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472 Conclusionspreventive effects. The programs developed by Greenberg and Gorman Barry mayhave long-term effects on the maturation of the prefrontal cortex and enable adolescentsto cope more adaptively with the natural stressors experienced during theadolescent years. Definitive support for this outcome awaits further research; however,the evidence in favor of the beneficial effects of these competence-enhancingprograms is already available (cf. Romer, 2003), and existing evidence of moreadaptive executive functioning is supportive. Given the predisposition to risky behaviorin adolescents (Spear, chapter 1) and in particular the susceptibility to druguse (O’Brien, chapter 17), these interventions have the capability of reducing the illeffects of these risky behaviors. The newly emerging study of educational neuroscienceis an exciting development that will hopefully bring greater understandingto the effects of school-based behavioral interventions and to education in general.Skill-Based Prevention as an Alternative to MedicationSkill-based treatments such as cognitive behavior therapy and educational interventionssuch as developed by Posner and colleagues can influence brain functionand possibly structure as much as medications. This exciting possibility isunderrecognized among both scientists and the lay public. The potential use ofsuch interventions should be studied to determine whether they can substitute forthe use of medications. For example, if the Rueda et al. training program weresuccessful in reducing attentional deficits typically diagnosed and treated as ADHD,then the use of stimulants to treat this disorder may decline. The Rueda et al. programcan be administered easily and in a short duration with what appear to bepowerful effects on the attention system. It remains to be seen if this interventionalone can undo the effects of all the attention deficits associated with ADHD, butthe possibility deserves further research. Because medications are powerful agentswith effects on brain development of their own, it would be desirable to identifyexperiential therapies that do not have untoward effects on the brain.At the same time, it is possible that the optimal approach to the prevention ofsome disorders will require a combination of medication and psychotherapeuticintervention. Kiki Chang, Kim Gallelli, and Meghan Howe (chapter 14) highlightthe potential for both pharmacologic and psychotherapeutic interventions for preventingor ameliorating the onset of bipolar disorder in children at risk. Moreover,their discussion of these strategies could easily generalize to other disorders,such as major depression and schizophrenia.Societal Understanding of the GeneticBasis of Mental DisorderGenetic effects on brain development are sizable. However, the research regardingthese effects on mental health suggests that the environment has a powerful