Behavioral Health Issues Among American Indians and Alaska Natives:

Explorations on the Frontiers of the Biobehavioral Sciences

Edited by Spero M. Manson and Norman G. Dinges

American Indian and Alaska Native Mental Health Research The Journal of the National Center Monograph Series

Volume 1, Monograph No. 1

Published by the National Center

University of Colorado Health Sciences Center Department of Psychiatry 4200 East Ninth Avenue

Denver, Colorado 80262

ISSN 0893-5394

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EDITOR-IN-CHIEF SPERO M. MANSON

JOURNAL MANAGER DEBORAH J. ARMUO

RESEARCH ASSOCIATES

MORTON BEISER, MD P.ePartu!ent of Psrchiatry Umversity of BritiSh Columbia

PHILIP A. MAY, PhD P.ePartment of Sociology UDIVenity of New Mextco

R. DALE WALKER, MD Alcohol & Drug ])epeodence Treatment Unit Seallle V etenns Me(lical Center and Hospital

lERESA LAFROMBOISE, PhD School of Medicine Stanford University

GEORGE GUILMET, PhD P.ePartment of Comparative Sociology UDIVersity of Puget Sound

JOHN RED HORSE, PhD American Indian Studies Center University of California, Los Angeles

GERALD V. MOHATT, EdD College of Human & Rural Development University of Alaska, Fairbanks

JOSEPH D. BLOOM , MD J?ei>artu!ent of Psychiatry Oregon Health Sciences University

WILLIAM H. SACK, MD ~I of Psychiatry Oregon Health Sciences University

LEN BRUCE. PhD l)epartment of Psychology WUhington State University

GORDON NELIGH, MD ~~of Psychiatry Umvenity of ColOrado Health Sciences Center

DONALD W. BECHTOLD, MD P.ePartu!ent of Psychiatry UDIVersity of Colorado Health Sciences Center

C. JOSEPH PINE, PhD Psychialric Services Sepulveda Veterans Administration Medical Center

DIANE J. WilLIS, PhD Child Study Center Olr.bhoma Health Sciences Center

SANDRA K. JOOS, PhD Portland Veterans Administration Medical Center

JERROlD E. LEVY, PhD P.ePartmatt of Anthropology UDIVersity of Arizona

JOSEPH E. TRIMBLE, PhD I>epartment of Psychology Western Washington Umversity

PAT Sll..K-WALKER, RN MS P.ePittment of Psycho6ocial Nursing UDIVersity of Washington

BEATRICE MEDICINE. PhD Department of Anthropology California State University~ Northridge

JOSEPH WESTERMEYER, MD P.ePartu!ent of Psychiatry UDIVersity of Minnesota

RICHARD SCHULZ, PhD Cathedral of~ University of Piusbufgh

NORMAN G. DINGES, PhD ~of Psychiatry Oregon Health Sciences University

J. DAVID KINZIE, MD I?ePittment of Psychiatry Oregon Health Sciences University

KENPEPION Native American Studies Program University of Montana

BOBBY WRIGHT, PhD Indian Sludies ~ Mootana State Umversity

JAMES H. SHORE MD P.ePartu!ent of Psychi~ UD1Versity of ColoradOAealth Sciences Center

ANNA E. BARON, PhD P.ePartment of Psychiatry UniVersity of ColOrado Health Sciences Center

RON PETERS, BA Greater Vancouver Community Mental Health Services

CANDACE M. FLEMING, PhD ~ent of Psychiatry Uruversity of ColOrado Health Sciences Center

Subscription rates are $35 ~ volumo-includiJ!g_ 3 issues plus the annual monograph edition. Malr.e checks payable to: UCHSCJNATIONAL CENTER/JOURNALl~200 East Ninth Avenue,

Campus Mail Box C249, Denver, Colorado 80.ta2.

ISSN 0893-5394

C 1988 The National Center for American Indian and Alaslr.a Native Mental Health Research All Rights Reserved

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Behavioral Health Issues Among American Indians and Alaska Natives:

Explorations on the Frontiers of the Biobehavioral Sciences

Edited by Spero M. Manson and Nonnan G. Dinges

American Indian and Alaska Native Mental Health Research Volume I, Monograph No. I

Introduction I

Stress, Coping, and Health: Models of Interaction for Indian and Native Populations 8

Norman G. Dinges, PhD, and Sandra K. Joos, PhD

Alcoholism, Alcohol Abuse, and Health in American Indians and Alaska Natives 65

Patricia Sillc-Walker, RN, MS, R. Dale Walker , MD, and Daniel Kivlahan, PhD

Diabetes and Behavior: American Indian Issues 94 Charles J. Pine, PhD

Major Mental Disorders and Behavior among American Indians and Alaska Natives 116

Gordon Neligh, MD

Health and Aging among American Indians: Issues and Challenges for the Biobehavioral Sciences I60

Spero M. Manson, PhD, and Donald G. Callaway, PhD

The Effects of Labeling on Health Behavior and Treatment Programs among Nortfi American Indians 2II

Je"old E. Levy, PhD

The Health Status of Indian Children: Problems and Prevention in Early Life 244

Philip A. May, PhD

Mental Health Care in a General Health Care System: The Experience of the Puyallup 290

George M. Guilmet, PhD, andDavidL. Whited, MFA

Societies, Families, and Change: The Alaskan Example 325 Gerald V. Mohatt, EdD, G. Williamson McDiarmid, EdD, and Valerie C. Montoya, MA

Recommendations 366

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