The ontogenesis of primary prevention: lengthy strides and stubbed toes.

Reviews evolution of the concept of primary prevention in the past 40 years and cites progress in overcoming significant early deterrents (e.g., loosely anchored, overinclusive definitions; weak supporting empirical base) to this development. Highlights the growing trend to define the concept specifically around the yoked notions of risk, and the goal of forestalling major psychological dysfunction. This de facto shift in definitional emphasis has obscured primary prevention's early vision of promoting health and wellness. Stresses need for a comprehensive, multilevel, proactive approach targeted systematically toward the enhancement of psychological wellness in all people, from the start.