction (pp. 11–48). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
  19. Kellam, S. G., Branch, J. D., Agrawal, K. C., & Ensminger, M. E. (1975). Mental health and going to school: The Woodlawn program of assessment, early intervention, and evaluation. Chicago: University of Chicago Press.Google Scholar
  20. Kellam, S. G., Branch, J. D., Brown, C. H., & Russell, G. (1981). Why teenagers come for treatment: A ten-year prospective epidemiological study in Woodlawn. Journal of the American Academy of Child Psychiatry, 20, 477–495.PubMedCrossRefGoogle Scholar
  21. Kellam, S. G., & Ensminger, M. E. (1980). Theory and method in child psychiatric epidemiology. In F. Earls (Ed.), Studying children epidemiologically. International Monograph Series in Psychosocial Epidemiology, Vol. 1 (pp. 145–180). New York: Neale Watson Academic Publishers.Google Scholar
  22. Kellam, S. G., Ensminger, M. E., & Turner, R. J. (1977). Family structure and the mental health of children: Concurrent and longitudinal community-wide studies. Archives of General Psychiatry, 34,1012–1022.PubMedCrossRefGoogle Scholar
  23. Kellam, S. G., & Hunter, R. C. (1990). Prevention begins in first grade. Principal, 70,17–19.Google Scholar
  24. Kellam, S. G., Ling, X., Merisca, R., Brown, H., & Ialongo, N. (1998). The effect of the level of aggression in the first grade classroom on the course and malleability of aggressive behavior into middle school. Development and Psychopathology, 10,165–185.PubMedCrossRefGoogle Scholar
  25. Kellam, S. G., Mayer, L. S., Rebok, G. W., & Hawkins, W. E. (in press). The effects of improving achievement on aggressive behavior and of improving aggressive behavior on achievement through two prevention interventions: An investigation of etiological roles. In B. Dohrenwend (Ed.), Adversity, stress and psychopathology (pp. 486–505). New York: Oxford University Press.Google Scholar
  26. Kellam, S. G., & Rebok, G. W. (1992). Building developmental and etiological theory through epidemiologically based preventive intervention trials. In J. McCord & R. E. Tremblay (Eds.), Preventing antisocial behavior: Interventions from birth through adolescence (pp. 162–195). New York: Guilford Press.Google Scholar
  27. Kellam, S. G., Rebok, G. W., Mayer, L. S., Ialongo, N., & Kalodner, C. R. (1994a). Depressive symptoms over first grade and their response to a developmental epidemiologically based preventive trial aimed at improving achievement. Development and Psychopathology, 6, 463–481.CrossRefGoogle Scholar
  28. Kellam, S. G., Rebok, G. W., Ialongo, N. & Mayer, L. S. (1994b). The course and malleability of aggressive behavior from early first grade into middle school: Results of a developmental epidemiologically based preventive trial. Journal of Child Psychology and Psychiatry and Allied Disciplines, 35, 259–281.CrossRefGoogle Scholar
  29. Kellam, S. G., & Werthamer-Larsson, L. (1986). Developmental epidemiology: A basis for prevention. In M. Kessler & S. E. Goldston (Eds.), A decade of progress in primary prevention (pp. 154–180). Hanover, NH: University Press of New England.Google Scholar
  30. Leaf, P., Alegria, M., & Cohen, P. (1996). Mental health service use in the community: Results from the four community MECA study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 889–897.PubMedCrossRefGoogle Scholar
  31. Lilienfeld, D. E., & Stolley, P. D. (1994). Foundations of epidemiology, 3rd ed. New York: Oxford University.Google Scholar
  32. Minkler, M. (1990). Improving health through community organization. In K. Glanz, F. M. Lewis, & B. Rimer (Eds.), Health behavior and health education: Theory research and practice (pp. 257–287). San Francisco: Jossey-Bass.Google Scholar
  33. Mirsky, A. F., Anthony, B. J., Duncan, C. C., Brouwers, P., Ahearn, M. B., & Kellam, S. G. (1991). Analyses of the elements of attention: A neuropsychological approach. Neuropsychology Review, 2,109–145.PubMedCrossRefGoogle Scholar
  34. Morris, J. N. (1975). Uses of epidemiology (3rd ed.). New York: Churchill Livingstone.Google Scholar
  35. Mrazek, P. G., & Haggerty, R. J. (Eds.). (1994). Reducing risks for mental disorders: Frontiers for preventive intervention research. Washington, DC: National Academy Press.Google Scholar
  36. National household survey on drug abuse: Population estimates 1994 (1995). U.S. DHHS, PHS, DHHS Pub. No. (SMA) 95-3063. National health interview survey: Form HIS-1A (1998). U.S. DHHS, PHS.Google Scholar
  37. National Institute of Mental Health. (1991). Implementation of the national plan for research on child and adolescent mental disorders (Program Announcement PA-91–46). Washington, DC: US Government Printing Office.Google Scholar
  38. Offord, D. R., Boyle, M. H., & Racine, Y. A. (1989). Ontario Child Health Study: Correlates of Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 856–860.PubMedCrossRefGoogle Scholar
  39. Offord, D., Boyle, M., & Szatmari, P., (1987). Ontario Child Health Study II. Six-month prevalence of disorder and rates of service utilization. Archives of General Psychiatry, 44, 832–836.PubMedCrossRefGoogle Scholar
  40. Pentz, M. A. (1993). Directions in the future research in drug abuse prevention. Preventive Medicine, 23, 646–652.CrossRefGoogle Scholar
  41. Perry, C., Williams, C., Veblen-Mortenson, S., Toomey, T., Komro, K., Anstine, P., McGovern, P., Finnegan, J.R., Forster, J., Wagenaar, A., & Wolfson, M. (1996). Project Northland: Outcomes of a community-wide alcohol use prevention program during early adolescence. American Journal of Public Health, 86, 956–965.PubMedCrossRefGoogle Scholar
  42. Reid, J. (1993). Prevention of conduct disorder before and after school entry: Relating interventions to developmental findings. Development and Psychopathology, 5, 243–262.CrossRefGoogle Scholar
  43. Sandler, I. N., West, S. G., Baca, L., Pillow, D. R., Gerston, J. C., Rogosch, F., Virdin, L., Beals, J., Reynolds, K. D., Kallgren, C., Tien, J., Kriege, G., Cole, E., & Ramirez, R. (1992). Linking empirically based theory and evaluation: The family bereavement program. American Journal of Community Psychology, 20, 491–521.PubMedCrossRefGoogle Scholar
  44. Schlesselman, J. (1981). Case-control studies: Design, conduct, analysis. New York: Oxford University Press.Google Scholar
  45. Snow, J. (1849). On the pathology and mode of communication of cholera. London Medical Gazette, 44, 745–752, 923-929.Google Scholar
  46. Tweed, D. L., Goldsmith, H. F., Jackson, D. J., Stiles, D., Rae, D. S., & Kramer, M. (1990). Racial congruity as a contextual correlate of mental disorder. American Journal of Orthopsychiatry, 60, 392–402.PubMedCrossRefGoogle Scholar
  47. Wagenaar, A., Murray, D., Wolfson, M., Forster, J., & Finnegan, J. R. (1994). Communities mobilizing for change on alcohol: Design of a randomized community trial. Journal of Community Psychology, CSAP Special Issue, 79–101.Google Scholar
  48. Zaner, G., Pawelkiewicz, W., DeFrancesco, J., & Adnopoz, J. (1992). Children’s mental health service needs and utilization patterns in an urban community: An epidemiological assessment. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 951–960.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Nicholas S. Ialongo
    • 1
  • Sheppard G. Kellam
    • 1
  • Jeanne Poduska
    • 1
  1. 1.Department of Mental HygieneJohns Hopkins UniversityBaltimoreUSA

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