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Suggested Citation:"Appendix E: Tables of Risk Factors." National Research Council and Institute of Medicine. 2009. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Washington, DC: The National Academies Press. doi: 10.17226/12480.
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Suggested Citation:"Appendix E: Tables of Risk Factors." National Research Council and Institute of Medicine. 2009. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Washington, DC: The National Academies Press. doi: 10.17226/12480.
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Page522
Suggested Citation:"Appendix E: Tables of Risk Factors." National Research Council and Institute of Medicine. 2009. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Washington, DC: The National Academies Press. doi: 10.17226/12480.
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Page523
Suggested Citation:"Appendix E: Tables of Risk Factors." National Research Council and Institute of Medicine. 2009. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Washington, DC: The National Academies Press. doi: 10.17226/12480.
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Page524
Suggested Citation:"Appendix E: Tables of Risk Factors." National Research Council and Institute of Medicine. 2009. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Washington, DC: The National Academies Press. doi: 10.17226/12480.
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Page525
Suggested Citation:"Appendix E: Tables of Risk Factors." National Research Council and Institute of Medicine. 2009. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Washington, DC: The National Academies Press. doi: 10.17226/12480.
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Page526
Suggested Citation:"Appendix E: Tables of Risk Factors." National Research Council and Institute of Medicine. 2009. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Washington, DC: The National Academies Press. doi: 10.17226/12480.
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Page527
Suggested Citation:"Appendix E: Tables of Risk Factors." National Research Council and Institute of Medicine. 2009. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Washington, DC: The National Academies Press. doi: 10.17226/12480.
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Page528
Suggested Citation:"Appendix E: Tables of Risk Factors." National Research Council and Institute of Medicine. 2009. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Washington, DC: The National Academies Press. doi: 10.17226/12480.
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Page529
Suggested Citation:"Appendix E: Tables of Risk Factors." National Research Council and Institute of Medicine. 2009. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Washington, DC: The National Academies Press. doi: 10.17226/12480.
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Page530
Suggested Citation:"Appendix E: Tables of Risk Factors." National Research Council and Institute of Medicine. 2009. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Washington, DC: The National Academies Press. doi: 10.17226/12480.
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Page531
Suggested Citation:"Appendix E: Tables of Risk Factors." National Research Council and Institute of Medicine. 2009. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. Washington, DC: The National Academies Press. doi: 10.17226/12480.
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Page532

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Appendix E Tables of Risk Factors 521

TABLE E-1 Risk Factors for Depression 522 Context Developmental Neighborhood and Period Individual Family School and Peers Community Preconception/ Genetic predisposition1,2,3,6 prenatal Infancy Left frontal lobe hypoactivation1,2,5 Difficult temperament, such as negative affect, difficult to soothe, and lower activity1 Insecure attachment1 Early childhood Dysregulated growth hormone Poor grades/ process2,3 achievement1,3 Left frontal lobe hypoactivation2,5 Temperament: inhibited, socially reticent and easily upset2,4 Subsyndromal symptoms and dysthymia4 Insecure attachment1 Hostile to peers, socially inhibited4

Middle Dysregulated growth hormone Parental depression1,2,3 Peer rejection2,3,5 and Poverty4 childhood process2,3 Poor parenting: rejection, poor-quality peer Community stressful Left frontal lobe hypoactivation2,5 lack of parental warmth, relationships3 events such as Temperament: apathy2 high hostility, harsh interpersonal conflict, Negative cognitions about self and discipline, high maternal Stressful life events2,5 separation, and negative explanatory and negative affect3 Self-generated stressors4,5 loss1,4,5 inferential style1,2,3 Child abuse/maltreatment1 Anxiety2 Loss1 Poor grades/ Dysthymia4 Marital conflict3,4,5 or achievement1,3 Insecure attachment1 divorce1 Disengagement, involuntary, and Aversive family environment3 emotion-focused coping2 Poor social skills: impulsive, aggressive, passive, withdrawal, poor social problems solving2,3 523 continued

TABLE E-1 Continued 524 Context Developmental Neighborhood and Period Individual Family School and Peers Community Adolescence Female gender1,2,3,4,5 Parental depression1,2,3 Peer rejection2,3,5 and Poverty and low SES Early puberty4 Parent-child conflict1,2,3 poor-quality peer Community-level stressful Dysregulated growth hormone Poor parenting: parental relationships3 events such as conflict, process2,3 rejection, lack of parental separation, and Left frontal lobe hypoactivation2 warmth, rejection, high Stressful events2,5 loss1,4,5 Difficult temperament: inflexibility, hostility, harsh Self-generated low positive mood, withdrawal, discipline,2,3 stressors4,5 poor concentration2 high maternal negative Negative cognitions such as low affect3 Poor grades/ global self-worth, perceived Child abuse/maltreatment1 achievement1,3 incompetence, negative Single parent family (for girls explanatory and inferential style5 only)1 Anxiety1,2 Divorce1 Subsyndromal depressive symptoms2 Marital conflict3,4,5 and dysthymia4 Family conflict3 Insecure attachment1,5 Aversive family environment3 Disengagement, involuntary, and emotion-focused coping2 Poor social skills: communication skills and problem-solving skills2 Extreme need for approval and social support4

Young Dysregulated growth hormone Parental depression1,2,3 Decrease in social Adulthood process2,3 support Left frontal lobe hypoactivation2,5 accompanying Early onset depression and anxiety2 entering new social Negative cognitions context4 Need for extensive social support4 1Cicchettiand Toth (1998). 2Garber (2006). 3Hammen and Rudolph (2003). 4Reinherz, Tanner, et al. (2006). 5Garber and Flynn (2001). 6Schulenberg and Zarrett (2006). 525

TABLE E-2  Risk Factors for Schizophrenia 526 Context Developmental Period Individual Family School and Peers Neighborhood Preconception/ Genetic predisposition2,3,4,5 Parental diagnosis of Urban setting1,3,4 prenatal 2nd generation immigrant1,3 schizophrenia2,4,5 Low SES1 Problems during pregnancy (diabetes and bleeding)3,4 Problems with fetal growth and development4,5 Maternal stress during pregnancy (such as spousal death)3,4 Maternal infection or flu exposure during pregnancy2,4,5 Hypoxia-related delivery complications2,3,4,5 Male gender3,5 Infancy Head injury2 Urban setting1,3,4 Social adversity1 Early childhood Head injury2 Family dysfunction1 Urban setting1,3,4 Motor, language, and cognitive Social adversity1 impairments3,4 Middle Head injury2 Family dysfunction1 Urban setting1,3,4 childhood Self-reported psychotic symptoms4 Social adversity1 Adolescence Head injury2 Family dysfunction1 Urban setting1,3,4 Cannabis use3,4 Social adversity1

Young Head injury2 Family dysfunction1 Social adversity1 adulthood 1Cantor-Graae (2007). 2Walker,Kestler, et al. (2004). 3Cannon and Clarke (2005a). 4Cannon and Clarke (2005b). 5Faraone, Brown, et al. (2002). 527

TABLE E-3  Risk Factors for Substance Abuse 528 Context Developmental Neighborhood and Period Individual Family School and Peers Community Preconception/ Genetic predisposition1,2,3 prenatal Prenatal alcohol exposure3 Infancy Early childhood Difficult temperament1,2,3 Cold and unresponsive mother behavior Parental modeling of drug/alcohol using1 Middle Poor impulse control1,2,3 Permissive parenting1,3 School failure 1,2 Laws and norms childhood Low harm avoidance1,2 Parent–child conflict1 Low commitment to favorable toward Sensation seeking1,2 Low parental warmth1 school1 use1,2 Lack of behavioral Parental hostility 1,3 Peer rejection1,2 Accessibility/ self-control/regulation2 Harsh discipline1,3 Deviant peer group2,3 availability1,2 Aggressiveness1,2,3 Child abuse/maltreatment2 Peer attitudes toward Extreme poverty for Anxiety2 Parental/sibling modeling of drug drug2 those children Depression2,3 using1,2 Interpersonal alienation antisocial in Hyperactivity Parental favorable attitudes toward 1,2,3 childhood1,2 ADHD1,2,3 alcohol and/or drugs1,2,3 Antisocial behavior1,3 Inadequate supervision and Early persistent problem monitoring1,2,3 behaviors1 Parental involvement Early substance use1,2 Low parental aspirations for child Lack of or inconsistent discipline

Adolescence Behavioral disengagement School failure1 Norms (e.g., coping Low commitment to school1 advertising) Negative emotionality Not college bound favorable toward Conduct disorder Aggression toward peers alcohol use Favorable attitudes toward Associating with drug-using peers Accessibility/ drugs availability Rebelliousness Early substance use Antisocial behavior Young Lack of commitment to Leaving home Attending college adulthood conventional adult roles Substance-using peers Antisocial behavior 1Hawkins, Catalano, and Miller (1992). 2Mayes and Suchman (2006). 3Sher, Grekin, and Williams (2005). 529

TABLE E-4  Risk Factors for Anxiety 530 Context Developmental Neighborhood and Period Individual Family School and Peers Community Preconception/ Genetic predisposition3 prenatal Infancy Insecure attachment3 Specific traumatic Specific traumatic Marital satisfaction1 experiences1 experiences3 Discrepant coparenting1 Parental modeling of anxiety1 Early childhood Behavioral inhibition2,3 Marital conflict1 Specific traumatic Specific traumatic Negative events2,3 experiences2 experiences2 Negative events2,3 Negative life events2,3 Lack of control Lack of control experiences experiences Middle Behavioral inhibition2,3 Parental anxiety2; parental Specific traumatic Specific traumatic childhood Disgust sensitivity3 overcontrol2,3 experiences2 experiences2 Cognitive development Rejection1,3 Negative events2,3 Negative life events2,3 allows cognitive errors3 Anxious childrearing3 Lack of control Lack of control Parents model, prompt, and reinforce experiences experiences threat appraisals and avoidant behavior2 Marital conflict1; poor marital adjustment1 Negative events2,3 Adolescence Behavioral inhibition2,3 Marital conflict1 Disgust sensitivity3 Family conflict1 Cognitive development allows cognitive errors3

Young Childhood history of Spousal conflict8 Negative life events10 adulthood untreated anxiety Single parenthood10 disorders4 Childhood history of poor physical health5 Poor physical health6,9 Childhood history of sleep and eating problems7 1Bögels and Brechman-Toussaint (2006). 2Donovan and Spence (2000). 3Muris (2006). 4Bittner, Egger, et al. (2007). 5Clark, Rodgers, ��������������� et al. �������� (2007). 6Benton, Christopher, and Walter (2007). 7Ong, Wickramaratne, �������������� et al. ������� (2006). 8Whisman (2007). 9Mehnert and Koch (2007). 10Fergusson, Boden, and Horwood (2007). 531

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Mental health and substance use disorders among children, youth, and young adults are major threats to the health and well-being of younger populations which often carryover into adulthood. The costs of treatment for mental health and addictive disorders, which create an enormous burden on the affected individuals, their families, and society, have stimulated increasing interest in prevention practices that can impede the onset or reduce the severity of the disorders.

Prevention practices have emerged in a variety of settings, including programs for selected at-risk populations (such as children and youth in the child welfare system), school-based interventions, interventions in primary care settings, and community services designed to address a broad array of mental health needs and populations.

Preventing Mental, Emotional, and Behavioral Disorders Among Young People updates a 1994 Institute of Medicine book, Reducing Risks for Mental Disorders, focusing special attention on the research base and program experience with younger populations that have emerged since that time.

Researchers, such as those involved in prevention science, mental health, education, substance abuse, juvenile justice, health, child and youth development, as well as policy makers involved in state and local mental health, substance abuse, welfare, education, and justice will depend on this updated information on the status of research and suggested directions for the field of mental health and prevention of disorders.

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