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An ongoing longitudinal community study (N = 375) examined childhood risks and later adult impairments associated with 1-year Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) diagnoses of major depression during the transition to adulthood. Risks from birth to age 9 were reported by mothers, participants, and teachers. Teacher-reported hostility at age 6 predicted later depression. At age 9, self-perceptions of anxiety/depression, unpopularity, familial rejection, and abuse were potent risks. For men, neonatal and childhood health problems predicted later depression. For women, risks included family constellation, parental death, and poor academic achievement at age 9. Men and women who were depressed at age 18, age 21, or both demonstrated extensive psychosocial impairments in early adulthood, including poor overall functioning, interpersonal and behavioral problems, low self-esteem, and suicidality.

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Several groups of prevention scholars and practitioners have recently worked independently and simultaneously to identify and disseminate guidelines for effective prevention and health promotion, reaching remarkably similar conclusions. The authors argue that community-based collaboration is an overarching best practice in prevention because it is crucial for achieving the characteristics identified as distinguishing effective prevention. This article reviews the elements that scholars have agreed are necessary for effective prevention and summarizes the ways in which community-based collaborations contribute to each.