ing to school and school achievement) were related to effects on problem behaviors (Najaka, Gottfredson, and Wilson, 2001). These findings provide guidance that future school-based prevention programs could usefully include components to promote these mediating factors.

TARGETING INTERVENTIONS FOR PREVENTION AND PROMOTION

The developmental and contextual patterns of risk and protective factors and the ways in which those factors relate to each other and to MEB disorders point to two complementary approaches to developing effective interventions for young people: approaches that target a specific disorder and approaches that target prominent risk and protective factors that are associated with multiple problem outcomes.

Targeting Specific Disorders

Disorder-specific risk factors are often identified on the basis of assessment of elevated but subclinical levels of the disorder or prodromal indicators of the disorder, particularly at a developmental stage at which risk for the onset of the disorder is elevated. When high-risk young people can be identified, indicated prevention programs for them can be a very efficient approach. For example, several interventions have demonstrated efficacy in preventing depression in adolescence by targeting adolescents with elevated but subclinical levels of depressive symptoms and providing brief skill-building interventions (see Chapter 7 and review by Horowitz and Garber, 2006).

Four specific MEB disorders—depression, anxiety, substance abuse, and schizophrenia—are used to illustrate disorder-specific risk factors (see Appendix E for tables that list risk factors for each of these disorders across developmental stages and across the various contexts of the social ecology3). As mentioned above, individual, family, and community characteristics can convey either a risk or an element of protection (e.g., positive versus punitive parenting). However, the current literature tends to focus on risk factors. Although not exhaustive of the disorders common among young people, these examples demonstrate that there are patterns of factors unique to specific disorders; they are also examples of disorders for which effective or promising preventive interventions are available. Some of the risk factors (e.g., poverty, family dysfunction) also appear across disorders or problem behaviors and are revisited in the next section.

3

This appendix is available only online. Go to http://www.nap.edu and search for Preventing Mental, Emotional, and Behavioral Disorders Among Young People.



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