Evidence for the efficacy of behavioral approaches to the treatment and management of physical illness is mounting, as is the evidence for behavioral interventions for psychological disorders. A pressing question that remains is how to effectively treat co-morbid physical and psychological illnesses. Diseases co-occur more often than not, and the co-occurrence of physical and psychological illnesses is associated with greater impairment and healthcare costs. Unfortunately, the treatment literature has traditionally been disease-specific, with fewer insights and discoveries regarding the underlying processes of co-morbid physical and psychological illnesses, and even fewer of approaches to treatment.
Research on co-morbidities between physical and psychological illnesses has focused primarily on depression. Quite extensive literatures describe the negative impact of depression on type 2 diabetes, cardiovascular disease, cancer, obesity, pain, and other physical illnesses. More recently, higher rates of physical illness have been documented in individuals with bipolar disorder, anxiety disorders, schizophrenia, and impulse control disorders. Studies emanating from the National Comorbidity Survey-Replication (NCS-R), the only U.S. population-based database that includes diagnostic information on all DSM-IV psychological disorders, have revealed strong links between a number of physical and psychological illnesses. These data draw attention to the prevalence of physical and psychological co-morbidities at the population level, which has stimulated research on the biobehavioral mechanisms of those co-morbidities, with the goal of developing and improving treatment approaches. As this area of research grows, practical resources are needed for clinicians and researchers who encounter individuals with co-morbid physical and psychological illnesses in their work. This book is the first to provide a comprehensive overview of psychological co-morbidities of physical illness, biological and behavioral mechanisms of those co-morbidities, and implications for treatment. Each chapter focuses on a physical condition, such as obesity, type 2 diabetes, HIV infection, tobacco dependence, cardiovascular disease, cancer, asthma, pain, irritable bowel syndrome, autoimmune disorders, and obstetric/gynecological conditions. Chapters are structured to cover 1) the epidemiology of the most prevalent co-morbid psychological disorders within that physical condition (e.g., depression and other mood disorders, anxiety disorders, psychotic disorders, impulse control disorders, and eating disorders; 2) biobehavioral mechanisms of the co-morbidity; 3) a review of the behavioral treatment literature including evidence-based practice guidelines (where available); and 4) treatment considerations including issues of stepped care, evidence-based treatment decisions, treatment sequencing, treatment blending, treatment interactions, and contraindications. Content is guided by available research evidence and relevant theoretical models, and it is presented in such a way as to inform clinical practice, identify important gaps in the research literature, and provide directions for future research. The book serves as a tool for clinicians and researchers who work in the area of behavioral medicine in medical, academic, and/or training settings. Patients with psychological and medical co-morbidities may be encountered by clinicians working in either mental health or medical settings, where the presenting problem could be either the psychological disorder or the medical disorder. As such, assessment and treatment issues are discussed from both perspectives. For the clinician, the book reviews brief assessment tools, provides practical summaries of the treatment outcome literature and treatment considerations (e.g., treatment sequencing, contraindications), and includes treatment decision hierarchies that help the clinician incorporate each facet of evidence-based decisions (the evidence, patient characteristics, and their own expertise). For the researcher, the book brings together the literature for the medical and psychological disorder, highlighting still unanswered research questions relevant to the co-morbidity. Literature relevant to the underlying biobehavioral mechanisms of the co-morbidity as well as treatment are summarized. While a vast literature exists for the treatment of these disorders in isolation, one important purpose of this book is to bring together this literature to uncover specific areas in need of future study that will further our understanding of why different disorders co-occur and the best ways to treat them when they do.
Chrâ€štien de Troyes is arguably the creator of Arthurian romance, and it is on his work that later writers have based their interpretations. This book offers both crucial information on, and a comprehensive coverage of, all aspects of the work of Chrâ€štien de Troyes - the literary and historical background, patronage, his influence on other writers, manuscripts and editions of his work and, at the heart of the volume, major essays on his themes, techniques and artistic achievements in each of his compositions; the contributions, all from leading experts in Chrâ€štien and related studies, have been commissioned especially for this volume and are designed to remain accessible to students while also addressing specialists in Arthurian studies and Chrâ€štien de Troyes. They reflect the most current critical and scholarly views on one of the greatest of medieval authors. CONTRIBUTORS: JOHN W. BALDWIN, JUNE HALL MCCASH, LAURENCE HARF-LANCNER, NORRIS J. LACY, DOUGLAS KELLY, KEITH BUSBY, PETER F. DEMBOWSKI, ROBERTA L. KRUEGER, DONALD MADDOX, SARA STURM-MADDOX, JOAN TASKER GRIMBERT, MATILDA TOMARYN BRUCKNER, TONY HUNT, RUPERT T. PICKENS, ANNIE COMBES, MICHELLE SZKILNIK, EMMANUELE BAUMGARTNER
The Dust Bowl was the largest ecological disaster in United States history, coinciding with the nation's worst economic crisis, the Great Depression of the 1930s. Massive dust storms, combined with nearly a decade of drought, wreaked havoc on parts of Colorado, New Mexico, Texas, Oklahoma, Kansas, Nebraska, and Arkansas. The storms were a relentless threat to the environment and the health and welfare of those in their path. The effects of the dust storms were far-reaching, impacting not just the farmers and their families, but the state of California. Many who were forced off their land viewed the state as a mecca and it became the new home for millions of former Midwesterners. However, many families stayed in the Great Plains and reluctantly turned to the federal government for assistance to make ends meet. The government's new role as a provider of economic relief and social aid was met with gratitude by some and anger by others.
This book is written to help support those who are taking care of either family member's with Alzheimer's or dementia or are caregivers of people with this disease. It is our journey as we take care of our family members with this disease and the joys and hardships we deal with along the way.
This volume uncovers the relations between globalization and dirty dealings in urban settings, focusing on some capital cities and on the relations between underground and overground dynamics all over the globe. It aims to provide a new take on the dark side of globalization.
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