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Showing papers by "University of Michigan published in 1996"



Journal ArticleDOI
TL;DR: In this article, the authors describe the development and validation of a new instrument, KEYS: Assessing the Climate for Creativity, designed to assess perceived stimulants and obstacles to creativity in organizational work environments.
Abstract: We describe the development and validation of a new instrument, KEYS: Assessing the Climate for Creativity, designed to assess perceived stimulants and obstacles to creativity in organizational work environments. The KEYS scales have acceptable factor structures, internal consistencies, test-retest reliabilities, and preliminary convergent and discriminant validity. A construct validity study shows that perceived work environments, as assessed by the KEYS scales, discriminate between high-creativity projects and low-creativity projects; certain scales discriminate more strongly and consistently than others. We discuss the utility of this tool for research and practice.

5,240 citations


Journal ArticleDOI
TL;DR: The American Customer Satisfaction Index (ACSI) as discussed by the authors is a new market-based performance measure for firms, industries, economic sectors, and national economies that measures the satisfaction of customers.
Abstract: The American Customer Satisfaction Index (ACSI) is a new type of market-based performance measure for firms, industries, economic sectors, and national economies. The authors discuss the nature and...

4,073 citations


Journal ArticleDOI
TL;DR: In this paper, a measure of changes in alliance partners' technological capabilities, based on the citation patterns of their patent portfolios, is used to analyze changes in the extent to which partner firms' technological resources overlap as a result of alliance participation.
Abstract: This paper examines interfirm knowledge transfers within strategic alliances. Using a new measure of changes in alliance partners' technological capabilities, based on the citation patterns of their patent portfolios, we analyze changes in the extent to which partner firms' technological resources ‘overlap’ as a result of alliance participation. This measure allows us to test hypotheses from the literature on interfirm knowledge transfer in alliances, with interesting results: we find support for some elements of this ‘received wisdom’—equity arrangements promote greater knowledge transfer, and ‘absorptive capacity’ helps explain the extent of technological capability transfer, at least in some alliances. But the results also suggest limits to the ‘capabilities acquisition’ view of strategic alliances. Consistent with the argument that alliance activity can promote increased specialization, we find that the capabilities of partner firms become more divergent in a substantial subset of alliances.

3,355 citations


Journal ArticleDOI
14 Jun 1996-Cell
TL;DR: This work utilized nano-electrospray tandem mass spectrometry to identify CAP3 and CAP4, components of the CD95 (Fas/APO-1) death-inducing signaling complex, and found a novel 55 kDa protein, designated FLICE, which has homology to both FADD and the ICE/CED-3 family of cysteine proteases.

3,181 citations


Journal ArticleDOI
TL;DR: This revision supersedes the four previous updates in which a nomenclature system, based on divergent evolution of the P450 superfamily has been described and is similar to that proposed in the previous updates.
Abstract: We provide here a list of 481 P450 genes and 22 pseudogenes, plus all accession numbers that have been reported as of October 18,1995. These genes have been described in 85 eukaryote (including vertebrates, invertebrates, fungi, and plants) and 20 prokaryote species. Of 74 gene families so far descr

2,888 citations


Journal ArticleDOI
TL;DR: This article examined the implications of this development by first considering the differences between the literatures on organizational culture and organizational climate and then examining the many similarities between these two literatures, focusing on their definition of the phenomena, their epistemology and methodology, and their theoretical foundations.
Abstract: Recently, organizational culture researchers have applied quantitative survey methods and identified comparative “dimensions” of culture in a way that appears to contradict some of the original foundations of culture research within organizational studies. This new quantitative culture research also bears a strong resemblance to earlier research on organizational climate. This article examines the implications of this development by first considering the differences between the literatures on organizational culture and organizational climate and then examining the many similarities between these two literatures. The literatures are compared by focusing on their definition of the phenomena, their epistemology and methodology, and their theoretical foundations. The implications of the differing theoretical foundations and their underlying assumptions about the phenomenon are discussed at some length, as are some of the consequences of the continued separation of these two literatures. The final discussion f...

1,890 citations


Book ChapterDOI
01 Jan 1996

1,837 citations


Journal ArticleDOI
01 Aug 1996-Stroke
TL;DR: It is concluded that ICH volume can be accurately estimated with the simple formula ABC/2 in less than 1 minute with the help of a bedside method.
Abstract: Background and Purpose Hemorrhage volume is a powerful predictor of 30-day mortality after spontaneous intracerebral hemorrhage (ICH). We compared a bedside method of measuring CT ICH volume with m...

1,794 citations


Journal ArticleDOI
TL;DR: Evidence from many sources is reviewed regarding both the psychological structure of food reward and the neural systems that mediate it and it is argued that this evidence suggests the following surprising possibilities regarding the functional components and brain substrates of food Reward.

1,780 citations


Journal ArticleDOI
TL;DR: In this paper, the relationship between emissions reduction and firm performance is examined empirically for a sample of S&P 500 firms using data drawn from the Investor Responsibility Research Center's Corporate Environmental Profile and Compustat.
Abstract: Evidence can be marshalled to support either the view that pollution abatement is a cost burden on firms and is detrimental to competitiveness, or that reducing emissions increases efficiency and saves money, giving firms a cost advantage. In an effort to resolve this seeming paradox, the relationship between emissions reduction and firm performance is examined empirically for a sample of S&P 500 firms using data drawn from the Investor Responsibility Research Center's Corporate Environmental Profile and Compustat. The results indicate that efforts to prevent pollution and reduce emissions drop to the ‘bottom line’ within one to two years of initiation and that those firms with the highest emission levels stand the most to gain.

01 Jan 1996
TL;DR: Three general approaches to the role of feelings in human cognition focus on the experiential, cognitive, and somatic components of feelings, respectively as mentioned in this paper, and they focus on basic theoretical principles and empirical regularities, rather than complete coverage of the literature.
Abstract: Following an initial emphasis on " cold " cognitive processes, which could be conceptualized within the computer metaphor of the information processing paradigm, social cognition researchers rediscovered " hot " cognition in the 1980's. Two decades later, their interest in the interplay of feeling and thinking is shared by researchers in decision making, cognitive psychology, and related fields. This chapter reviews what has been learned; it focuses on basic theoretical principles and empirical regularities, rather than complete coverage of the literature. We first introduce three broad approaches to the interface of feeling and thinking and subsequently evaluate them in light of empirical findings in three key domains, namely, human judgment, strategies of information processing, and memory. Throughout, we emphasize the influence of feelings on cognitive processes; the reverse influence of cognition on emotion is Three general approaches to the role of feelings in human cognition focus on the experiential, cognitive, and somatic components of feelings, respectively. The first approach emphasizes the experiential quality of feelings and addresses their informational functions. A second approach emphasizes the thoughts that accompany feelings, whereas a third approach emphasizes hard-wired processes, focusing on the somatic components of affective states. Central to the experiential approach is the assumption that feelings can serve as a source of information in their own right. This assumption is consistent with traditional theorizing on emotions and has been fruitfully extended to other subjective experiences. Social psychologists often subsume moods and emotions under the generic term affect. This term, however, can also refer simply to valence-the positive and negative aspect of things. All emotions are affective, but not all affective things are emotions. Emotions arise in response to ongoing, implicit appraisals of situations with respect to positive or negative implications for one's goals and concerns (e. have an identifiable referent (what the emotion is "about"), a sharp rise time, limited duration, and often high intensity. Emotion researchers commonly assume that "emotions exist for the Feelings-2 sake of signaling states of the world that have to be responded to, or that no longer need response and action" (Frijda, 1988, p. 354). What exactly emotions signal can be derived from their underlying appraisal patterns. Sadness, for example, signals a loss or lack of reward that is not attributed to the causal action of another agent; when it is attributed to the causal action of another agent, it gives rise to anger. Accordingly, sadness and …

Journal ArticleDOI
TL;DR: Prior insomnia remained a significant predictor of subsequent major depression when history of other prior depressive symptoms was controlled for, and complaints of 2 weeks or more of insomnia nearly every night might be a useful marker of subsequent onset of major depression.

Journal ArticleDOI
01 Aug 1996-Nature
TL;DR: This study provides the first evidence that osteocalcin is a determinant of bone formation, and generates osteocalin-deficient mice that develop a phenotype marked by higher bone mass and bones of improved functional quality.
Abstract: Vertebrates constantly remodel bone. The resorption of preexisting bone by osteoclasts and the formation of new bone by osteoblasts is strictly coordinated to maintain bone mass within defined limits. A few molecular determinants of bone remodelling that affect osteoclast activity have been characterized, but the molecular determinants of osteoblast activity are unknown. To investigate the role of osteocalcin, the most abundant osteoblast-specific non-collagenous protein, we have generated osteocalcin-deficient mice. These mice develop a phenotype marked by higher bone mass and bones of improved functional quality. Histomorphometric studies done before and after ovariectomy showed that the absence of osteocalcin leads to an increase in bone formation without impairing bone resorption. To our knowledge, this study provides the first evidence that osteocalcin is a determinant of bone formation.


Journal ArticleDOI
TL;DR: Functional magnetic resonance imaging is used to probe PFC activity during a sequential letter task in which memory load was varied in an incremental fashion, providing a "dose-response curve" describing the involvement of both PFC and related brain regions in WM function.

Journal ArticleDOI
05 Dec 1996-Nature
TL;DR: It is shown that subjects with the MODY3-form of NIDDM have mutations in the gene encoding hepatocyte nuclear factor-1α (HNF-1 α), which is encoded by the gene TCF1, which is a transcription factor that helps in the tissue-specific regulation of the expression of several liver genes.
Abstract: The disease non-insulin-dependent (type 2) diabetes mellitus (NIDDM) is characterized by abnormally high blood glucose resulting from a relative deficiency of insulin. It affects about 2% of the world's population and treatment of diabetes and its complications are an increasing health-care burden. Genetic factors are important in the aetiology of NIDDM, and linkage studies are starting to localize some of the genes that influence the development of this disorder. Maturity-onset diabetes of the young (MODY), a single-gene disorder responsible for 2-5% of NIDDM, is characterized by autosomal dominant inheritance and an age of onset of 25 years or younger. MODY genes have been localized to chromosomes 7, 12 and 20 (refs 5, 7, 8) and clinical studies indicate that mutations in these genes are associated with abnormal patterns of glucose-stimulated insulin secretion. The gene on chromosome 7 (MODY2) encodes the glycolytic enzyme glucokinases which plays a key role in generating the metabolic signal for insulin secretion and in integrating hepatic glucose uptake. Here we show that subjects with the MODY3-form of NIDDM have mutations in the gene encoding hepatocyte nuclear factor-1alpha (HNF-1alpha, which is encoded by the gene TCF1). HNF-1alpha is a transcription factor that helps in the tissue-specific regulation of the expression of several liver genes and also functions as a weak transactivator of the rat insulin-I gene.

Journal ArticleDOI
TL;DR: For analysis of large matrices, parsimony jackknifing is hundreds of thousands of times faster than extensive branch‐swapping, yet is better able to screen out poorly‐supported groups.

Journal ArticleDOI
TL;DR: General population data from the National Comorbidity Survey are presented on co-occurring DSM-III-R addictive and mental disorders, with the finding that fewer than half of cases with 12-monthCo-occurrence received any treatment in the year prior to interview suggests the need for greater outreach efforts.
Abstract: General population data from the National Comorbidity Survey are presented on co-occurring DSM-III-R addictive and mental disorders. Co-occurrence is highly prevalent in the general population and usually due to the association of a primary mental disorder with a secondary addictive disorder. It is associated with a significantly increased probability of treatment, although the finding that fewer than half of cases with 12-month co-occurrence received any treatment in the year prior to interview suggests the need for greater outreach efforts.

Book
01 Jan 1996
TL;DR: This paper found that racial resentment remains the most powerful determinant of white opinion on such racially-charged issues as welfare, affirmative action, school desegregation, and the plight of the inner city.
Abstract: When news of the O.J. Simpson verdict swept across the United States, a nation stood divided as blacks and whites reacted differently to the decision. Seldom has the racial division that permeates American society come so clearly and prominently into view. This book aims to supply the reasons for this division, asserting that racial resentment continues to exist. Despite a parade of recent books optimistically touting the demise of racial hostility in the United States, the authors marshal a wealth of the most current and comprehensive evidence available to prove their case. They reveal that racial resentment remains the most powerful determinant of white opinion on such racially-charged issues as welfare, affirmative action, school desegregation, and the plight of the inner city. The book seeks to explain just why black and white Americans believe what they do. It analyzes the critical factors that shape people's opinion on race-related issues, uncovering the relative importance of self-interest, group identity, ideological principles, as well as racial animosity. Finally, the authors explore how the racial divide has insinuated itself into the presidential election process, and they examine the role of political elites in framing racial issues for ordinary citizens.

Journal ArticleDOI
TL;DR: In this article, the authors extend the routine activity perspective's situational analysis of crime to individual offending and to a broad range of deviant behaviors, finding that participants who spend more time in unstructured socializing activities engage in deviant behaviours more frequently.
Abstract: We extend the routine activity perspective's situational analysis of crime to individual offending and to a broad range of deviant behaviors. In this view, unstructured socializing with peers in the absence of authority figures presents opportunities for deviance: In the presence of peers, deviant acts will be easier and more rewarding; the absence of authority figures reduces the potential for social control responses to deviance; and the lack of structure leaves time available for deviant behavior. To determine whether individuals who spend more time in unstructured socializing activities engage in deviant behaviors more frequently, we analyzed within-individual changes in routine activities and deviance across five waves of data for a national sample of more than 1,700 18- to 26-year-olds. Participation in these routine activities was strongly associated with criminal behavior, heavy alcohol use, use of marijuana and other illicit drugs, and dangerous driving. Furthermore, routine activities accounted for a substantial portion of the association between these deviant behaviors and age, sex, and socioeconomic status.

Journal ArticleDOI
TL;DR: In this paper, the authors examined the role of personal achievement goals and feelings of school belonging in mediating the relation between perceptions of the school psychological environment and school-related beliefs, affect, and achievement.
Abstract: In a sample of 296 8th-grade middle school students, the authors examined the role of personal achievement goals and feelings of school belonging in mediating the relation between perceptions of the school psychological environment and school-related beliefs, affect, and achievement. Sequential regression analyses indicated that perceiving a task goal structure in middle school was positively related to academic self-efficacy and that this relation was mediated through personal task goals. Perceiving an ability goal structure was related to academic self-consciousness and this relation was mediated through personal relative ability goals. Perceiving positive teacher-student relationships predicted positive school-related affect and this relation was mediated through feelings of school belonging. Feelings of academic efficacy and school belonging in turn were positively related to final-semester academic grades. Results are discussed in relation to current middle school reform efforts. During the early adolescent years, middle schools play an important role in facilitating or inhibiting successful adolescent development (Carnegie Council on Adolescent Development, 1989). Schools potentially can provide early adolescents with opportunities to develop their intellectual capacities, to experience a sense of competence and belonging, and to interact with supportive, nonparental adults. Unfortunately, just when adolescents are particularly in need of these opportunities, the middle-school learning environment often fails to provide them (Carnegie Council on Adolescent Development, 1989; Eccles & Midgley, 1989). For instance, at a time when adolescents are known to be sensitive about how they appear to others, middle schools emphasize relative ability and social comparison in learning situations (Midgley, Anderman, & Hicks, 1995); and at a time when adolescents are particularly in need of supportive relationships with adults outside the home, the quality of relationships with teachers is less than optimal (Midgley, Feldlaufer, & Eccles, 1989). Understanding how particular

Journal ArticleDOI
TL;DR: The prophylactic use of a specific potassium-channel blocker does not reduce mortality, and may be associated with increased mortality in high-risk patients after myocardial infarction.

Journal ArticleDOI
25 Jan 1996-Nature
TL;DR: It is proposed that elevated metalloprotein-ases, resulting from activation of AP-1 and NF-KB by low-dose solar irradiation, degrade collagen and elastin in skin, which would result in solar scars, which through accumulation from a lifetime of repeated low- dose sunlight exposure could cause premature skin ageing (photoageing).
Abstract: DAMAGE to skin collagen and elastin (extracellular matrix) is the hallmark of long-term exposure to solar ultraviolet irradiation1–3, and is believed to be responsible for the wrinkled appearance of sun-exposed skin4,5. We report here that matrix-degrading metalloproteinase messenger RNAs, proteins and activities are induced in human skin in vivo within hours of exposure to ultraviolet-B irradiation (UVB). Induction of metalloproteinase proteins and activities occurred at UVB doses well below those that cause skin reddening. Within minutes, low-dose UVB upregulated the transcription factors AP-1 and NF-KB, which are known to be stimulators of metalloproteinase genes6,7. All-transretinoic acid, which transrepresses AP-1 (ref. 8), applied before irradiation with UVB, substantially reduced AP-1 and metalloproteinase induction. We propose that elevated metalloprotein-ases, resulting from activation of AP-1 and NF-KB by low-dose solar irradiation, degrade collagen and elastin in skin. Such damage, if imperfectly repaired, would result in solar scars, which through accumulation from a lifetime of repeated low-dose sunlight exposure could cause premature skin ageing (photoageing).

Journal ArticleDOI
TL;DR: In late middle age, cognitively normal subjects who are homozygous for the epsilon 4 allele for apolipoprotein E have reduced glucose metabolism in the same regions of the brain as in patients with probable Alzheimer's disease.
Abstract: Background Variants of the apolipoprotein E allele appear to account for most cases of late-onset Alzheimer's disease, and persons with two copies of the e4 allele appear to have an especially high risk of dementia. Positron-emission tomography (PET) has identified specific regions of the brain in which the rate of glucose metabolism declines progressively in patients with probable Alzheimer's disease. We used PET to investigate whether these same regions of the brain are affected in subjects homozygous for the e4 allele before the onset of cognitive impairment. Methods Apolipoprotein E genotypes were established in 235 volunteers 50 to 65 years of age who reported a family history of probable Alzheimer's disease. Neurologic and psychiatric evaluations, a battery of neuropsychological tests, magnetic resonance imaging, and PET were performed in 11 e4 homozygotes and 22 controls without the e4 allele who were matched for sex, age, and level of education. An automated method was used to generate an aggregat...

Journal ArticleDOI
TL;DR: In the United States, curriculum materials dominate teaching practice as mentioned in this paper and are the stuff of lessons and units, of what teachers and students do, and that centrality affords curriculum materials a uniquely intimate connection to teaching.
Abstract: Commercially published curriculum materials dominate teaching practice in the United States (Goodlad, 1984).' Unlike frameworks, objectives, assessments, and other mechanisms that seek to guide curriculum, instructional materials are concrete and daily. They are the stuff of lessons and units, of what teachers and students do. That centrality affords curricular materials a uniquely intimate connection to teaching. Not only are curriculum materials well-positioned to influence individual teachers' work but, unlike many other innovations, textbooks are already \"scaled up\" and part of the routine of schools. They have \"reach\" in the system. At the local level, text adoptions are the primary routine in most districts for updating the curriculum every five to seven years (Carus, 1990). In our fragmented school system, textbooks are also one way that educators strive for a common curriculum across diverse settings. Despite their central role in the instructional system, however, curriculum materials have played an uneven role in practice.

Journal ArticleDOI
TL;DR: Partial least squares serves as an important extension by extracting new information from imaging data that is not accessible through other currently used univariate and multivariate image analysis tools.

Journal ArticleDOI
Gregory D. Schuler1, Mark S. Boguski1, Elizabeth A. Stewart2, Lincoln Stein3, Gabor Gyapay, Kate Rice4, Robert E. White5, P. Rodriguez-Tomé6, Amita Aggarwal2, Eva Bajorek2, S. Bentolila, B. B. Birren3, Adam Butler4, Andrew B. Castle3, N. Chiannilkulchai, Angela M. Chu2, C M Clee4, Sid Cowles2, P. J. R. Day5, T. Dibling4, N. Drouot, Ian Dunham4, Simone Duprat, C. East4, C A Edwards4, Jun Fan2, Nicole Y. Fang7, Cécile Fizames, Christine Garrett4, L. Green4, David Hadley2, Midori A. Harris2, Paul Harrison4, Shannon T. Brady2, Andrew A. Hicks4, E. Holloway4, L. Hui3, S. Hussain2, C. Louis-Dit-Sully5, J. Ma3, A. MacGilvery4, Christopher Mader2, A. Maratukulam2, Tara C. Matise8, K. B. McKusick2, Jean Morissette9, Andrew J. Mungall4, Delphine Muselet, H. C. Nusbaum3, David C. Page3, Ammon B. Peck4, Shanti M. Perkins2, Mark Piercy2, Fawn Qin2, John Quackenbush2, S A Ranby4, Tim Reif2, Steve Rozen3, C. Sanders2, X. She2, James Silva3, Donna K. Slonim3, Carol Soderlund4, W.-L. Sun2, P. Tabar2, T. Thangarajah5, Nathalie Vega-Czarny, Douglas Vollrath2, S. Voyticky2, T. E. Wilmer4, Xiao-Yu Wu3, Mark Raymond Adams10, Charles Auffray11, Nicole A.R. Walter12, Rhonda Brandon10, Anindya Dehejia1, Peter N. Goodfellow13, R. Houlgatte11, James R. Hudson1, Susan E. Ide1, K. R. Iorio10, Wha‐Young Lee, N. Seki, Takahiro Nagase, K. Ishikawa, N. Nomura, Cheryl Phillips10, Mihael H. Polymeropoulos1, Mina Sandusky10, Karin Schmitt13, Richard Berry12, K. Swanson, R. Torres1, J. C. Venter10, James M. Sikela12, Jacques S. Beckmann, Jean Weissenbach, Richard M. Myers2, David R. Cox2, Michael R. James5, David Bentley4, Panos Deloukas4, Eric S. Lander3, Thomas J. Hudson3, Thomas J. Hudson14 
25 Oct 1996-Science
TL;DR: The gene map unifies the existing genetic and physical maps with the nucleotide and protein sequence databases in a fashion that should speed the discovery of genes underlying inherited human disease.
Abstract: The human genome is thought to harbor 50,000 to 100,000 genes, of which about half have been sampled to date in the form of expressed sequence tags. An international consortium was organized to develop and map gene-based sequence tagged site markers on a set of two radiation hybrid panels and a yeast artificial chromosome library. More than 16,000 human genes have been mapped relative to a framework map that contains about 1000 polymorphic genetic markers. The gene map unifies the existing genetic and physical maps with the nucleotide and protein sequence databases in a fashion that should speed the discovery of genes underlying inherited human disease. The integrated resource is available through a site on the World Wide Web at http://www.ncbi.nlm.nih.gov/SCIENCE96/.

Journal ArticleDOI
TL;DR: It is demonstrated that Starburst dendrimers can transfect a wide variety of cell types in vitro and offer an efficient method for producing permanently transfected cell lines.
Abstract: Starburst polyamidoamine dendrimers are a new class of synthetic polymers with unique structural and physical characteristics. These polymers were investigated for the ability to bind DNA and enhance DNA transfer and expression in a variety of mammalian cell lines. Twenty different types of polyamidoamine dendrimers were synthesized, and the polymer structure was confirmed using well-defined analytical techniques. The efficiency of plasmid DNA transfection using dendrimers was examined using two reporter gene systems: firefly luciferase and bacterial beta-galactosidase. The transfections were performed using various dendrimers, and levels of expression of the reporter protein were determined. Highly efficient transfection of a broad range of eukaryotic cells and cell lines was achieved with minimal cytotoxicity using the DNA/dendrimer complexes. However, the ability to transfect cells was restricted to certain types of dendrimers and in some situations required the presence of additional compounds, such as DEAE-dextran, that appeared to alter the nature of the complex. A few cell lines demonstrated enhanced transfection with the addition of chloroquine, indicating endosomal localization of the complexes. The capability of a dendrimer to transfect cells appeared to depend on the size, shape, and number of primary amino groups on the surface of the polymer. However, the specific dendrimer most efficient in achieving transfection varied between different types of cells. These studies demonstrate that Starburst dendrimers can transfect a wide variety of cell types in vitro and offer an efficient method for producing permanently transfected cell lines.

Journal ArticleDOI
TL;DR: The analysis shows that most cases of lifetime MDD are secondary, in the sense that they occur in people with a prior history of another DSM-III-R disorder, which is more persistent and severe than pure or primary MDD.
Abstract: General population data are presented on the prevalence and correlates of comorbidity between DSM–III–R major depressive disorder (MDD) and other DSM–III–R disorders. The data come from the US National Comorbidity Survey, a large general population survey of persons aged 15–54 years in the non-institutionalised civilian population. Diagnoses are based on a modified version of the Composite International Diagnostic Interview (CIDI). The analysis shows that most cases of lifetime MDD are secondary, in the sense that they occur in people with a prior history of another DSM–III–R disorder. Anxiety disorders are the most common primary disorders. The time-lagged effects of most primary disorders on the risk of subsequent MDD continue for many years without change in magnitude. Secondary MDD is, in general, more persistent and severe than pure or primary MDD. This has special public health significance because lifetime prevalence of secondary MDD has increased in recent cohorts, while the prevalence of pure and primary depression has remained unchanged.