. "8 Treatment Research and Prevention Research: A Collaborative Frontier." Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research. Washington, DC: The National Academies Press, 1994.
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REDUCING RISKS FOR Mental Disorders: FRONTIERS FOR PREVENTIVE INTERVENTION RESEARCH
Effective psychosocial and pharmacological treatments are now available for many of the mental disorders in DSM-III-R (Kaplan and Sadock, 1989; Karasu, 1989; Dobson and Shaw, 1988; see also Chapter 5). When these treatment interventions are used, they can substantially reduce the morbidity, chronicity, and disability of mental disorders. One justification for mining the principles grounded in treatment intervention research to learn lessons for designing, conducting, and analyzing preventive intervention research programs is that preventive interventions and treatment interventions are often based on similar multifactorial causal models. Therefore it is possible that if a particular treatment intervention is effective for treating an already developed mental disorder, the same or a similar intervention may be effective in preventing the disorder in individuals who are at high risk. Moreover, even if the preventive intervention fails to prevent the onset of the disorder, it may delay onset or may lessen the severity of the disorder. Many treatment interventions aimed at enhancing protective factors, such as literacy and academic and social skills, are generic and not specific to any one mental disorder, and they are good in and of themselves. They may also provide beneficial effects when used in preventive intervention research programs, regardless of how critical they may be in actually preventing a mental disorder.
In this discussion, as in the rest of this report, the terms intervention program and intervention trial are carefully delineated. The intervention program is the activity or activities provided to the targeted population. Its design includes considerations regarding the timing, duration, and environment of those activities, as well as the interveners involved. The intervention trial is the research component designed with experimental and methodological protocols to analyze and validate the success of the intervention program. Intervention research program is the inclusive term for the program plus the trial.
Principles and lessons that can be shared between treatment intervention research and preventive intervention research are listed and described in this chapter. The list is illustrative, rather than exhaustive, and the principles and lessons fall into several categories according to the main concept to which they apply. The categories applicable to the design of intervention programs include risk and protective factors and etiological chains; co-morbidity of disorders; progressive course of maladaptive behavior; individual differences; multimodal interventions; timing, duration, and environment of interventions; and the effects of interventions on family members. Principles and lessons applicable to research methodology, ethical and cultural concerns, and dissemination are also presented. The suggestions in this chapter regarding transla