Primary prevention of secondary disorders: A proposal and agenda

This paper calls for consideration of a new class of preventive interventions designed explicitly to prevent comorbidity of psychiatric disorders. Epidemiologic data show that successful interventions of this type could be extremely valuable, as up to half of lifetime psychiatric disorders and an even larger percent of chronic and seriously impairing disorders occur to people with a prior history of some other disorder. Furthermore, a review of etiologic hypotheses concerning the causes of comorbidity suggests that interventions aimed at primary prevention of secondary disorders might be feasible. However, more basic risk factor research is needed on the causes of comorbidity before we can make a clear assessment of feasibility and discover promising intervention targets. A number of methodological problems arise in carrying out this type of formative research. These problems are reviewed and suggestions are offered for solutions involving innovations in measurement, design, and data analysis.     

Challenges in Defining and Developing the Field of Rural Mental Disorder Preventive Intervention Research

An overview of selected issues and challenges in defining and developing the field of rural preventive intervention research is presented. One fundamental challenge is to clarify the distinguishing characteristics of prevention science in rural contexts. Other challenges are evident in the need to address: the lack of consensus on conceptual and methodological approaches to this field, limited empirical study to date, the tremendous diversity of rural populations, and inconsistencies in the usage of the term rural. This article suggests the organization of a work group to formulate and implement a clear research agenda. In addition, several general questions are discussed that, if addressed, might serve to better define and further develop the field. These questions concern the implications of multiple approaches to prevention science in rural contexts, the classification of rural populations, the functional relevance of rural residence in the etiology of specific disorders, the application of extant etiological models to interventions designed specifically for rural populations, the conduct of rural area prevention needs assessments, the development of models for collaboration between intervention researchers and rural community stakeholders, and strategies to engage rural residents in preventive interventions.     

Issues in group work with older lesbians

This article outlines considerations in group interventions with older lesbians. It is intended for mental health professionals who work—as leaders, supervisors, and consultants—with various kinds of groups in their professional practice, including therapy, psychoeducational, support, growth, recreational, and self-help groups. First, unique issues in the life circumstances of older lesbians are addressed. Next, five case examples are presented that illustrate the usefulness of group interventions with this population. The article concludes with recommendations for effective practice.     

The Effect of Active Supervision and Pre-correction on Minor Behavioral Incidents in a Sixth Grade General Education Classroom

This study examines the effect of using active supervision, pre-correction, and daily data review on occurrences of minor behavioral incidents in a sixth grade general education classroom. The results suggest a functional relationship between the use of the teacher-training package and concomitant decreases in minor behavioral incidents. The findings from this study extend the existing literature on the use of active supervision and pre-correction, and establish a useful model for bringing teachers in contact with proactive instructional strategies.     

Keeping the Spirit of Community Partnerships Alive in the Scale Up of HIV/AIDS Prevention: Critical Reflections on the Roll Out of DEBI (Diffusion of Effective Behavioral Interventions)

DEBI, or the Diffusion of Effective Behavioral Interventions is the largest centralized effort to diffuse evidence-based prevention science to fight HIV/AIDS in the United States. DEBI seeks to ensure that the most effective science-based prevention interventions are widely implemented across the country in community-based organizations. Thus, this is a particularly timely juncture in which to critically reflect on the extent to which known principles of community collaboration have guided key processes associated with the DEBI rollout. We review the available evidence on how the dissemination of packaged interventions is necessary but not sufficient for ensuring the success of technology transfer. We consider additional principles that are vital for successful technology transfer, which were not central considerations in the rollout of the DEBI initiative. These issues are: (1) community perceptions of a top-down mode of dissemination; (2) the extent to which local innovations are being embraced, bolstered, or eliminated; and (3) contextual and methodological considerations that shape community preparedness. Consideration of these additional factors is necessary in order to effectively document, manage, and advance the science of dissemination and technology transfer in centralized prevention efforts within and outside of HIV/AIDS.     

Phenylketonuria in Children and Mothers: Genes, Environments, Behavior

ABSTRACT— Phenylketonuria (PKU) is an inborn metabolic error in which metabolism of phenylalanine into tyrosine is disrupted. If the diet of an infant with PKU is not restricted, blood phenylalanine levels are elevated, leading to irremediable brain damage and severe mental retardation. Children with PKU who are placed early and continuously on a low-phenylalanine diet develop normal levels of intelligence, and brain damage is largely prevented. However, if the diet of a mother with PKU is unrestricted during her pregnancy, high phenylalanine levels in her blood can cross the placental barrier and damage the developing fetus in multiple ways. These results demonstrate how genes and environmental factors combine to create prenatal environments that can have profound effects on the growth and development of offspring during infancy and childhood.     

Effects of Prenatal Social Stress on Offspring Development: Pathology or Adaptation?

ABSTRACT— In nonhuman mammals, the social environment in which pregnant females live is critical for their offsprings' brain development, endocrine state, and social and sexual behavior later in life. Social instability during pregnancy generally brings about a behavioral and neuroendocrine masculinization in daughters and a less pronounced expression of male-typical traits in sons. We favor the hypothesis that such behavioral effects of prenatal social stress are not necessarily "pathological" (nonadaptive) consequences of adverse social conditions. Rather, pregnant mothers could be adjusting their offspring to their environment in an adaptive way.     

产前母亲心理压力对儿童心理行为发展影响的研究述评

产前母亲心理压力对儿童心理行为发展有着重要的影响。大量的研究证据表明,产前母亲的心理应激,对后代的情感或认知发展会产生消极的影响,如容易出现注意力缺陷/活动过度、焦虑、语言迟缓等问题。这种影响的潜在机制之一是下丘脑-垂体-肾上腺（HPA）轴的变化,另一个机制可能是,母亲压力或焦虑引起交感-肾上腺系统高度激活。关于产前母亲心理压力对儿童心理行为发展影响的研究,在方法学上存在一定的缺陷,也还有一些未明确的问题,如产前压力的敏感期、性别特异性效应等。未来这一领域应该开发更多的研究途径。已有的证据足以表明,应该积极开展关于预防、干预和支持性方案方面的研究,以减轻妊娠期的压力或焦虑及其对儿童发展的不利影响。