Family Relationships and
Major Mental Disorder: Risk
Factors and Preventive
Jill M. Hooley and Jordan B. Hiller
Harvard University, Cambridge, MA
No one, regardless of culture, income, or privilege, is entirely immune from mental disorder. Schizophrenia, the most serious and complex form of psychopathology, has little respect for geographical, financial, or social boundaries. With a prevalence of just under 1%, it currently affects the lives of more than two million Americans (American Psychiatric Association, 1994). Moreover, with lifetime prevalence estimates in North America averaging around 5% for major depression and 1% for bipolar disorder (see Smith & Weissman, 1992), countless more patients suffer from mood disorders. When the impact of these disorders on close family members is also considered, it is clear that many lives are fractured, either directly or indirectly, as a result of mental illness.
Understanding the etiology of major mental disorder has long been at the forefront of the clinical research agenda. Encouragingly, as investigators have risen to meet this challenge, important ground has been gained. For example, much has been learned about the role of genetic factors in the development of schizophrenia (Kendler & Diehl, 1993). It is also becoming increasingly apparent that schizophrenia is a disorder characterized by abnormalities in a number of different brain areas, and that in all probability at least some of these deficits or abnormalities are present from birth (e.g., Benes et al., 1991;Berquier&Ashton, 1991; Roberts, 1991; Weinberger, 1987).