The proposed project examines psychiatric nosology and selected risk factors for psychiatric disorders in the context of a representative community-based sample. Psychiatric disorders are examined using three approaches: (a) DIS/DSM-III diagnoses, (b) DIS symptom counts, and (c) symptom profiles generated by grade of membership (GOM) analysis. The GOM analyses are particularly important in that they provide information about the extent to which empirically-based symptom profiles match the diagnostic categories that comprise the nosologic framework of DIS-III. This eclectic approach to psychiatric diagnosis also permits examination of the kinds of mental health problems that are most prevalent in community populations (e.g. symptom syndromes as well as formal diagnoses). Risk factor analyses focus on three areas: (a) the extent to which job characteristics are risk factors for psychiatric disorders, (b) the relationships among life events, social support, social integration, and psychiatric disorders, and (c) the extent to which environmental characteristics of the residential area are risk factors for psychiatric disorders. A variety of statistical modeling techniques will be employed in the risk analyses, including multilevel analysis for examining the impact of enviromental effects. Special attention will be devoted to the interactive, as well as the direct and indirect effects, of the risk factors examined. The proposed analyses will be contribute to our understanding of psychiatric disorders in community populations and the identification of variables that place individuals at increased risk of psychiatric disorders. The data to be used in the proposed project are from the Epidemiologic Catchment Area Program. Most analyses will be used on the Duke ECA sample, but selected analyses will use pooled from all five ECA sites. The proposed analyses included both cross-sectional and longitudinal models. Where possible, length of exposure to the risk factors of interest also will be examined. The proposed project capitalizes upon the richness and breadth of the ECA Project and will examine issues of long- standing interest in psychiatric epidemiology in a creative and methodologically sophisticated manner.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
Project #
Application #
Study Section
Epidemiologic and Services Research Review Committee (EPS)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Duke University
Schools of Medicine
United States
Zip Code
Connor, Kathryn M; Davidson, Jonathan R T; Hughes, Dana C et al. (2002) The impact of borderline personality disorder on post-traumatic stress in the community: a study of health status, health utilization, and functioning. Compr Psychiatry 43:41-8
Swartz, M S; Wagner, H R; Swanson, J W et al. (1998) Administrative update: utilization of services. I. Comparing use of public and private mental health services: the enduring barriers of race and age. Community Ment Health J 34:133-44
Davidson, J R; Hughes, D C; George, L K et al. (1996) The association of sexual assault and attempted suicide within the community. Arch Gen Psychiatry 53:550-5
Ellison, C G (1995) Race, religious involvement and depressive symptomatology in a southeastern U.S. community. Soc Sci Med 40:1561-72
Koenig, H G; George, L K; Meador, K G et al. (1994) Religious affiliation and psychiatric disorder among Protestant baby boomers. Hosp Community Psychiatry 45:586-96
Landerman, L R; Burns, B J; Swartz, M S et al. (1994) The relationship between insurance coverage and psychiatric disorder in predicting use of mental health services. Am J Psychiatry 151:1785-90
Koenig, H G; George, L K; Meador, K G et al. (1994) Religious practices and alcoholism in a southern adult population. Hosp Community Psychiatry 45:225-31
Mathew, R J; Wilson, W H; Blazer, D G et al. (1993) Psychiatric disorders in adult children of alcoholics: data from the Epidemiologic Catchment Area project. Am J Psychiatry 150:793-800
Greenfield, S F; Swartz, M S; Landerman, L R et al. (1993) Long-term psychosocial effects of childhood exposure to parental problem drinking. Am J Psychiatry 150:608-13
Meador, K G; Koenig, H G; Hughes, D C et al. (1992) Religious affiliation and major depression. Hosp Community Psychiatry 43:1204-8

Showing the most recent 10 out of 14 publications