The Great Smoky Mountains Study (GSMS) is a longitudinal, community-based study of the development of psychiatric and substance use disorders among children in the rural southeastern United States between 1993 and 2003. It was initiated by researchers from Duke University, including principal investigators such as Dr. William Copeland and Dr. E. Jane Costello.
The study focuses on children growing up in the western North Carolina mountains, an area that includes a significant portion of the Eastern Band of Cherokee Indians, allowing the study to include both Native American and non-Native American children. Today, the partcipants are in their 30’s, causing researchers to shift their focus to adult outcomes of childhood interventions.
A 2016 article in Social Psychiatry and Psychaitric Epidemiology by the original investigators discuss its background and contributions over the years.
Participants were randomly selected from the population of 11 counties in North Carolina, and the study began with over 1,000 children aged 9, 11, and 13 years. These participants have been followed up with numerous times since the study’s inception, providing valuable longitudinal data.
Perhaps the most unique aspect of this study is that a casino was built during the initial study period, resulting in tribal families gaining and additional $4,000 per year. This provided a unique research opportunity to study the effects of household income on the traits and behavior of children. Perhaps unsurprisingly, the sudden windfall dramatically improved the lives of children where previous early childhood interventions had failed.
The GSMS database contains a wealth of information on psychiatric diagnoses, health service use, educational outcomes, and various risk and protective factors. It is considered one of the most comprehensive sources of longitudinal psychiatric epidemiological data in the United States, especially in a rural context. Researchers use this database to understand the complex interplay of factors that influence mental health and to develop interventions aimed at preventing mental health disorders and promoting overall well-being.
Costello, E. J., Angold, A., Burns, B. J., Stangl, D. K., Tweed, D. L., Erkanli, A., & Worthman, C. M. (1996). The Great Smoky Mountains Study of Youth. Goals, design, methods, and the prevalence of DSM-III-R disorders. Archives of general psychiatry, 53(12), 1129–1136. https://doi.org/10.1001/archpsyc.1996.01830120067012
Lee, C. M., Horvath, C., & Hunsley, J. (2013). Does it work in the real world? The effectiveness of treatments for psychological problems in children and adolescents. Professional Psychology: Research and Practice, 44(2), 81–88. https://doi.org/10.1037/a0031133
Shaw, M., Hodgkins, P., Caci, H., Young, S., Kahle, J., Woods, A. G., & Arnold, L. E. (2012). A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: Effects of treatment and non-treatment. BMC Medicine, 10(1), 99. https://doi.org/10.1186/1741-7015-10-99