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Poverty and Child Mental Health
Natural Experiments and Social Causation
Michael Rutter, MD
JAMA. 2003;290:2063-2064.
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Most social scientists have tended to assume that poverty predisposes to mental disorder, on the grounds that numerous studies have shown statistical associations between the two.1-2 However, as Costello et al3 point out in this issue of THE JOURNAL, causal inference is problematic in the absence of experimental evidence because of the crucial need to differentiate between social selection and social causation.4-5 In other words, does the statistical association reflect the tendency for individuals with mental disorder to drift into or remain in poverty, or does the experience of poverty itself predispose to mental disorder?
The problem arises when both poverty and the mental disorder apply to the same individuals, as would be the case with studies of adults, but it is especially a concern when poverty derives from the parents, with the effects being considered with respect to mental disorder in the children. Sometimes social selection . . . [Full Text of this Article]
Author Affiliation: Social, Genetic and Developmental Psychiatry Research Centre Institute of Psychiatry, King's College, London, England.
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