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Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities
problem behaviors among young people. Prevention of substance use is included in the report given the inclusion of substance abuse in our charge; discussion of other problem behaviors is intended to illustrate the synergy in risk factors and approaches to prevention.
Similarly, for ease of reading, the committee has adopted the term “young people” throughout the report when referring to “children, youth, and young adults” as a group. When the discussion of a particular topic or preventive approach applies to a specific developmental phase (e.g., childhood, adolescence), the relevant descriptor (e.g., children) is used instead.
Scope of the Study
In general, prevention research is focused on the factors empirically demonstrated to be associated with MEB disorders, either as risk factors, protective factors, or constructive interventions to reduce them; risk factors often represent risks for multiple disorders or problem behaviors. In addition, relatively few studies to date measure the incidence of actual MEB disorders as an outcome. The committee’s review focuses on the developmental processes and factors that modify mental, emotional, and behavioral outcomes, rather than on individual disorders. When evidence is available related to the prevention of specific disorders (e.g., depression, schizophrenia, substance abuse), as opposed to risks for disorders, we have presented it as well. Over the long term, studies to address risk factors and improve the lives of children as well as studies to demonstrate the effects of interventions on the actual incidence of disorders are needed.
Given the extensive work already done by the IOM and others on smoking prevention, substance abuse was interpreted to mean primarily prevention of alcohol and drug use, with a focus on the trajectories and mechanisms they share with other mental, emotional, or behavioral problems. We do not provide a comprehensive epidemiological review of use of various substances by this population. Lessons from smoking are drawn on when appropriate.
The committee considers problem behaviors, such as risky sexual behavior and violence, to be integrally related to future mental, emotional, and behavioral problems among young people, with common trajectories and risk factors associated with both. HIV preventive interventions aimed at reducing risky sexual behavior as well as interventions designed to prevent violence are included in our review.
The committee was not asked to consider the status of treatment. Although we recognize that there are significant issues related to the quality and accessibility of treatment for young people (Burns, Costello, et al., 1995; Masi and Cooper, 2006), this was outside our charge. Still, given our charge to focus on promotion and prevention, we have articulated