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Defining Psychopathology in the 21st Century

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Among today's astounding research discoveries, perhaps the most fascinating is the mapping of the human genome and its implications for a vastly improved understanding of how genes affect our physiology and behavior. With that understanding comes a critical need to establish a diagnostic taxonomy for psychiatric illness that is more precise but still clinically relevant.This volume responds to that need. It highlights the shortcomings of current categorical diagnoses, such as those used in DSM-IV, for future research needs in behavioral disorders in general and psychiatric genetics in particular. With a chapter by each distinguished neuroscientist who presented at the 2000 American Psychopathological Association (APPA) meeting, this volume is divided into four sections: Definitional Tensions, which discusses the difficulties with the current categorical diagnostic system; Imaging Psychopathology, which presents research demonstrating how imaging technologies can tremendously improve our illness definitions; Longitudinal Studies, which details what we can learn from epidemiological and other longitudinal studies; and Exploring Alternatives, which discusses the application of dimensional classification systems in genetics research in psychopathology, with a fascinating chapter on using new methodologies for treating subsyndromal or pre-schizophrenia, a taxonomic condition defined herein as "schizotaxia."This unique collection represents a significant step in developing approaches to classification that will lead to more accurate diagnoses and treatments for patients and a broader range of taxonomic options for researchers. As such, it will also be welcomed by psychiatric clinicians and educators, as well as by anyone interested in genetics and how it governs human behavior.

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Mental Health Issues in Lesbian, Gay, Bisexual, and Transgender Communities

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Over the last three decades, the visibility -- and public acceptance -- of self-identified lesbian women and gay men and bisexual and transgender individuals has increased dramatically, making it more important than ever to understand the dynamics of their relationships.This timely work, part of Volume 21 in the Review of Psychiatry series, offers compelling facts and insights in a concise yet comprehensive format, bringing together the latest research and clinical practice in this rapidly evolving field.   Chapter 1 details normal adolescent development and the extra challenges imposed by the development of a sexual identity that is different from that of most of their peers, including the lack of lesbian, gay, bisexual, and transgender role models. Chapter 2 presents a rare discussion about theoretical models (managing a concealable stigma, minority stress and resilience, and coping with multiple minority statuses) and empirical data on aging as a stigmatized sexual minority, including the similarities and differences of aging between the sexual minority communities and the heterosexual community and special issues in working with aging ethnic minority gay men, lesbians, and bisexual persons. Chapter 3 breaks new ground by detailing the expanding role of the psychiatrist or other mental health professional as forensic expert and therapist -- requiring not only an in-depth understanding of lesbian and gay mental health issues, but also the often-daunting task of encouraging and teaching judges and juries to better understand these issues as they relate to discriminatory laws in child custody/visitation, workplace harassment/other discrimination, domestic violence, and immigration/asylum. Chapter 4 covers both the three types of etiological theories on homosexuality presented in the scientific literature and an historical overview of clinical attitudes toward homosexuality, from early modern theories (Karl Ulrichs, Krafft-Ebing, and Freud) to the present day, reporting on some adverse side effects of sexual conversion treatment that have been either overlooked or ignored in the reparative therapy literature and raising important clinical and ethical concerns. Chapter 5 examines the public and professional evolution of thinking toward U.S. African race and toward sexual orientation with regard to the reevaluation of the psychiatric diagnosis and treatment of gender identity disorder. Among other topics, the author presents a fascinating discussion of differences between sexual orientation and gender (e.g., anatomical, social, hormonal, psychological, legal, or political), and distinctions between transgenderism and homosexuality, including an illuminating case example. Thought-provoking and informative, this compact volume will be welcomed by residents, clinicians, and students alike as they continue to look for ways to better differentiate health from pathology and successfully treat these remarkably diverse individuals.

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How can professionals maintain or improve the quality of care they provide when pressured by payers to reduce the cost of care?Clinicians today face the challenge of providing optimal care in an environment where costs drive clinical practice. But high quality, not cost, remains the goal of professionals. By arming themselves with measurable results, clinicians can improve the processes of delivering mental health care and translate those improvements into better outcomes for patients and their families. In this timely guide, the editors have gathered the work of 49 distinguished contributors and crafted a valuable resource for overcoming the extraordinary challenge of delivering high quality mental health care. This groundbreaking book is divided into three sections:   The challenges today's clinicians face in providing optimal mental health care -- Beginning with a review of the report to then-President Clinton from the Advisory Commission on Consumer Protection and Quality in the Health Care Industry, subsequent chapters discuss professional ethics and managed care, how Wall Street investors are changing the practice of medicine, problems faced by managed care, and changes needed in medical education to ensure that physicians are well prepared to practice medicine in the 21st century.  Proven techniques for quality measurement -- Measuring quality of care presents significant conceptual and methodological problems. These chapters review quality measurement methods and describe support by the federal government to improve these methods. Also addressed are how consumers are joining the quality of care measurement movement and how one large urban county mental health program is advancing quality measurement. Fourteen case reports of quality improvement projects -- These chapters detail principles and techniques that can be replicated or tailored to fulfill the requirements of a variety of clinical settings, ranging from the national health service in Great Britain to a small geriatric unit in a large hospital. The work showcased here was done by clinicians or administrators who, concerned about the quality of care in their own settings, used data to test for themselves whether their interventions resulted in improved care. Even if managed care disappeared, we would still need to question, examine, and improve the quality of patient care -- with clinicians taking the lead, because only they can appreciate the subtle nuances that maintain or improve quality standards, and only they can make substantive changes in their clinical settings. As both a broad conceptual framework for considering the quality of mental health care and as a practical field guide to real-life techniques for measuring the quality of care, this volume will prove exceptionally valuable for mental health care professionals, administrators, and policymakers as well as for consumers and consumer advocates, researchers, students, and public health professionals.

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Cultural Assessment in Clinical Psychiatry

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Culture permeates human activity the world over. In today's technological "global village," people from very different cultures are interacting more closely and more often than ever -- making it critical for clinicians to understand and incorporate cultural dimensions into their daily practices.This volume offers a contemporary pragmatic understanding of how culture is inextricably intertwined with mental health and mental illness. In Chapter 1, the 17-member GAP Committee on Cultural Psychiatry begins by discussing the history (particularly within the last two decades) and scope of culture in clinical psychiatry. In Chapter 2, the authors describe 11 selected cultural variables that strongly influence clinical work: ethnic identity, race, gender and sexual orientations, age, religion, migration and country of origin, socioeconomic status, acculturation and acculturative processes, language, dietary influences, and education. In Chapter 3, the authors present a brief history and detailed analysis of the Cultural Formulation, the newest instrument for ensuring thorough clinical assessments, explaining its clinical use based on DSM-IV guidelines.In Chapter 4, the authors integrate the 11 cultural variables described in Chapter 2 with the use of the Cultural Formulation described in Chapter 3, producing an extraordinary cross-section of case vignettes:   How the son of Irish Catholic immigrants struggles to reconcile old-country traditions with life in modern American society The sometimes painful and always complex process and outcomes of acculturation for a Pakistani Muslim family who had come to the United States for only a temporary period but ended up staying permanently Diagnosing social phobia in an Asian American, whose traditional reticence must be viewed within the context of Asian culture  Loss of country of origin and family ties as catalysts leading to significant behavioral changes and severe depressive symptoms in an African immigrant tribesman from Kenya and the cultural context of his recovery The interplay of gender, age, and religion with developmental issues, personality organization, and symptom development for a "good Catholic girl"  The existential, interpersonal, and clinical experiences of a Protestant minister from predominantly Catholic Ecuador, who came to the United States as pastor of an Hispanic church in a predominantly white city In Chapter 5, the authors conclude with a summary and suggestions regarding the complex issues raised by a thorough cultural assessment.Enhanced by a detailed index, this powerful work meets the significant -- and rapidly growing -- need for psychiatrists and other mental health professionals to understand the role of culture in psychiatry and to integrate this knowledge into their practice so that they can provide the most comprehensive and useful care to their patients.

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This pocket-sized, practical reference summarizes everything you need to know to diagnose and treat unipolar and bipolar mood disorders. Designed for daily use in the clinical setting, the Concise Guide to Mood Disorders is a fingertip library of the latest information; easy to understand and quick to access. Praised by practitioners, the Concise Guides Series from American Psychiatric Publishing Inc. was developed to disburse a great deal of practical information in a convenient format. Features of the Concise Guide to Mood Disorders include:   One-stop, comprehensive guidance. Never again will you have to search several resources to find answers to your questions about mood disorders. The Concise Guide to Mood Disorders presents all the essential information you need on epidemiology, etiology, physical treatments, psychosocial treatments, outcomes, and comorbidity in a single source.  Easy and quick reference. This handy resource is organized to give you fast, easy access to information -- a necessity in daily practice. The detailed table of contents and key word index enable you to pinpoint the facts you need in seconds. Charts, tables, and other graphic representations help you comprehend information quickly.  The latest research findings presented for practical use. Here are the most current research results, distilled and presented in easy-to-understand language for practical application with patients. Some information appears in the Concise Guide to Mood Disorders for the first time anywhere. The Concise Guide to Mood Disorders is the best reference tool you'll find for making informed decisions that lead to better clinical outcomes. Psychiatrists, psychologists, primary care physicians, and any other clinical professionals who diagnose and treat patients with mental health disorders should have this authoritative reference on hand.

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Environmental and Chemical Toxins and Psychiatric Illness

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During the past 60 years, the number of chemical disasters worldwide from military, occupational, and environmental sources has risen at an alarming rate. The profound controversy surrounding many chemicals makes objective analysis nearly impossible. Yet now more than ever -- with the daily exposure to a wide range of chemicals and the increased threat of chemical terrorism -- it is critical that we understand the role of chemicals in causing psychiatric illness.Unlike related books, this remarkable reference is intended specifically for psychiatric applications and is thus the definitive sourcebook for the many professionals called on to respond to these events.This work stands alone as the first on this topic to be written by a psychiatrist and the first to bring together the military, occupational, and environmental exposures causing psychiatric illness, including multiple chemical sensitivities, mass hysteria, radiation exposures, community stress reactions, and Gulf War and other syndromes.Unique highlights include    A summary of the reported psychiatric symptoms attributed to each chemical class (chemical weapons, pesticides, fumigants, metals, solvents, gases, PCBs, Agent Orange, and other miscellaneous chemicals) in tables for easy reference. We use personal care products, take prescription drugs, pump gasoline, drink alcohol, and spray insecticides as part of our everyday lives. Yet rarely do we realize that significant exposures to the chemicals described in this book -- many of which we are exposed to in daily activities -- can damage the central nervous system, causing psychiatric illness.  A comprehensive bibliography, in every chapter, of all the important material in English-language medical journals and books that has appeared on this subject since the late 19th century. These bibliographies cover everything from the first published reports of the dangers of carbon disulfide in the French rubber industry -- dangers that American medicine ignored for years -- through more recent large-scale chemical exposures that have serious long-term consequences. (e.g., Love Canal).  The latest information about terrorist and military uses of chemical weapons -- of critical relevance in psychiatry today -- from World War I combatants exposed to chlorine, phosgene, mustard gas, arsenic, and cyanide to the first organophosphate, or nerve, gases (such as tabun and sarin) developed by the Germans before and during World War II (and used by Iraq in the Gulf War and by a religious cult in the terrorist subway attacks in Tokyo and Matsumoto, Japan). Quite simply, this book is a "must have" for psychiatric and medical professionals everywhere, with extended appeal among laypersons such as environmental/consumer advocates, attorneys, insurance professionals, industrial hygienists, disaster planners, and medical librarians.

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Defining and Measuring Quality in Psychiatric Care for Adults and Children (Report of the APA Task Force on Quality Indicators)

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The past decade has witnessed remarkable growth in the field of quality measurement in health care. Today's patients want to know that the care they receive is safe, effective, and accessible.This compelling monograph combines -- for the first time -- the reports from two American Psychiatric Association task forces on quality in psychiatric care (March 1999, which focused on adults, and October 2001, which focused on children and adolescents), offering a clinical framework for quality measurement that provides sample indicators of quality for health plans, facilities, and systems of care.Using similar formats and definitions, each task force considered a matrix of priority areas of care, including specific patient populations (e.g., elderly, seriously and persistently mentally ill, developmentally disabled people) and diagnostic categories (e.g., depressive disorder, schizophrenia, substance use disorders). Each then examined important aspects of patient care and constructed a quality framework that included dimensions of access, quality (appropriateness of care), perception of care (satisfaction), outcome, and -- for the children's report -- prevention.Each task force also considered relevant methodological issues: cultural, linguistic, and ethnic differences; data collection and tracking; confidentiality of data; risk adjustment; use of rating scales and standardized instruments; and designation of standards.Sample recommended goals include   For adults: patients with serious and persistent mental illness should have access to newer generations of antipsychotic medications as these become available; patients should achieve a significant reduction in symptom. For children and adolescents: the mental health status of children and adolescents should be assessed annually; children with severe or persistent mental illness whose care involves multiple child-serving systems, caregivers, and service providers should have their care coordinated Sample indicators include   For adults: utilization of new antipsychotics for patients with the diagnosis of schizophrenia; reduction in frequency of panic attacks in patients with the diagnosis of panic disorder For children and adolescents: high levels of satisfaction of adolescents using mental health services or substance abuse services; reduction in a family's stress level and impact of illness As the initial step in what must be an evolving effort by clinicians to define, measure, report, and improve the care that patients and their families receive, this monograph is essential reading for those who provide and receive care, accredit and regulate care, and purchase and administer clinical services.Purchasers of mental health care want clear, reliable, meaningful, and comparable information on what care is provided and with what results. APA convened these two task forces to lend its professional expertise to that issue, to advise on how to develop clinically based, patient focused quality indicators that use existing and ongoing research and clinical consensus in selecting potential indicators.

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Confusion. Fear. Isolation. This is the human experience of dementing illness, and it is at the heart of this practical, informative volume by a broad range of clinically grounded experts.This book is designed to meet the needs of clinicians dealing with persons with dementing illness and to serve as an introduction to the pathophysiology of dementing illness and a resource for clinical investigators.The giant strides in dementia research since the publication of the first edition in 1991 have generated optimism that we will soon be able to delay onset and even prevent these diseases that devastate both patients and caregivers. This third edition has been revised, updated, and expanded to cover changes in the classification, management and treatment of dementing illnesses and to give a more extensive account of basic and clinical research findings. At the same time, this remarkable volume indicates the interaction of the patient's personality, the caregiver, and the environment with the pathophysiology of dementing illnesses that creates the variety of symptoms accompanying these illnesses and impacting their treatment.Like the second edition, this third edition has three sections, flowing from diagnosis through management/treatment to research. New to this edition are   A world-class presentation on the molecular and genetic basis of Alzheimer's disease A beautifully illustrated chapter on contemporary neuroimaging Discussions of mild cognitive impairment, the frontotemporal dementias, and the dementias associated with Lewy bodies This third edition is exceptionally valuable for addressing the day-to-day challenges of dealing effectively and humanely with persons with dementing illness. Case examples are used in the chapters on psychological/behavioral and drug management to indicate practical approaches to maintaining patients at their optimal level of function. Unlike similar texts, this volume also reviews legal and ethical issues in the care of persons with dementing illness and shows how clinicians and caregivers how to mobilize community resources. Extensive reference lists round out each chapter. The book concludes with 11 assessment guides and rating scales and an index.Now more than ever, there is hope that advances in understanding dementing illnesses such as Alzheimer's disease will lead to their effective treatment, and ultimately to their prevention. Until then, clinicians, families, and society will continue to be faced with the challenges posed by these illnesses -- making this book a "must read" for physicians and other health care professionals, whether in training, in practice, or engaged in clinical research.

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The Scientific Basis of Clinical Practice

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The mind-body connection is one of the hottest topics in medicine today, documented by enormous amounts of data regarding hormone effects on the brain and behavior.Yet it is only now -- with the debut of this thought-provoking volume -- that we find an up-to-date, sophisticated reference that focuses on the clinical relevance of behavioral endocrinology and is written for practicing clinicians and researchers.This wide-ranging volume shows how the principles and emerging findings of psychoneuroendocrinology can inform modern clinical practice and lead to new breakthroughs in future science and practice. Here, leading authorities -- internationally respected researchers and practicing clinicians -- review empirical findings in their areas of expertise, highlight the clinical significance of these findings, and provide, wherever appropriate, clinical guidelines for the management of patients.Beginning with a lively history of psychoneuroendocrinology (including its many false starts), this book continues on to discussions of the hypothalamic-pituitary-adrenal axis hormone system, the gonadal hormone system, and the thyroid hormone system from each of the three paths generally used for psychoneuroendocrinological investigation:   Alterations in endogenous hormone levels observed in primary psychiatric illness Psychiatric concomitants or sequelae of hormonal dysregulation in primary endocrinologic illness Behavioral effects of exogenously administered hormones or hormone antagonists (both the study of the side effects of hormonal medications and the use of hormones and hormone antagonists as psychotropic medications) An unmatched diversity of topics reveals the full breadth and depth of this volume: diabetes mellitus, corticosteroid effects on mood and cognition, Cushing's syndrome and Addison's disease, oral contraceptives and estrogen replacement therapy, psychiatric illness associated with the menstrual cycle and perimenopause, postpartum behavioral changes, anabolic/androgenic steroid use, and a thorough review of thyroid function in psychiatric disorders.Particularly fascinating are sections on the role of neuropeptides and hypothalamic-releasing factors in psychiatric illness, the use of laboratory tests and imaging procedures in evaluating hormonal function in psychiatric patients, the place of newer "alternative" hormonal medications such as melatonin and DHEA in therapeutics, and a provocative and compelling final chapter on the role stress plays in precipitating illness.Designed for both clinician and researcher-scientist, this richly informative guide will also prove an invaluable addition to graduate courses in neuroscience, neuroendocrinology, the biological basis of behavior, and consultation psychiatry. Neuroscientists/neurologists, endocrinologists, obstetricians/gynecologists, internists, family practitioners, nurses, and interested laypersons round out the wide audience for this remarkable volume.

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Owen M. Wolkowitz, Anthony J. Rothschild

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Trauma and Disaster Responses and Management

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In our increasingly dangerous world -- brought into urgent focus by the September 11, 2001, attacks -- the need to manage the psychiatric consequences of traumatic events and disasters has never been greater. The editors of this powerful reference summarize our current understanding of the complex psychological, behavioral, and social responses to disaster, and present a compelling case for intensifying our focus on delivery and intervention efforts.In just five chapters, 16 distinguished contributors examine the impact of trauma from the personal to the community level. This critical book    reviews the neurobiologic and neuroanatomic responses to severe traumatic events, focusing on posttraumatic stress disorder to show how an initially adaptive response becomes maladaptive by producing long-term adverse consequences. discusses the psychiatric epidemiology of disaster, presenting a guide for clinicians in identifying and following groups at high risk for developing psychiatric disorders and an empirical blueprint for developing community interventions. details the impact of traumatic stressors on children, using the 9/11 terrorist attacks to illustrate many points and debunking the myth that children are more resilient than adults -- thus reinforcing their assertion that we need to improve the delivery of mental health services to traumatized children. presents material from an international consensus conference on the psychological interventions following mass violence, reviewing the psychological impact of disasters (including risk and protective factors) and acute interventions for trauma (e.g., psychological debriefing, treatment of traumatic grief, pharmacotherapy, cognitive-behavioral therapy, and interventions for children). concludes with the special dilemmas posed by weapons of mass destruction, including chemical, biological, nuclear, radiological, and high-yield explosives, discussing the attributes that make these weapons especially effective as instruments of terror and offering recommendations on how nations can enhance preparedness against these weapons. This volume is a must-read for educators, students, residents, clinicians, and social workers -- in short, anyone interested in helping to heal the psychological fallout from traumatic events and disasters.

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Posttraumatic Stress Disorder in Litigation

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The terrorist attacks on the World Trade Center in September 2001 turned PTSD into a household word. But posttraumatic stress disorder has been documented throughout history: For example, as long ago as 1666, Samuel Pepys wrote in his diary that he still had night terrors 6 months after the great fire of London. PTSD, officially recognized as a diagnosis by DSM-III in 1980, is only the most recent term used to describe the suffering of trauma victims.Few could have foreseen its profound impact on litigation. Often dubbed the "black hole" of litigation -- where allegations are relatively easy to assert but difficult to defend because the symptoms are subjective -- PTSD has deeply influenced civil and criminal law in cases ranging from malpractice and personal injury to sexual harassment and child abuse. It is thus vital for all legal parties involved that forensic examiners perform credible psychiatric and psychological examinations of PTSD claimants.Intended to add direction and discipline to the forensic assessment of PTSD litigants, this expanded second edition begins with an updated chapter on current and future trends for the role of PTSD in litigation.   Chapter 2 notes the increasing evidence that exposure to multiple events not only is more common than previously thought but also increases the risk for development of PTSD following the target event. Chapter 3 details diagnostic criteria and guidelines for the forensic psychiatric examination of the PTSD claimant. Most literature discusses PTSD in adults. Chapter 4 offers a rare perspective on PTSD in children and adolescents, including parental response to the trauma, developmental effects, and delayed onset symptoms. Forensic assessment of PTSD claimants is presented in Chapter 5, followed by new chapters on disability determinants (how PTSD impairs occupational functioning) and PTSD in the workplace, where the causal relationship between employment stress and a resulting mental or emotional disorder must be determined. Chapter 8 covers guidelines for malingering in PTSD, where the claimant may be motivated by financial gain or by a reduced charge resulting from an insanity defense. A new chapter on forensic laboratory testing in PTSD presents the tantalizing potential of psychophysiologic measurement to redeem the PTSD diagnosis from its daunting subjectivity. This essential collection by 13 U.S. experts sheds important new light on forensic guidelines for effective assessment and diagnosis and determination of disability, serving both plaintiffs and defendants in litigation involving PTSD claims. Mental health and legal professionals, third-party payers, and interested laypersons will welcome this balanced approach to a complex and difficult field.

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Psychosocial and Legal Perspectives on Mothers Who Kill

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Maternal infanticide, or the murder of a child in its first year of life by its mother, elicits sorrow, anger, horror, and outrage. But the perpetrator is often a victim, too.The editor of this revealing work asks us to reach beyond rage, stretch the limits of compassion, and enter the minds of mothers who kill their babies -- with the hope that advancing the knowledge base and stimulating inquiry in this neglected area of maternal-infant research will save young lives.  Written to help remedy today's dearth of up-to-date, research-based literature, this unique volume brings together a multidisciplinary group of 17 experts -- scholars, clinicians, researchers, clinical and forensic psychiatrists, pediatric psychoanalysts, attorneys, and an epidemiologist -- who focus on the psychiatric perspective of this tragic cause of infant death. This comprehensive, practical work is organized into four parts for easy reference:   Part I presents historical and epidemiological data, including a compelling discussion of the contrasting legal views of infanticide in the United States, United Kingdom, and other Western countries, a review of the latest statistics on maternal infanticide, and a discussion of the problems of underreporting and the lack of available documentation.  Part II covers the psychiatric, psychological, cultural, and biological underpinnings of infanticide, detailing how to identify, evaluate, and treat postpartum psychiatric disorders. The authors explore clinical diagnosis, symptom recognition, risk factors, biological precipitants, and alternative motives, such as cultural infanticide. Chapter 3, developed to assist the attorney or mental health professional in understanding the implications of postpartum psychiatric illness as they relate to infanticide, presents a sensitive and thorough inquiry into infanticidal ideation. Part III focuses on contemporary legislation, criminal defenses, and disparate treatment in U.S. law and compares U.S. law with the U.K.'s model of probation and treatment. Chapter 8 is an especially useful resource for the attorney or expert psychiatric witness preparing for an infanticide/neonaticide case in the criminal court system. Part IV discusses clinical experience with mothers as perpetrators and countertransference in therapy, the range of mother-infant interactions (from healthy to pathological), and methods of early intervention and prevention. This balanced perspective on a highly emotional issue will find a wide audience among psychiatric and medical professionals (child, clinical, and forensic psychiatrists and psychologists; social workers; obstetricians/gynecologists and midwives; nurses; and pediatricians), legal professionals (judges, attorneys, law students), public health professionals, and interested laypersons.

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In the past decade, family therapy has evolved from a loosely defined aggregate of approaches to a mature field with codified schools of theoretical systems and concepts. Textbook of Family and Couples Therapy: Clinical Applications is the first book to draw together theories and techniques from these various schools and combine them with specific clinical approaches in a single comprehensive resource.Under the editorial direction of acclaimed expert G. Pirooz Sholevar, Textbook of Family and Couples Therapy presents the current body of theoretical knowledge in the field along with the latest practical applications for working with couples and families. The book is divided into seven major sections: Family Therapy: Theory and Techniques; Family Assessment; Family Therapy With Children and Adolescents; Marital Therapy; Family Therapy With Different Disorders; and Research in Family and Marital Therapy. Most sections begin with overview chapters to lay the groundwork for clinical applications.With contributions from today's leading practitioners, Textbook of Family and Couples Therapy includes unique features such as:   Family therapy approaches to specific mental disorders, including depression, psychiatric hospitalization, alcohol and substance abuse, incest, and personality disorders  Specific guidance for working with couples, with detailed approaches to problems such as sexual dysfunction, divorce, remarriage, and stepfamilies -- invaluable for practicing in today's society The unique considerations of treating children in a family therapy context with practical applications such as whole-family intervention and a method for parent management training An overview of the evolution and theoretical underpinnings of family therapy which helps readers develop a solid foundation of understanding to support their clinical knowledge The latest information on issues related to gender, culture, and ethnicity and how they affect family therapyimportant for enhancing awareness and understanding  The state of family therapy research today and future research directions with perspectives from leading academics to point the way Blending theoretical training and up-to-date clinical strategies, Textbook of Family and Couples Therapy is a landmark event in the field. It is a must for clinicians who are currently treating couples and families -- and a major resource for training future clinicians in these highly effective therapeutic techniques.

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What Every Patient, Family, Friend, and Caregiver Needs to Know About Psychiatry

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If you care for someone with a mental illness -- whether as a family member, friend, or practitioner -- this hands-on reference is for you. The acclaimed What Every Patient, Family, Friend, and Caregiver Needs to Know About Psychiatry is now available in a long-awaited second edition. Like the first, it is written in a simple, concise style for the layperson -- and is packed with need-to-know information on adult psychiatric disorders, including their causes, approaches to treatment, and what caregivers can do to help. It is an excellent resource for therapist's waiting room.What Every Patient, Family, Friend, and Caregiver Needs to Know About Psychiatry features a wealth of immediately usable guidance for caregivers. It's an excellent text for introduction to psychiatry classes in colleges and nursing schools for helping students develop valuable knowledge and skills to apply in practice. This one-stop resource is the first place to turn for practical guidance for the latest research-based techniques. You'll   Get a solid understanding of the causes of psychiatric disorders, including stress, genetics and heredity, and emotional and physical problems Develop hands-on skills for the full range of emotional and mental disorders, including psychosomatic disorders, anxiety, substance abuse, sexual problems, loss, personality and mood disorders, schizophrenia, and cognitive disorders such as Alzheimer's disease  Find out how the psychiatrist should function in the patient-caregiver-doctor relationship -- and learn how to choose a psychotherapist. This second edition has been extensively revised and updated with new information on diagnostic techniques and brain scans, the role of genetics, new medications and psychotherapeutic approaches, and more. In addition, it features a unique and illuminating look at mental health in our post-9/11 nation, including the rising incidence of posttraumatic stress disorder.Whether you're a social worker or psychologist, nurse or other professional, friend or family member, you'll get a sound framework to help you achieve better results.Caring for a person with mental illness requires knowledge, skill, understanding, and strength. What Every Patient, Family, Friend, and Caregiver Needs to Know About Psychiatry gives you a source of guidance and techniques that will make you more confident and successful in your role as practitioner or caregiver.

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Neuroleptic Malignant Syndrome and Related Conditions

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Neuroleptic malignant syndrome (NMS) and other hyperthermic conditions are rare complications of antipsychotic drugs that can cause discomfort, disability, and even death. As a result, every psychiatrist, physician, and mental health care professional needs to understand and identify these disorders in time to prevent a fatal outcome. Neuroleptic Malignant Syndrome and Related Conditions is an important tool for clinicians, outlining a framework for understanding, diagnosing, treating, and preventing these little-understood disorders. This new edition extensively updates and revises the first edition, integrating an explosion of findings that have occurred since the earlier edition was published in 1989. In addition to NMS, chapters focus on antipsychotic drug-related heatstroke, hyperthermia associated with other neuropsychiatric drugs, and malignant catatonia, as well as   A new chapter on serotonin syndrome, the first comprehensive review to appear in the world literature. With the proliferation of serotonergic drugs such as Selective Serotonin Reuptake Inhibitors (SSRIs), the incidence of adverse reactions is on the rise, and this information will help practitioners spot early warning signals.  Important information on thermoregulatory mechanisms to help clinicians understand the pathogenesis of hyperthermic conditions. With an understanding of the basic mechanisms underlying these conditions, practitioners will develop more effective strategies for recognition, diagnosis, and treatment. Written by four internationally renowned authorities on NMS, Neuroleptic Malignant Syndrome and Related Conditions is the most comprehensive resource on the subject in existence. With nearly 850 citations in the reference section, it is a must for researchers -- and for practitioners who need a practical approach based on the most current science.

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Stephan C. Mann, Stanley N. Caroff, Paul E. Keck, Arthur Lazarus

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Fundamentals of Psychiatric Treatment Planning

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First published in 1992, Fundamentals of Psychiatric Treatment Planning outlines an approach that quickly became the definitive standard for writing treatment plans. Developed by clinical psychiatrist James A. Kennedy, this practical, intuitive method organizes psychiatric problems into seven categories: psychological impairment, social skills, violence, activities of daily living, substance abuse, medical impairment, and ancillary impairment. Treatment plans are developed using information gathered with the Kennedy Axis V, an instrument that has proven more successful than both the Global Assessment of Functioning (GAF) scale and the Brief Psychiatric Rating Scale (BPRS) in establishing baselines and determining outcome measures. Fundamentals of Psychiatric Treatment Planning serves as a powerful, highly effective tool that   Promotes a cohesive approach. By using a consistent approach to planning, the clinical team works in concert toward uniform goals and outcomes. Helps staff gather critical information to improve outcomes. For establishing baselines and determining outcome measures, the Kennedy Axis V instrument has proven more successful than both the GAF and the BPRS. Includes many examples to help staff write their own plans. Rich with real-life examples to guide staff, including problem names and descriptions, treatment modalities, and samples of individual plans for each of the seven problem categories. In addition to the Kennedy Axis V questionnaire, Fundamentals of Psychiatric Treatment Planning includes blank forms for treatment planning and tabbed sections to allow for quick reference. New features in the second edition include the integration of nursing care plans into master treatment plans, new systematic steps for building goals and modalities, refinements to the questionnaire, and the introduction of online support via the author's website. With its readily adaptable, uniform approach to a complex subject, Fundamentals of Psychiatric Treatment Planning, Second Edition, is a powerful, highly effective planning tool for all members of the clinical staff.

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A New Psychiatric Assessment of Patient Functioning

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Mastering the Kennedy Axis V: A New Psychiatric Assessment of Patient Functioning is a hands-on guide to using the Kennedy Axis V (K Axis). This fast and powerful instrument is at the heart of James A. Kennedy's approach to psychiatric treatment planning.This versatile and practical workbook is an excellent training tool to help clinicians (including psychiatrists, psychologists, social workers and nurses) develop knowledge, skill, and confidence in using the K Axis. Mastering the Kennedy Axis V will help you   Develop ease and facility with the concepts on which the K Axis is founded Gain practical experience in using the K Axis through practical exercises Build a foundation for systematically tracking response to treatment, including response to medication Organize and track the flow of clinical information through a patient's clinical databases, treatment plan and progress notes Step-by-step, you'll walk through the conceptual underpinnings and rating systems of the seven subscales: psychological impairment, social skills, violence, activities of daily living/occupational skills, substance abuse, medical impairment and ancillary impairment. Through a wide variety of clinical vignettes, you will gain practical experience in using the K Axis to quickly develop basic clinical measurements and profiles.Developed as an alternative to the Global Assessment of Functioning (GAF) Scale, the Kennedy Axis V is clear, intuitive, effective -- and preferred by a growing number of clinicians. Mastering the Kennedy Axis V provides a user-friendly roadmap to using the K Axis to more thoroughly assess patients' clinical status, resulting in better treatment and outcome.

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A Developmental Model of Borderline Personality Disorder

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Understanding Variations in Course and Outcome

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Patients with borderline personality disorder (BPD) are among the most challenging patients for clinicians to treat. Their behaviors and emotions can shift abruptly. As a result, these patients can seem like therapeutic moving targets, and improvement can be vexingly slow.A Developmental Model of Borderline Personality Disorder is a landmark work on this difficult condition. The book emphasizes a developmental approach to BPD based on an in-depth study of inpatients at Chestnut Lodge in Rockville, Maryland, during the years 1950 through 1975 and the authors' thirty years of clinical and supervisory experience. Using information gleaned from the original clinical notes and follow-up studies, the authors present four intriguing case studies to chart the etiology, long-term course, and clinical manifestations of BPD. With three main parts that cover theory, case examples, and practical strategies for treatment, A Developmental Model of Borderline Personality Disorder   Introduces the reader to a multidimensional and integrated etiologic model of BPD to inform treatment Helps clinicians develop the understanding and empathy needed to deal with difficult patient behaviors Gives strategies for designing psychotherapy in tandem with psychosocial services to help patients with BPD improve or sustain functioning in the community A Developmental Model of Borderline Personality Disorder combines rich clinical case descriptions with an integrated theoretical model that captures the complexities of BPD. The first resource to chart BPD over the long term in such depth, this book is a first-rate clinical resource that reads like a novel, illuminating the disorder to help interpret its causes and course. It will inspire and encourage clinicians, along with patients and their family members, to strive for success in treating this difficult disease.

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Patricia Hoffman Judd, Thomas H. McGlashan

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Ideal for both novices and advanced practitioners, the new edition of Stanley Greenspan's classic guide outlines a practical process for observing and interviewing children -- and organizing and interpreting their unfolding communications.Highly acclaimed, The Clinical Interview of the Child uses actual interviews with children to show readers how to   Apply a developmental, biopsychosocial framework for understanding the inner lives of children at different ages and stages Observe and assess human development, including emotional and cognitive patterns and perceptual capacities Help infants and children to reveal their feelings, thoughts, and behaviors during the clinical interview Organize and interpret the interview data by constructing a developmental profile and translating it into DSM-IV-TR diagnostic categories The third edition has been expanded and revised extensively, with updated theoretical and conceptual foundations; information on higher levels of ego development and reflective and thinking capacities of older children; and a new section on a developmental biopsychosocial model -- the developmental, individual-difference, relationship-based (DIR) approach.An invaluable educational and practical resource, The Clinical Interview of the Child, Third Edition, is an ideal tool for psychiatrists and psychologists, pediatricians, educators, social workers, speech pathologists, occupational therapists, and judges and attorneys dealing with children and families.

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Concise Guide to Anxiety Disorders summarizes the latest research and translates it into practical treatment strategies for the best clinical outcomes. Designed for daily use in the clinical setting, it serves as an instant library of current information, quick to access and easy to understand.Running the gamut of anxiety-related illnesses -- panic disorder, obsessive-compulsive disorder, generalized anxiety disorder, posttraumatic stress disorder, social phobia, and specific phobia -- this comprehensive handbook includes   Comprehensive information in a single source. The discussion of each disorder includes information on etiology, diagnosis and differential diagnosis, course and prognosis, biological and psychological theories, medications and interventional treatments, psychotherapeutic treatments, and combined treatments -- all in a single user-friendly resource to save you time. Fast, easy access to information. With the detailed table of contents and index, you'll pinpoint the facts you need in seconds. Convenient tables help you comprehend information quickly.  Strategies and methods reflecting the latest research. Consult Concise Guide to Anxiety Disorders, and you'll know that you're making the best decisions, based on up-to-the-minute research findings. Every clinician who diagnoses and treats patients with anxiety disorders -- including psychiatrists, residents and medical students, psychologists, and mental health professionals -- will find Concise Guide to Anxiety Disorders invaluable for making informed treatment decisions.