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Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities
the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD). They include a variety of conditions, such as schizophrenia, depression, conduct disorder, attention deficit hyperactivity disorder, and anxiety disorder. Although the DSM and ICD criteria are widely used for diagnostic purposes, federal agencies have adopted alternative terminology, such as “mental and behavioral disorders,”3 “emotional, behavioral and mental disorders,”4 and “mental, emotional, and behavioral disorders”5 to communicate information about the range of disorders experienced by young people. The National Association of School Psychologists has identified children with “emotional and behavioral disorders”6 as needing focused attention in the education system. Similarly, health care professionals are seeing significant numbers of children as a result of parental concerns regarding their behavior.
The committee debated the term to use for purposes of this report, weighing the potential implications for the DSM and the ICD, the stigma often associated with the term “mental disorders,” and the perspectives of the multiple audiences at whom the report is aimed—including researchers; service providers in the education, health, and social service systems; and parents themselves. Although “mental disorders” is the accepted term among many in diagnostic roles, less stigmatizing terminology is likely to resonate with others, including parents and school personnel. In the end, the committee decided to use “mental, emotional, and behavioral (MEB) disorders” based on its comprehensiveness, relevance to multiple audiences, and reduced stigma. More specific terminology is used when the discussion refers to a specific disorder.
Substance abuse and dependence are mental disorders included in the DSM and diagnosed when symptoms and impairment reach a high level. However, substance use, including underage drinking, is a problem behavior of significant public health concern even when the symptoms are not severe enough to be considered a substance use disorder. Such problem behaviors as early substance use, violence, and aggression are often signs or symptoms of mental disorders, although they may not be frequent or severe enough to meet diagnostic criteria. Nonetheless, intervention when these signs or symptoms are apparent, or actions to prevent them from occurring in the first place, can alter the course toward disorder and, as this report outlines, are an important component of prevention in this area. The committee could not thoroughly consider the complete range of behaviors (e.g., truancy, unprotected sex, reckless driving) that might be considered