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Lee N. Robins dies at 87; pioneer in field of psychiatric epidemiology

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Lee N. Robins, who pioneered the field of psychiatric epidemiology, which looks at the roots of abnormal behavior, and who played a key role in determining the prevalence of mental problems in the United States and the world, died peacefully at her home in St. Louis on Sept. 25.

She was 87 and had been battling cancer for several years.

Among other findings, Robins demonstrated that abnormal behavior in childhood is the major predictor of psychiatric problems later in life and was the first to show that many drug-addicted Vietnam veterans spontaneously lost their addictions when they returned to the States.

"Lee Robins is one of the giants of psychiatric epidemiology," said Kathleen Bucholz, a professor of psychiatry at Washington University in St. Louis School of Medicine.

Her particular genius, rooted in a questioning childhood, was devising carefully honed questions for surveys that gathered information about the origins and incidence of mental illness, Bucholz said.

When Robins began her work at Washington University in the late 1950s, researchers thought that the major sources of psychiatric problems, alcoholism, bad marriages and incarceration in adulthood were such childhood factors as social class, family background, fears and depression.

Through her carefully designed studies, however, Robins demonstrated that abnormal behavior during childhood was by far the most important predictor of adult behavior, overwhelming all the others.

Her studies grew into the 1966 book "Deviant Children Grown Up: A Sociological and Psychiatric Study of Sociopathic Personality."

In the 1970s, the federal government commissioned her to study returning Vietnam veterans who had been addicted to heroin or opium.

She reached what Bucholz called "the startling revelation that many recovered spontaneously from their addiction on their return, thus challenging notions of the irreversible nature of this form of addiction." Robins also studied survivors of natural disasters and other similar groups.

In the 1980s, working with her then-husband, Dr. Eli Robins, she played a central role in the Epidemiological Catchment Area study, which interviewed more than 20,000 Americans to determine for the first time the incidence of psychiatric disorders in the United States.

Her primary contribution was the development of a structured interview, called the Diagnostic Interview Schedule, that allowed epidemiologists to evaluate patients reliably.

Her questions were so successful that the World Health Organization asked her to develop a multicultural version of the survey that is now used internationally.

Lee Nelken Robins was born Aug. 29, 1922, in New Orleans. As a teenager, she later said, she was filled with questions: Why did people do the things they did? Why did they behave violently? Above all, why did countries resort to war?

When she headed off to Radcliffe College, her elder brother gave her some key advice: Study sociology if you want to answer those questions.

She received her doctorate in the discipline from Harvard University in 1951, joining the faculty of Washington University three years later.

There, she developed the Master Program in Psychiatric Epidemiology, which still flourishes.

She retired in 2001, after winning numerous awards.

In a recent interview, she said that "I still don't know why people go to war. That is one question I never answered."

Eli Robins died in 1994. In 1998, she married Dr. Hugh Chaplin Jr., a fellow faculty member.

In addition to her husband, she is survived by four sons, Paul of Redwood City, Calif., Jamie of Cambridge, Mass., Tom of Ann Arbor, Mich., and Nick of San Francisco; eight grandchildren; and two great-grandchildren.

thomas.maugh@latimes.com

Copyright © 2014, Los Angeles Times
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