. "4 Using a Developmental Framework to Guide Prevention and Promotion." Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Washington, DC: The National Academies Press, 2009.
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Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities
the child, and children’s appraisals of how much recent stressful events threatened their well-being (Lin, Sandler, et al., 2004). Other factors, such as coping efficacy, control beliefs, postbereavement stressful events, and children’s fears that they will be abandoned by the surviving caregiver, have been associated with mental health outcomes for bereaved children (Wolchik, Tein, et al., 2006).
An interesting focus of research has investigated the pathways that lead from family disruption due to divorce or bereavement, along with other commonly co-occurring biological and social risk factors, to adult depression. One analysis of longitudinal data on female twins, siblings, and unrelated women found support for three pathways to the development of depression (Kendler, Gardner, and Prescott, 2002). In an internalizing pathway, genetic risk leads to neuroticism, which in turn leads to early-onset anxiety disorder, and these three influences each lead to episodes of major depression. In an externalizing pathway, conduct disorder and substance misuse lead to depressive disorder. In an adversity pathway, early childhood exposure to a disturbed family environment, childhood sexual abuse, and parental loss lead to low educational attainment, lifetime trauma, and low social support, which in turn lead to four adult risk factors (marital problems, difficulties in the past year, dependent stressful events, and independent stressful events), which in turn lead to an episode of major depression. All three pathways include contributions from genetic factors and interconnections among family adversity, externalizing problems, and later adult adversities.
A prospective longitudinal study, the National Collaborative Perinatal project, also considered timing in an examination of the association between family disruption (divorce or separation before age 7), low socioeconomic status, and residential instability and the onset of adult depression (Gilman, Kawachi, et al., 2003). The effect of low socioeconomic status in childhood on depression risk persisted into adulthood, but the effects of family disruption and residential instability were specific to early-onset depression. Early-onset depression is of special concern because it carries with it a poorer prognosis of increased recurrence and, in some studies, more severe depressions.
Community and School Risk Factors
Most prevention research has focused on risk and protective factors at the level of the individual and the family, but there is increasing recognition that child development is powerfully affected by the broader social contexts of schools and communities (Boyce, Frank, et al., 1998). Risk factors, such as victimization, bullying, academic failure, association with deviant peers, norms and laws favoring antisocial behavior, violence, and