Ten good reasons to consider biological processes in prevention and intervention research

Abstract

Most contemporary accounts of psychopathology acknowledge the importance of both biological and environmental influences on behavior. In developmental psychopathology, multiple etiological mechanisms for psychiatric disturbance are well recognized, including those operating at genetic, neurobiological, and environmental levels of analysis. However, neuroscientific principles are rarely considered in current approaches to prevention or intervention. In this article, we explain why a deeper understanding of the genetic and neural substrates of behavior is essential for the next generation of preventive interventions, and we outline 10 specific reasons why considering biological processes can improve treatment efficacy. Among these, we discuss (a) the role of biomarkers and endophenotypes in identifying those most in need of prevention; (b) implications for treatment of genetic and neural mechanisms of homotypic comorbidity, heterotypic comorbidity, and heterotypic continuity; (c) ways in which biological vulnerabilities moderate the effects of environmental experience; (d) situations in which Biology x Environment interactions account for more variance in key outcomes than main effects; and (e) sensitivity of neural systems, via epigenesis, programming, and neural plasticity, to environmental moderation across the life span. For each of the 10 reasons outlined we present an example from current literature and discuss critical implications for prevention.

Figure 1

A hypothetical distribution of individual differences in age of onset for schizophrenia across 10 twin pairs. Solid bars indicate age of onset for each individual. Concordance is determined by the proportion of the 10 twin pairs who are both afflicted. Because individual differences in age of onset are observed for almost all forms of psychopathology, concordance rates necessarily increase across the life span. Note that the final concordance rate of .80 indicates a highly heritable trait. Although dichotomous outcomes are used for simplicity of presentation, the same argument applies to continuously assessed traits.

Figure 2

Symptom overlap in CD and depression. Both disorders are characterized by CNS reward dysfunction, leading to common symptoms. The disorders are differentiated by behavioral inhibition. [A color version of this figure can be viewed online at journals.cambridge.org/dpp]

Figure 3

The main effects of (top) dyadic mother–daughter negativity and (middle) adolescent peripheral serotonin on lifetime self-harm events in a sample of 41 adolescent girls. Negativity and peripheral serotonin accounted for 23 and 3% of the variance in self-harm, respectively. In contrast, (bottom) the conjoint effects of negativity and peripheral serotonin accounted for 64% of the variance in self-injury. From “Parent–Child Interactions, Peripheral Serotonin, and Self-Inflicted Injury in Adolescents,” by S. E. Crowell, T. P. Beauchaine, E. McCauley, C. J. Smith, C. A. Vasilev, and A. L. Stevens, 2008, Journal of Consulting and Clinical Psychology. Copyright 2008 by American Psychological Association. Adapted with permission.