SOCIAL STATUS AND PSYCHOLOGICAL DISORDERS

这是对ADAMHA研究科学家奖的申请。

This is a request for an ADAMHA Research Scientist Award. Three projects will be worked on during the five-year period: One on relations between depression and chronic pain; the second on measuring life events; the third and most central to long-term goals, a study of socioeconomic status (SES) and psychiatric disorders. The first two will be summarized briefly; the last in more detail. The long-term goal of the research is to contribute to understanding of the role of adversity in the causation of psychiatric disorders. In the main project, we investigate social, psychological, and family history factors that may be important in the etiology of the types of psychopathology that are inversely related to socioeconomic status (SES) - schizophrenia, major depression, antisocial personality, substance abuse, and nonspecific distress or "demoralization." The point of departure is a strategy for testing the social stress-social selection issue posed by the SES differences. Israel was chosen as the research setting for three main reasons: First, the strategy requires an urban society in which the assimilation of one or more initially disadvantaged ethnic groups is taking place; second, Israelis have been exposed to unusual as well as usual stressful circumstances during the country's history of war; and third, the existence in Israel of a well-kept population register makes possible the kind of sampling of a birth cohort that we require. The research has focused since 1982 on a nationwide cohort of young adult, Israel-born Jews of relatively disadvantaged North African background and relatively advantaged European background. Screening and diagnostic interviews by psychiatrists have been conducted with a full probability sample of 4914 persons from this cohort. A subsample of 361 persons diagnosed as having the key types of psychiatric disorder and 198 persons diagnosed as having no disorders have been selected from the larger sample and followed up with intensive interviews about possible risk factors; screening interviews have been conducted with at least one sibling of most of these cases and controls. The main analyses of the data from the 4914 member epidemiological sample have been completed and reported. Focus is now on processing and statistical analyses of the detailed data on the 361 cases and 198 controls. Taken together with the completed analyses of the epidemiological data, the planned analyses of the case/control data will provide a major contribution to our understanding of the role of adversity. The results will also provide a basis for designing a 10-year follow up of the cohort sample in 1993.