Epidemiology of Mental Disorders

Elmer Struening, Ph.D. Director
Patricia Cohen, Ph.D., Senior Research Scientist
Bruce Link, Ph.D., Principal Research Scientist
Howard Andrews, Ph.D., Research Scientist
Daniel Herman, D.S.W., Research Scientist IV
Susan Barrow, Ph.D., Research Scientist
Roderick Wallace, Ph.D., Research Scientist
Fredric Hellman, B.A., Program Evaluation Specialist II
Kathy Berenson, Ph.D., Research Scientist
Dorothy Castille, Ph.D., Research Scientist
Thomas Crawford, Ph.D., Research Scientist
Henian Chen, MD, Ph.D., Research Scientist
Jeffrey Johnson, Ph.D., Research Scientist
Stephanie Kasen, Ph.D., Research Scientist

OVERVIEW
The research of the Epidemiology of Mental Disorders Department is focused on two areas: 1) risks influencing the onset and course of mental disorders and 2) factors affecting the quality of life of persons with mental disorder in the community. In addition to the research in these areas, members of the Department provide data management and statistical services to a number of major research studies at Psychiatric Institute and the Columbia Medical Center (the Data Coordinating Center), helped to develop and actively participate in PI's Research Information Services Consortium, and oversee the Psychiatric Epidemiology Training program. Dr. Link serves as the Director of the Center for Youth Violence Prevention (Mailman School of Public Health) and the Columbia Health and Society Scholars Program (Mailman School of Public health and the Institute for Social, Economic and Policy Research).

CURRENT RESEARCH
Dr. Struening continues to collaborate with colleagues from several institutions. He provides consultation to Dr. Rein Lepnurm (University of Saskatchewan) on research focused on job satisfaction of physicians; to Dr. Perry Hoffman (Weill Medical College of Cornell College and Columbia University) in the assessment of background, perceptions and attitudes of people who provide care for individuals with Borderline Personality Disorder; to Ms. Mary Guardino (Freedom from Fear) on studies of depression in the general population. Columbia students participate in developing and publishing papers in this important area of research. Continuing a long partnership with the Psychiatry Department at Harlem Hospital, Dr. Struening currently provides consultation in psychometric principles and applications to Dr. Charles Nnadi. With Dr. Bill Tucker, he is developing evaluation of tele-therapy for prisoners with mental disorders in northern New York State prisons.

Dr. Patricia Cohen continues to lead a productive team conducting the Children in the Community study. A representative community sample of over 800 people originally living in upstate New York and selected in 1975, it is in the sixth round of interviews. The "Children" in the study title are now on average 33 years old. Best known for its assessment of personality disorders beginning in childhood, this study continues to investigate the course of both Axis I and Axis II disorders and the associated risks and consequences. Researchers in the study continue to add to the 140 articles previously published covering a wide range of topics.
(CIC web site: http://www.nyspi.cpmc.columbia.edu/ChildCom/index.htm)

Beginning in 2001, this team also began a follow-up study of the mothers of the Children in the Community subjects on whom data have also been collected since 1975. The current study focuses on life circumstances affecting the well-being of these now middle-aged women. Dr. Stephanie Kasen has published findings showing that the life course of depression in women varies depending upon the time of their birth; despite the well-known elevated depression in early adulthood for the post WWII cohort, differences diminish in late middle age.

The Children in the Community study group recently joined other longitudinal studies in collaborative research on the psychiatric precursors of substance abuse disorders. This research, initiated at Duke University, involves studies from New Zealand and Germany as well as several studies from the United States.

Dr. Bruce Link continues his research examining the life circumstances and psychiatric status of people assigned to outpatient commitment under New York State’s Kendra’s Law. The study is being conducted in conjunction with Bronx and Creedmor Psychiatric Centers as well as Bronx Lebanon Hospital and will provide critical information to policy makers concerning the success of this program in New York State. Dr. Link’s address upon receiving the Leonard Pearlin Award “The Production of Understanding” was published in the December 2003 edition of the Journal of health and Social Behavior. Dr. Link continues his work as Director of the NIMH Psychiatric Epidemiology Training Program in the Departments of Psychiatry and Epidemiology and as Director of the Robert Wood Johnson Foundation Health and Society Scholars Program in the School of Public Health and the downtown Columbia Center for Public Policy.

Dr. Howard Andrews, Director of the Data Coordinating Center (DCC) , continues to provide comprehensive data management and statistical services to a number of major research Initiatives at Psychiatric Institute and the CPMC campus. These include (PI): Alzheimer's Disease Research Center (M Shelanski), Alzheimer's Disease Sibling Study (R Mayeux), Child Environmental Health (F Perera), Community Wellness Project (E Susser), Dept of Health Pest-Control Intervention (D. Evans), Endotoxin, Obesity & Asthma in NYC Head Start (J. Jacobson), Environmental Protection Agency (R Whyatt), Alzheimer's Disease Prevention Trial with Estrogens (M Sano), Haloperidol Discontinuation Trial (D Devanand), High-Dose Supplements for Homocysteine in Alzheimer's Disease (M Sano), Parkinson's Disease Genetics Study (K Marder), Predictors of Severity in Alzheimer's Disease (Y Stern), Adolescent Risk and Resilience Study (C. Mellins), Risk Factors Underlying Essential Tremor (E Louis), Traumatic Brain Injury Data Coordinating Center (W. Friedewald), Vitamin E Trial in Persons with Down's Syndrome (A Dalton), Washington Heights-Inwood Community Aging Project/2 databases (R Mayeux), World Trade Center Pregnancy Study (F Perera).

Dr. Susan Barrow has continued her research on housing and service models for homeless adults with mental illness. She has also edited and contributed to a major new reference work on homelessness. Current research includes a four-city study of service engagement and residential stability in programs for adults with multiple disabilities and long-term homelessness and (with colleagues at NKI) an outcome study comparing supported housing models with clinically managed residential alternatives. Both of these studies take a dual focus on individual outcomes and social context, examining housing programs as sets of social practices that not only affect individual residential stability and service utilization but also entail distinctive concepts of and strategies for achieving quality of life and community integration. With Dr. Kim Hopper of NKI, she has documented alternative approaches to reducing stigma, building community, and promoting social integration taken by programs representing two variants of the “supported housing” model.

Dr. Barrow is also pursuing research on family separations and parenting by homeless mothers with mental illness. She has been examining barriers and supports for such mothers who are separated from their children and the circumstances of mother-child separation and reunification in homeless families in Westchester County with NKI investigators. Initial findings reveal that 45% of families entering homeless shelters have experienced past or current separation from at least one minor child.

Dr. Rodrick Wallace continues his close collaboration with a number of Columbia faculty, including Mindy Fullilove of the Dept. of Psychiatry, and Deborah Wallace of the Division of Sociomedical Sciences. He is also working with an SMS graduate student who is expanding his earlier work on commuting patterns and the diffusion of infectious disease and risk behavior. From 1998 through 2003 he was a Co-investigator in the Columbia Childrens’ Center for Environmental Health.

EDUCATION & TRAINING
Drs. Link and Cohen serve as Director and Co-Director of the Psychiatric Epidemiology Training Program (in Psychiatry and the Mailman School of Public Health). Dr. Link is also Director of the Center for the Study of Violence (Mailman School of Public Health. Dr. Cohen is also on the faculty of the Child Psychiatry Research Fellow program and of the Center for Children and Families of the Columbia University Teachers College.

Dr. Cohen serves as mentor to three K-award recipients.

AWARDS & HONORS
Dr. Link was recently awarded the Leonard Pearlin Award for a career of outstanding contributions to mental health sociology. His address upon receiving the award “The Production of Understanding” was published in the December 2003 edition of the Journal of Health and Social Behavior.

GRANTS
Elmer Struening
New York City Department of Mental Health, Mental Retardation and Alcoholism Services Contract #1003580

Howard Andrews, PI for site
5R01-AG16381-04 Multicenter Vitamin E Trial in Persons with Down Syndrome (PI site)

Patricia Cohen PI
RO1MH60911 Personality Disorder over 20 years – Risks, Course and Impact
RO1HD40685 Change in Women's Roles and Well-Being: Age-Cohort Effects
RO1DA016977 Multi-Site Longitudinal Analysis of Psychiatric Risk of SUDs

BIBLIOGRAPHY
Alexander, L.A. and Link, B.G. (2003) The impact of contact on stigmatizing attitudes toward people with mental illness. Journal of Mental Health. 12: 271-289.
Lee, B.A., Farrell, C.R. & Link, B.G. (in press) Revisiting the Contact Hypothesis: Public Exposure to Homelessness. American Sociological Review.
Barrow, S.M. (In press) Separation and Reunification of Homeless Families; Homeless women; Transitional Housing. In: Encyclopedia of Homelessness. Sage, Inc.
Brown, J., Berenson, K., & Cohen, P. (in press). Documented and self-reported child abuse and adult pain in a community sample.Clinical Journal of Pain.
Chen, H., Cohen, P., Kasen, S., Gordon, K., Dufur, R., & Smailes, E. (2004).Construction and validation of a quality of life instrument for young adults. Quality of Life Research., 13, 747-759.
Cohen, P., Kasen, S., Chen, H., Hartmark, C., & Gordon, K. (2003). Variations in patterns of developmental transitions in the emerging adulthood period. Developmental Psychology. 39 (4), 657-669.
Cohen, P., Smailes, E., & Brown, J.(in press). Effects of childhood maltreatment on adult arrests in a general population sample.In B. Fisher (Ed.), Violence against women and family violence. Washington, DC: National Institute of Justice.
Crawford T.N., Cohen P., Johnson J.G., Sneed J.R., & Brook JS. (in press). The early course of personality disorder symptoms: Erickson's developmental theory revisited. Journal of Youth and Adolescence.
Ehrensaft, M. K. , Cohen, P., Brown, J., Smailes, E., Chen, H. & Johnson, J. G. (2003). Intergenerational transmission of partner violence: A 20-years prospective study. Journal of Consulting and Clinical Psychology, 71 (4), 741-753.
Henderson C, Liu, X, Roux, A.D., Link, B.G., & Hasin, D. (2004) The effects of US state income inequality and alcohol policies on symptoms of depression and alcohol dependence. Social Science & Medicine. 58:565-75.
Hopper, K. & Barrow, S. (2003) Two genealogies of supported housing and their implications for outcome assessment. Psychiatric Services. 54(1):50-54.
Johnson, J. G., Cohen, P., Kasen, S., & Brook, J. S. (in press).Paternal psychiatric symptoms and maladaptive paternal behavior in the home during the child-rearing years. Journal of Child and Family Studies.
Johnson, J. G., Cohen, P., Kasen, S., Brook, J. S. (in press). Risk factors and outcomes associated with adolescent eating disorders: Findings of the Children in the Community Study. In F. Columbus (Ed.), Progress in Eating Disorders. Hauppauge, NY: Nova Science Publishers.
Johnson, J. G., Cohen, P., Kasen, S., First, M. B., & Brook, J. S. (in press). Association between television viewing and sleep problems during adolescence and early adulthood. Archives of Pediatrics and Adolescent Medicine.
Johnson, J. G., Smailes, E. M., Cohen, P., Kasen, S., & Brook, J. S. (in press). Antisocial parental behavior, maladaptive parenting, aggressive offspring behavior during adulthood: a 25-year longitudinal investigation. British Journal of Criminology.
Kasen, S., Berenson, K., Cohen, P., & Johson, J.G. (In press) The effects of school climate on changes in aggressive and other behaviors related to bullying. In D.L. Espelage & S.M. Swearer (eds.), A social-ecological perspective on bullying prevention and intervention in American schools. New York: Lawrence Erlbaum Associates.
Kasen, S., Cohen, P., Chen, H., & Castille, D. (2003). Depression in adult women: Age changes and cohort effects. American Journal of Public Health, 93 (12), 2061-2066.
Link, B.G. (2003) The production of understanding. Journal of Health and Social Behavior. 44:457-469.
Link, B.G., Yang, L., Phelan, J.C. & Collins,P.. (in press) Measuring Mental Illness Stigma. Schizophrenia Bulletin.
Link, B.G. & Phelan, J.C. (In press) Fundamental sources of health inequalities. Policy Challenges in Modern Health Care. D. Mechanic, L. Rogut, D. Colby and J.Knickman eds. Rutgers University Press.
Marder, K., Levy,G., Louis, E.D., Mejia Santana, H., Cote, L., Andrews, H., Harris, J., Waters, C., Ford, B., Frucht, S., Fahn, S. and Ottman, R. 2003. Familial aggregation of early and late onset Parkinson’s disease. Annals of Neurology, 54(4): 507 413, 2003.
Phelan, J.C. & Link, B.G.. (In press) Fundamental Social Causes of Disease and Mortality. Encyclopedia of Health and Behavior, edited by Norman Anderson.
Phelan, J.C. and Link, B.G. (2004) Fear of people with mental illnesses: The role of personal and impersonal contact and exposure to threat or harm. Journal of Health and Social Behavior. 45: 68-80.
Rauh, V.A., Lamb Parker, F., Garfkel, R.S., Perry, J. and Andrews, H. (2003) Biological, social and community influences on third grade reading levels of minority Head Start children: a multi level approach. J. Comm. Psychology, 31(3): 255 278.
VanderStoep, A., Weiss, N.S., Kuo, E.S., Cheney, D., & Cohen, P. (2003). What proportion of failure to complete secondary school in the U.S. population is attributable to adolescent psychiatric disorder? Journal of Behavioral Health Services & Research, 30 (1), 119-124.
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Wallace, R., (In press) "Comorbidity and anticomorbidity: Autocognitive developmental disorders of structured psychosocial stress". Acta Biotheoretica.
Wallace, R., Wallace, D., and Wallace, R.G., (In press) Biological limits to reduction in rates of coronary heart disease: a punctuated equilibrium approach to immune cognition, chronic inflammation, and pathogenic social hierarchy. Journal of the National Medical Association.
Wallace, R., (2003) Systemic lupus erythematosus in African-American women: cognitive physiological modules, autoimmune disease, and pathogenic social hierarchy. Advances in Complex Systems, 6:599.
Wallace, R.G. and Wallace, R., (2003) The geographic search engine: one way urban epidemics find susceptible populations and evade public health interventions. Poster, Second International Conference on Urban Health, New York City, October 15-18.
Wallace, R., Wallace, R.G., and Wallace, D., (2003) Toward Cultural Oncology: The Evolutionary Information Dynamics of Cancer. Open Systems and Information Dynamics 10:159.
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Yanos, P.T., Barrow, S.M., Tsemberis, S. (2004) Community Integration in the Early Phase of Housing among Homeless Persons Diagnosed with Severe Mental Illness: Successes and Challenges. Community Mental Health Journal.