Tracked mental health of children
Patricia Cohen, a researcher who tracked the mental health of a large group of children as they grew to adulthood, detailing the natural history of psychiatric problems and helping to create a framework for future long-term studies, died July 16 in Marlborough, Mass. She was 81.
Her daughter, Erika Bourne, said the cause was complications of an infection. Ms. Cohen had dementia, Ms. Bourne said.
Ms. Cohen was a midcareer research psychologist at Columbia University when she devised the project that would become her life’s work. In the early 1980s, she and colleagues recruited more than 800 children as young as 9 years old in upstate New York and began to chart their mental health.
At the time, psychiatrists knew little about when mental health problems emerge and how they evolve through development; diagnoses were snapshots in time, blurrier than they are today.
Ms. Cohen saw that patience could be an ally. She stayed in touch with the children and obtained funding over the years to revisit them and assess their mental well-being as they grew into their 20s and 30s.
TheChildren in the Community Study, as it was known, became one of the longest-running of its kind, and provided Ms. Cohen and her collaborators with enough data and findings to fill a career.
Ms. Cohen found, among other things, correlations between parenting styles and mental health. For instance, children who were disciplined by the rod tended to have more mood problems later on than those whose parents disciplined less harshly.
She found, too, that mental issues could shape-shift over time, in the same child. The anxious, hyperactive 7-year-old could become a depressed, lethargic teenager.
The study was particularly helpful in elucidating the correlations between mood problems and socalled personality disorders. In diagnostic terms, the two occupy separate categories: mood problems refer to common conditions like anxiety and depression; personality disorders are rare, idiosyncratic behaviors, characterized by patterns, like a fear of abandonment and urges to selfharm (borderline personalitydisorder), grandiose selfregard (narcissistic), or smothering clingy-ness (dependent).
“Its strength was that she included measures of both psychiatric mood diagnoses and personality disorders, and so was able to compare the long-term effects of both,” said E. Jane Costello, a professor of psychiatry and behavioral sciences at Duke University. (Ms. Costello’s long-term Great Smoky Mountains Study, in rural North Carolina, has similarly tracked mental disorders over a lifetime.)
“And she was statistically very good,” Ms. Costello said, which added rigor to the results.
Ezra Susser, a professor of epidemiology and psychiatry at Columbia, said of Ms. Cohen’s work: “Hers was a foundational study, in what we nowadays call life-course psychiatric epidemiology.”
Life-course studies like Ms. Cohen’s and Ms. Costello’s are especially crucial in psychiatry as a check on faddish diagnoses, Mr. Susser said. In the early 2000s, for example, doctors at Massachusetts General Hospital and elsewhere began diagnosing bipolar disorder in children as young as 3.
But studies like Ms. Cohen’s and Ms. Costello’s showed that the trend was mistaken. In adults, the disorder involves periods of sadness alternating with periods of mania. Young children, however, did not exhibit classic manias, the studies found, and those who were given the diagnosis so early rarely, if ever, went on to develop fullblown adult bipolar disorder.
Patricia Ruth Childs was born on Oct. 20, 1936, in Park Rapids, in northern Minnesota, the second of five daughters of John Keble Childs, a forester, and Margaret Richardson Childs, a teacher. She grew up in the nearby city of Bemidji.
After graduating from high school, she attended Hamline University in St. Paul and finished with a degree in English and music in 1958. She earned a Ph.D. in psychology at New York University, where she met Jacob Cohen, one of her professors and an authority on statistical analyses in the behavioral sciences. They married in 1969. Her first marriage, to Haider Walty, ended in divorce.
Jacob Cohen died in 1998. Ms. Cohen was a researcher in the New York state Office of Mental Health in the 1970s when she and her husband published “Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences” — a landmark text in the field.