Sheppard G. Kellam

Mental health in first grade and teenage drug, alcohol, and cigarette use.

Abstract This paper reports on prospective studies of the effects of psychological and social variables measured in first grade on the use of various drugs, alcohol, and cigarettes by teenagers 10 years later. The population consisted of all of the 1966–1967 first graders of Woodlawn, a poor, black, Chicago neighborhood. In a 10-year follow-up, the population, which had been studied three times in first grade and once in third grade, was reassessed for family, psychological, and social data, in addition to drug, alcohol and cigarette use. The former Woodlawn first graders, now aged 16–17, used beer or wine, hard liquor, marijuana or hashish, and cigarettes with considerable frequency. Psychedelics, amphetamines, barbiturates, tranquilizers, opiates, cocaine, inhalants, and cough syrup or codeine were used with much lower frequency. Three separate kinds of characteristics observable in first grade were associated with drug use by adolescents ten years later. (1) Higher first-grade IQ test scores or school readiness test scores predicted more frequent drug use for both sexes. (2) Males used drugs and alcohol (not cigarettes) more often than females, and, antecedents of later drug use by males were more clear than those for females. (3) Those children whose first-grade teachers rated them as shy used drugs least often 10 years later; first graders rated as aggressive used drugs most often 10 years later; adapting first graders and those with learning problems only were found to be moderate drug, alcohol and cigarette users. These results were much more clear for males. Among females, higher levels of psychiatric symptoms in first grade predicted, to some extent, lower teenage drug use. Teenage antisocial behavior was an important mediator of teenage drug use for first-grade shy-aggressive males and somewhat less important for first-grade aggressive males.

Early predictors of age at first use of alcohol, marijuana, and cigarettes

This paper is a report of the relationships between various measures of social adaptation to the first grade classroom and the age at which alcohol, cigarettes, and marijuana were first used by teenagers who began elementary school in a poor black urban community on the South Side of Chicago. Prospective longitudinal community epidemiological data were collected periodically in first and third grades from consecutive total cohorts of children in the 1960s. The 1966-67 population (cohort 3) was followed up at age 16 or 17. This population of 705 children is reported on here regarding early predictors of their first use of these substances. There are three main findings: (1) boys tended to use all substances at an earlier age than girls; (2) students who performed better on first grade IQ and Readiness tests tended to initiate substance use at an earlier age; (3) girls (but not boys) who were rated by their first grade teachers as shy or having learning problems tended to initiate use at a later age. The relationships of these findings to our past investigations of paths leading to substance use are discussed.

Ward atmosphere and outcome of treatment of acute schizophrenia.

Abstract The purpose of this study was to examine the relationship among various dimensions of ward atmosphere in twelve wards of four hospitals (N = 202), and the short-term outcome of schizophrenic patients treated with either phenothiazines or placebo. The detailed rationale and description of the quantified measures of ward atmosphere is the subject of an earlier paper.15 The wards were divided into ‘high’ and ‘low’ groups along each ward atmosphere dimension for analysis of the association of dimensions of ward atmosphere with treatment outcome. Hypotheses were formulated and tested that patients will improve more if assigned to wards: 1. (1) whose other patients are less disturbed; 2. (2) whose patients are less aggressive; 3. (3) where the other patients are less alone; 4. (4) where the patients not alone form larger rather than smaller social clusters; 5. (5) where there is more staff-patient contact; 6. (6) where patients are given more adults status; 7. (7) where the ward census is smaller; 8. (8) where the number of patients/staff member is smaller. Although the study hospitals did not have an explicit policy regarding transfer of patients from ward to ward on the basis of improvement, they tended to assign new patients to different wards according to initial severity of illness. The effect of ward atmosphere on short-term symptom reduction depended on the kind of symptom in question. The greatest number of effects were found on ‘paranoid’ symptoms, while the least number of effects were found on symptoms of ‘withdrawal’. Symptoms which could not be classified as ‘paranoid’ or ‘withdrawal’ held an intermediate position. The results generally conformed to the hypotheses concerning the association of good treatment outcome with wards with low disturbed behavior, low aggressive behavior, low aloneness, high cluster-size and high staff-patient contact (called patient behavior variables). However, the results were diametrically opposed to the hypotheses, at a statistically significant level, for the ward atmosphere dimensions adult status, ward census, and number of patients/staff member. The latter have been termed hospital policy dimensions. The interpretation is offered that the patient behavior dimensions of ward atmosphere are a part of far more powerful social forces affecting clinical course than are the hospital policy dimensions.

Measurement of the Psychological Well-Being of Adolescents: The Psychometric Properties and Assessment Procedures of the How I Feel.

The assessment procedures and psychometric properties of the How I Feel (HIF), an instrument used to assess psychological well-being in a population of Black adolescents are described. The audiovisual mode of presentation obviates problems related to reading skill; in addition, it standardizes the administration of the instrument. The How I Feel appears to measure reliably and validly several multi-item constructs representing psychological well-being. These constructs relate to other instruments and constructs in meaningful and interesting ways. A major result of our validity studies is that there appear to be two major components of psychological well-being, psychopathology and self-esteem.

Why Teenagers Come for Treatment: A Ten-Year Prospective Epidemiological Study in Woodlawn

Abstract The factors that influence people to come for psychiatric treatment are not well known. This report comes from a long-term prospective study of the 1966–1967 first-grade population of children and families in Woodlawn, a poor, black, urban community on Chicagos South Side. These children, now adolescents, were recently reassessed in a 10-year follow-up and were offered access to a free, broad psychiatric treatment program. Prior and current psychological and social problems did not discriminate those who came for the program from those who did not. However, the black college students who conducted the reassessment sessions were significant in determining which teenagers came for treatment.

The Prevention of Teenage Substance Use: Longitudinal Research and Strategy

Publisher Summary The prevention of substance abuse by adolescents in our society is being given an increasingly higher priority, particularly by the parents of such adolescents. Prevention programs have usually been limited to disseminating information on the consequences of use. The creation of laws has been another kind of preventive effort. Such efforts are essential and must continue. However, for prevention to be more effective, specific antecedents in the life course must be identified and their functions in the paths leading to use or nonuse must be determined. Specific preventive interventions can then be tested experimentally. However, it may take time to examine the status of the scientific information regarding longitudinal research on the early and evolving paths leading to substance abuse and other important outcomes. Longitudinal research is essential in uncovering the early and continuing course of events and conditions leading to social, behavioral, psychological, and psychopathological outcomes. Most of our understanding of substance use is based upon either research at a single point in time or relatively short-term longitudinal studies. Understanding the remote origins of use and paths leading to use is essential to the creation of the theory of causes and prevention.

The Character of Danger.

The Character of Danger is the third in a series of volumes containing the results of the Stirling County Study of Psychiatric Disorder and Sociocultural Environment. Volume 3 contains an interesting discussion of ecology and epidemiology as they apply to mental illness, an estimation of the amount of mental disorder in Stirling County (a geographically defined population of 20,000 people in the northeast area of America) and a series of correlation studies of the relationships between the prevalence rates of psychiatric symptoms in the people living in Stirling County and certain aspects of their sociocultural environment. The methods used to obtain the estimation of the prevalence of psychiatric disorder were those of the door-to-door survey carried out by nonpsychiatric, but trained personnel who filled in a protocol after an interview with a member of the Stirling County community. This protocol contained questions having to do with the family history