Developmental Epidemiology: The Perfect Partner for Clinical Practice Chanequa J. Walker-Barnes Department of Psychology, University of North Carolina at Chapel Hill Outlines the complimentary and, at times, the seemingly contradictory relation between developmental epidemiology and the practice of clinical child psychology from the per- spective of a clinical child psychologist. I argue that, although there has been a perception of tension between clinical practice and epidemiological research, the two are, in fact, closely related. Epidemiology can contribute to clinical practice by advancing psychol- ogy as a primary care profession, informing case conceptualization, and facilitating psy- chologists’communication with the public. Clinicians, in turn, can help advance the field of epidemiology by using clinical observations to inform the design of epidemiological studies and providing solid theoretical modeling for epidemiological research. What interests do clinical child psychologists have in epidemiology? Although it is clear that developmen- tal epidemiologists and child clinicians focus on simi- lar kinds of behavioral and emotional problems, the two fields’ approaches to these problems oftentimes seem starkly different, perhaps even opposing. There has been a perception that a tension exists between epi- demiology, with its emphasis on prevalence rates and community levels of risk, and clinical practice, which focuses on the diagnosis and treatment of individuals. However, as argued in the following, the distinction be- tween the two fields is not at all sharply defined. Al- though the goals and approaches of epidemiological research and clinical practice are at times conflicting, the two fields share an interwoven relation in which each informs and advances the other. This article dis- cusses this complex relation—first by describing how the general epidemiological approach to the study of psychiatric disorders is both distinct from and similar to that of clinical child psychology, and second by dis- cussing the specific contributions that developmental epidemiologists and clinical child psychologists can potentially make to advance each other’s efforts. A Clinician’s View of the Distinctions Between Epidemiology and Clinical Psychology Although many clinicians would agree that devel- opmental epidemiology and clinical child psychology are both ultimately concerned with the prevention and treatment of psychopathology in children, epidemiology appears to differentiate itself from tradi- tional clinical research and practice in three key ways. First, with the exception of clinical trial studies (which rely heavily on epidemiological methods), clinicians generally view epidemiology as a science of observa- tion. In contrast to the experimental and quasi-experi- mental research methods typically used by clinical psychologists, epidemiologists do not typically manip- ulate independent variables. Instead, many of the stud- ies that are explicitly labeled as epidemiological re- search focus on observing and measuring psychiatric phenomena as they exist within the community. In- deed, this has been one of the primary goals of two of the most prominent large-scale epidemiological sur- veys that have been conducted over the past 20 years— the Epidemiological Catchment Area survey and the National Comorbidity Survey (Kessler, McGonagle, Zhao, & Paul, 1994). This is not to say, however, that identifying prevalence rates is the only activity in which epidemiologists engage. Recent epidemiologi- cal research has been extended to examining issues that are much more salient to clinicians, including identify- ing clinical syndromes, identifying factors associated with psychiatric disorders, and determining individual risk for disorder. Nevertheless, epidemiology’s histori- cal focus on the prevalence and distribution of psychi- atric disorder in the population has strongly influenced clinicians’ views of the field. A second distinguishing characteristic of epidemi- ology perceived by clinicians is that epidemiology of- ten involves categorical behavior; cases are defined by the presence or absence of the disorder being studied. This reflects epidemiology’s roots as an applied sci- ence aimed at informing public policy decisions. Pol- icy decisions are inherently a dichotomous variable— an individual does or does not have an illness; he or she does or does not receive treatment. In contrast, devel- Journal of Clinical Child and Adolescent Psychology 2003, Vol. 32, No. 2, 181–186 Copyright © 2003 by Lawrence Erlbaum Associates, Inc. 181 I would like to thank Felicia Mebane, Andrew Perrin, and Wendy Wolford for their comments on an earlier draft of this article. Requests for reprints should be sent to Chanequa Walker-Barnes, University of North Carolina at Chapel Hill, Department of Psychol- ogy, CB#3270, Chapel Hill, NC 27599–3270. E-mail: cwalkerb@ unc.edu