Joanne C. Gersten

An evaluation of the etiologic role of stressful life-change events in psychological disorders.

The hypothesis, suggested by associations found in previous research, that stressful gife events play a direct etiological role in psychological disorders was investigated. Preexistent methodological problems which permitted no clear inference regarding this role were treated. Competing hypotheses which posited that the life event-psychological disorder associations represented confounded relationships among events, pathology, and sociocultural factors were examined and controlled. Data used were from a survey of mothers of 732 children ranging in age from 11 to 23 years old, who constituted the follow-up sample collectedfive years laterfrom an original sample of 1,034 children randomly selected from a cross-section of Manhattan households. Event scores differing as to the change and undesirability stress conceptions, each objectively and subjectively defined, were studied. No significant differences were found between correlations of event scores with behavioral pathology prior to and after the events. Multiple regression analyses which added event scores after controlling for stressful life processes demonstrated that events made no minimally meaningful contribution to the prediction of any disturbed behavior. The confounding hypothesis rather than the etiological hypothesis was supported and discussed.

Stability and change in types of behavioral disturbance of children and adolescents.

Changes with aging and stability of dimensions of behavioral disturbance were determined for 732 children and adolescents who constituted the sample reassessed after 5 years of an original cross-sectional sample of Manhattan youth 6 to 18 years old. On three of the six types of disturbance strongly related to the total impairment judgments of psychiatrists, specifically those tapping domains of aggression, greater or constant levels of pathology were noted over time. Cross-sectional versus longitudinal analyses on the same types of disturbance had discrepant results half the time. Stability coefficients for five of the six types of disturbance were greater than .55. Stability curves by age cohorts investigated whether a type of disturbance appeared transitory at certain age periods but more crystallized at other ages. Its prognostic significance would vary accordingly. Implications for intervention-treatment and for studies comparing the predictive value of different classes of behavior, e.g., neurotic versus antisocial, are discussed.

Early Precursors and Concurrent Correlates of Patterns of Illicit Drug Use in Adolescence

This study examines social, familial and child behavior antecedents of adolescent illicit drug use. The sample studied is a subsample of a follow-up sample of Manhattan children, whose mothers were interviewed at two points in time, with a 5 year interval. The subsample constitutes those study children age 14 to 22 at Time II, who were interviewed directly 6 months following the second interview with the mother. The findings indicate that early predictors have a significant and substantial influence on later illicit drug use. Importantly, differential patterns of illicit drug use exhibit relatively distinct antecedents. The use of marijuana-only is related to socioeconomic background and early child behaviors; the use of drugs other than marijuana is related to parental-marital behaviors, the quality of the bond between parents and children and early adjustment problems (with peers and at home); heroin use is strongly associated with parental-marital behaviors indicative of familial disorganization and parental antisocial behaviors.

Approaches to Measurement and Definition in the Epidemiology of Behavior Disorders: Ethnic Background and Child Behavior

This paper presents methods of approaching mental illness which represent alternatives to the medical model and the current diagnostic system. It also points to new ways of handling such complex independent variables as race and class to more clearly delineate the critical components of those constructs for observed relationships. These approaches are briefly discussed and then exemplified in the context of a study which investigated the types and levels of stress to which children of different ethnicity were exposed and the congruence between impairment levels and stress exposure. Differential behavior patterns by ethnicity were determined, as were the relative roles of class versus ethnicity in childrens disturbed behaviors. Measures were developed from questionnaire data collected from 1034 randomly selected Manhattan mothers. White children were least exposed to social stress, Spanish most exposed to marital-parental stress, and Black most exposed to stressful parental practices. While the estimated impairment rank-order was White, Spanish, and Black, both minority groups of children were significantly higher than Whites but similar to each other in impairment level. Analyses showed strong differences in behavior patterns by ethnicity and indicated that race made a stronger contribution than class to disturbed behaviors.

Developmental Patterns of Types of Behavioral Disturbance and Secondary Prevention

Referral to a mental health professional for treatment at young ages is predicated in part upon the assumption that early forms of disturbance have prognostic import for maladjustment in later life. Early referral and treatment are thus seen as serving a secondaryprevention function, i.e., halting further disturbed development. However, the evidence to support this secondary -prevention function has been sparse and often nonsupporti ve (Kohlberg, LaCrosse, & Ricks, 1972; Robins, 1972; Rutter, 1973 ). A critical factor not considered in most prior relevant research is the developmental pattern of a disturbance, a factor that could seriously qualify or moderate the effects of secondary prevention. Gersten and coworkers investigated the stability and change of types of behavioral disturbance by age groups and, drawing on this information, postulated the age at which secondary -prevention programs for each type of disturbance should be targeted in order to obtain the expected benefits of treatment (Gersten, Langner, Eisenberg, Simcha-Fagan, & McCarthy, 1976).