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Research Advances in Genetics and Genomics: Implications for Psychiatry introduces mental health professionals to exciting breakthroughs in endophenotypes, animal models, microarrays, and genetic mapping, as well as general strategies for identifying the genetic mechanisms of mental illnesses.Uniquely valuable both as summary and signpost, this concise volume provides a fascinating overview of recent cutting-edge developments in the application of molecular genetics, genomics, and proteomics to the study of psychiatric populations. By reading Research Advances in Genetics and Genomics, you will gain a better understanding of Psychiatric Genetics – Reviews and assesses the major research paradigms that have emerged in the field of psychiatric genetics over the several past decades, exploring the major conceptual and philosophical issues they pose and the value of their integration. Molecular Structure of Nucleic Acids – An overview of the double-helix discovery and provides a context for current endeavors, the original one-page April 1953 Nature paper by Watson and Crick, which sparked a revolution in the life sciences. Psychiatry in the Genomics Era – Posits that one of the most important consequences of genomics will be the development of individualized treatments that allow a clinician to tailor therapy on the basis of the unique genotype of each patient rather than on the mean responses of groups of unrelated patients. The Genomics Revolution – Details the implications of the genome for future medical practice, including the potential for developing methods and tools to better understand, treat, and prevent major mental disorders. The Endophenotype Concept in Psychiatry – Explains the etymology and strategy behind the use of endophenotypes in neuropsychiatric research and, more generally, in research on other diseases with complex genetics, such as schizophrenia. The Genes and Brains of Mice and Men – Shows why a detailed assessment of brain function in mice is so important for advancing psychiatric research in humans. Humans and mice share numerous features-in fact, for an estimated 99% of human genes a mouse version may be identified-of brain organization and behavioral responses to many pharmacological agents. Microarray Technology – Asserts that microarrays present a methodology for identifying genes or pathways for new and unique potential drug targets, determining premorbid diagnosis, predicting drug responsiveness for individual patients, and, eventually, initiating gene therapy and prevention strategies. Meticulously referenced, this volume is exceptionally useful as a starting point for understanding the impact of genetics and genomics on psychiatry, serving to introduce psychiatrists, psychologists, neurologists, and geneticists to this exciting field.

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Seeking to integrate the large volume of clinical research on relational processes and mental health disorders with other scientific advances in psychiatry, Relational Processes and DSM-V builds on exciting advances in clinical research on troubled relationships. These advances included marked improvements in the assessment and epidemiology of troubled relationships as well the use of genetics, neuroscience, and immunology to explore the importance of close relationships in clinical practice. Advances in family-based intervention, and prevention are also highlighted to help practitioners and researchers find common ground and begin an empirically based discussion about the best way to revise the DSM. Given the overwhelming research showing that relationships play a role in regulating neurobiology and genetic expression and are critical for understanding schizophrenia, conduct disorder, and depression among other disorders, relational processes must be a part of any empirically based plan for revising psychiatric nosology in DSM-V. The chapters in this book counter the perspective that we can safely discard the biopsychosocial model that has guided psychiatry in the past. The contributors examine the relevance of close relationships in such issues as the basic psychopathology of mental disorders, factors influencing maintenance and relapse, sources of burden for family members, and guiding family-based interventions. By tying relational processes to basic research on psychopathology, they demonstrate the value of integrating basic behavioral and brain research with a sophisticated understanding of the self-organizing and self-sustaining characteristics of relationships. Coverage includes: research linking relational processes to neuroscience, neurobiology, health outcomes, intervention research, prevention research, and genetics consideration of specific circumstances, such as promoting healthy parenting following divorce and relational processes in depressed Latino adolescents optimal approaches to the assessment of relational processes with clinical significance, such as child abuse, partner abuse, and expressed emotion. a simple introduction to the methodology of taxometrics, offering insight into whether key relational processes are distinct categories or continuously distributed variables an overview of the links between relational processes and psychiatric outcomes, providing a theoretical foundation for the discussion of links to psychopathology Together, these contributions seek to develop a shared commitment among clinicians, researchers, and psychopathologists to take seriously the issue of relational processes as they relate to diagnoses within DSM-and to encourage mental health care workers at all levels to harness the generative and healing properties of intimate relationships and make them a focus of clinical practice. It is a book that will prove useful to all who are interested in integrating greater sensitivity to relational processes in their work.

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Recognizing that favorable clinical outcomes are associated with earlier initiation of treatment – and even more ideally with prevention – this volume addresses the current status of early intervention in, and prevention of, major mental and substance use disorders. A team of distinguished participants addresses this problem at many levels – from the DNA molecule to public policy – in order to show how prevention efforts should be informed by a better understanding of etiology and by a knowledge of indicators of vulnerability.In considering the current standing of etiological knowledge, Recognition and Prevention of Major Mental and Substance Use Disorders addresses issues that are critical precursors to the prevention of mental disorders and offers an understanding of factors that contribute to the disorders' development. The contributors review genetic methodologies and current findings in mental disorders, with an emphasis on schizophrenia, and then show how biological and psychosocial environmental variables may affect vulnerability. Chapters devoted specifically to lessons in prevention drawn from recent research into schizophrenia discuss the implications of prodromal studies and relationships between stress, critical periods, and the development of the disorder. The book includes contributions from NIH representatives on how basic scientific understanding of mental disorders can be translated into public policy. It also features chapters that describe cutting-edge projects in prevention research for Alzheimer's disease, drug dependence, antisocial behavior, and posttraumatic stress disorder – each providing compelling accounts of how existing knowledge can be adapted to promising prevention efforts. Among the volume's contributions: New data on the role of substance abuse – particularly marijuana and psychostimulants – in increasing vulnerability to schizophrenia Review of vulnerability factors for several relevant disorders, examining stress and its concomitant psychobiological responses and the contribution of cognitive factors to vulnerability to depression Intriguing approach for translating successful treatment methods for schizophrenia into efforts to prevent the transition from the prodrome of the disorder to the full-blown illness Program for prevention of antisocial behavior that can be implemented as early as the first grade Secondary prevention efforts for posttraumatic stress disorder, with a focus on pharmacological interventions Each chapter reviews clinical implications of the research presented, contributing to a volume that will benefit clinicians and researchers who share the goal of preventing these debilitating conditions. This multidimensional, interdisciplinary work represents a major step toward cutting the social costs of these disorders – and, more important, their untold cost in human suffering.

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Psychiatric Genetics is a concise reference that presents the complexities of this dynamic field in a clearly written, easily accessible format, with numerous tables and illustrations. Ten expert contributors offer a fascinating view of psychiatric genetics in a text that is thorough and scholarly yet also succinct and accessible.The introduction summarizes the field's four distinct paradigms – and their interrelationships – that help us understand the role of genetic factors in the etiology of psychiatric disorders: basic genetic epidemiology, which demonstrates heritability; advanced genetic epidemiology, which explores the nature and mode of action of these genetic risk factors; gene finding, which enables us to infer the probability that a locus in the genomic region under investigation contributes to psychiatric disorder liability; and molecular genetics, which traces the biological mechanisms by which the DNA variant identified using gene finding methods contributes to the disorder itself.Psychiatric Genetics illustrates the importance of Appreciating the complex field of psychiatric genetics – Presents the major conceptual and statistical issues in psychiatric genetics, including many of the basic principles of both genetic epidemiology and gene finding, as well as a brief review of DNA itself. Detailing the results for one disorder where substantial progress had been made in gene finding and molecular genetics – Covers schizophrenia, because of the substantial progress made during the past few years. Presenting results for a more typical and common set of psychiatric disorders where most of our information comes from basic and advanced genetic epidemiology and where we are just beginning to make advances using gene finding – Discusses anxiety disorders, which illustrate these sets of issues. Covering disorders where major advances have been made using basic and advanced genetic epidemiology – Details substance use disorders, where the paradigm has shifted from sociological to genetic factors and where, in contrast to the genetics of more traditional psychiatric disorders, researchers must consider the inherent conditionality of drug abuse. Investigating the role of genetics in personality disorders – Focuses on the development of conduct and antisocial behavior and how to incorporate developmental processes into analyses of the role of genetics. Psychiatric Genetics draws students, educators, and practitioners alike into the exciting world of psychiatric genetics with a lively discussion of its broad trends and of the strengths and limitations of its methods to provide true insight into the etiology of psychiatric and substance use disorders.

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Determining the amenability of personality disorders to psychotherapy – a patient's capacity to benefit from verbal approaches to treatment – is important in helping clinicians determine the treatability of cases. Michael Stone here shares the factors he has observed over long years of practice that can help practitioners evaluate patients, stressing the amenability of the various disorders to amelioration. By focusing on which patients are likely to respond well to therapeutic intervention and which will prove most resistive, his book will help therapists determine with what kinds of patients they will most likely succeed and with which ones failure is almost a certainty. Stone establishes the attributes that affect this amenability – such as the capacity for self-reflection, motivation, and life circumstances – as guidelines for evaluating patients, then describes borderline and other personality-disordered patients with varying levels of amenability, from high to low. This coverage progresses from patients belonging to the DSM «anxious cluster,» along with the depressive-masochistic character and the hysteric character, to patients who demonstrate an intermediate level of amenability to psychotherapy. He introduces the interrelationship between borderline personality disorder and dissociative disorders and discusses treatability among certain patients in Clusters "A" and «C,» as well as others with narcissistic, histrionic, depressive disorders. Final chapters address the most severe aberrations of personality and the limitations they impose on the efficacy of therapy. Personality-Disordered Patients is filled with practical, clinically focused information. This guideline structured book: Covers all personality disorders-including ones not addressed in the latest DSM such as sadistic, depressive, hypomanic, and irritable-explosive Identifies both attributes necessary for treatability and factors associated with low treatability Pays particular attention to borderline disorders, which represent the most discussed conditions and are among the most challenging to psychotherapists Reviews personality traits whose presence, if intense-even if unaccompanied by a definable personality disorder-creates severe problems for psychotherapy Numerous case studies throughout the book provide examples that will help therapists determine which of their own patients are most likely to benefit from their efforts and thereby establish their own limits of effectiveness. By alerting practitioners to when therapy is likely to fail, these guidelines can help them avoid the professional disappointment of being unable to reach the most intractable patients.

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Mood and Anxiety Disorders During Pregnancy and Postpartum earns its important place in the literature by detailing our current understanding of the course, diagnosis, and treatment of psychiatric illness during pregnancy and postpartum, including breast-feeding – a top priority today because we now know that active maternal psychiatric illness during pregnancy and postpartum can exert long-term negative effects on child development and cause significant morbidity for the mother.In just five concise richly informative chapters, the nine distinguished contributors to Mood and Anxiety Disorders During Pregnancy and Postpartum dispel prevailing beliefs and offer invaluable guidance in treating women during pregnancy and postpartum: Course of Psychiatric Illness During Pregnancy and the Postpartum Period – Despite the enduring belief that pregnancy is a time of emotional well-being for women, emerging data show that pregnancy is instead a time of increased vulnerability to psychiatric illness. Diagnosis and Treatment of Mood and Anxiety Disorders During Pregnancy – Though the use of psychotropic medications during pregnancy and postpartum raises concerns, the accumulating data support the use of certain SSRIs/tricyclic antidepressants, especially when balanced against the risk to both mother and child of depression during pregnancy. Management of Bipolar Disorder During Pregnancy and the Postpartum Period: Weighing the Risks and Benefits – Although the onset of bipolar disorder (BP) tends to occur during women's reproductive years, surprisingly little is known about the impact of the menstrual cycle, pregnancy, postpartum, breast-feeding, and menopause on the course and treatment of bipolar disorder. Postpartum Mood Disorders – Women experience a dramatic increase in their risk of developing severe psychiatric illness during postpartum for a full year after delivery. Often overlooked, postpartum disorders must be identified and treated as early as possible to reduce the mother's risk for recurrent and treatment-refractory illness and the child's risk for long-term development problems due to the detrimental effect of maternal depression. Use of Antidepressants and Mood Stabilizers in Breast-feeding Women – This expanded clinical appraisal of the literature on antidepressant and mood stabilizer use in breast-feeding women shows that additional detailed pharmacokinetic investigations are urgently needed to enhance our understanding of nursing infant exposure and the role(s) of pharmacogenomics in determining infant exposure. Meticulously referenced and remarkably succinct, Mood and Anxiety Disorders During Pregnancy and Postpartum provides critical information about the course of illness during pregnancy and postpartum to help guide effective individualized treatment decisions-decisions that are ultimately based on the patient's wishes.

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Compiled from presentations given at the 2004 American Psychopathological Association (APPA) annual meeting, Medical and Psychiatric Comorbidity Over the Course of Life reviews the comorbidity of mental and chronic physical syndromes in an epidemiological and life course context, offering fresh insights and identifying crucial clues – gleaned from the overlapping areas or areas of mutual pathogenesis linking disparate realms of knowledge – to the etiology and nosological distinctiveness of both physical and mental disorders.Once relatively ignored, the study of lifetime comorbidity has the potential to suggest etiological clues and to advance our ability to prevent secondary disorders by increasing our knowledge about the course and pathology of the primary disease. The etiologically relevant period, beginning with the earliest causal action and ending with diagnosis, helps us understand this potential and thus is vital to the study of comorbidity. Divided into five main sections (epidemiology, risk factors, mood disorders, emotions and health, and schizophrenia), Medical and Psychiatric Comorbidity Over the Course of Life discusses critical aspects of the life course characteristics of the etiologically relevant period: It can be long, e.g., temperament, a relatively enduring emotional predisposition, may situate an individual more or less permanently at high risk, culminating in irreversibility only after decades of induction. The action of identical genes produces different disorders that may occur at different stages of life, such as the comorbidity of panic disorder and cystitis. It may involve critical stages, i.e., relatively narrow periods during development, such as fetal growth and puberty, to which the action of a given cause is limited. Critical periods of varying durations may exist throughout the course of life. It may have a cumulative quality to it, in which years or even decades of accumulation are required to reach the point of irreversibility, e.g., the years-long burden of lower class life, or of increased allostatic burden, for the causal nexus to reach sufficiency. It may involve multiple causes, representing different disciplines and different spheres of action spread throughout the life course. Medical and Psychiatric Comorbidity Over the Course of Life will prove invaluable for practitioners in general and consultation-liaison psychiatry, family practice and internal medicine, and psychosomatics, behavioral medicine, and health psychology.

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This refreshing new work is a practical overview of religious and spiritual issues in psychiatric assessment and treatment. Eleven distinguished contributors assert that everyone has a worldview and that these religious and spiritual variables can be collaborative partners of science, bringing critical insight to assessment and healing to treatment. Unlike other works in this field, which focus primarily on spiritual experience, this clearly written volume focuses on the cognitive aspects of belief – and how personal worldview affects the behavior of both patient and clinician. Informative case vignettes and discussions illustrate how assessment, formulation, and treatment principles can be incorporated within different worldviews, including practical clinical information on major faith traditions and on atheist and agnostic worldviews.The book's four main sections give concise yet comprehensive coverage of varying aspects of worldview: Conceptual Foundation – The Introduction explains the significance of worldview and its context in the development of psychiatry; reviews misunderstandings about spirituality and worldview and how they can be resolved in contemporary practice; and discusses Freud's significant influence on psychiatry's approach to religion and spirituality. Clinical Foundations – Three chapters review how clinicians can integrate spiritual and religious perspectives in the basic clinical processes of assessment (gathering a religious or spiritual history); diagnosis and case formulation (including religious and spiritual factors); and treatment (including a review of ethical issues). Patients and Their Traditions – Six chapters discuss Catholic and Protestant Christians, Hindus, Buddhists, Muslims, Jews, and secularists (atheists and agnostics), including a brief history, clinical implications of core beliefs, and variations of therapeutic encounters (both where patient and clinician share the same faith and where they do not) for each faith tradition. Worldview and Culture – A concluding chapter reviews issues of a global culture where faiths once rarely encountered in North America are increasingly seen in clinical practice. This well-organized text sheds much-needed light on an area too often obscure to many clinicians, fostering a balanced integration of religion and spirituality in mental health training and practice. Bridging several disciplines in a novel way, this thought-provoking volume will find a diverse audience among mental health care students, educators, and professionals everywhere who seek to better integrate the religious and spiritual aspects of their patients' lives into assessment and treatment.

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Concise Guide to Evidence-Based Psychiatry (EBP) is a must-have resource for informed decision-making in psychiatric practice today. This single, easy-to-use reference will enable practitioners to find answers to clinical questions, critically appraise articles, and apply the results of their findings to patients. This practical handbook provides quick access to EBP theories, tools, and methods. Concise Guide to Evidence-Based Psychiatry is a one-stop reference for using the literature to improve patient outcomes. Features include: Practical – Filled with how-to information, Concise Guide to Evidence-Based Psychiatry outlines the latest techniques for accessing, assessing, and interpreting the literature. Easy to use – Includes many tables of essential websites for finding reliable information on the Internet, best-practice strategies for searching the medical literature. Concise Guide to Evidence-Based Psychiatry fills an important role as the first EBP text for teaching residents, who are now required to develop such skills to meet the ACGME «practice-based learning and improvement» core competency. Special features for pedagogical use include suggestions for teaching EBP in residency programs, profuse examples from the psychiatric literature, and worksheets for the critical appraisal of clinical trials, diagnostic tests, epidemiologic studies, studies of prognosis, and more.Whether for self-study or use in residency programs, Concise Guide to Evidence-Based Psychiatry is the best resource available to help practitioners apply current research findings to their work with patients.

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The past five years have witnessed dramatic advances in research on pathological gambling – a diagnosis often overlooked by clinicians who are unaware not only of the personal and social consequences of pathological gambling, but also of the possible treatment options. Today, clinicians can choose from an array of treatment options to substantially improve the lives of patients with this disabling illness.Eloquently attesting to this extraordinary progress, this remarkable clinician's guide comprises the most extensive coverage on public health, clinical characteristics and treatment, psychotherapy and psychopharmacology, and interventions for adolescents, adults, and older adults. Written by the world's leading researchers on psychiatric aspects of gambling, this truly comprehensive volume discusses how to diagnose pathological gambling and provides the tools to do so. Here, 32 experts detail the clinical phenomenology, etiology, and treatment of pathological gambling, highlighting the current clinical approaches most likely to lead to early identification, symptom remission, and improvement maintenance.Useful appendixes provide specific tests, scales, and diagnostic criteria following four major sections of the book: Public Health and Epidemiology discusses prevalence and definitions of recreational, problem, and pathological gambling; the relationship between the different levels of gambling severity; and gambling's effects on societal, familial, and individual health and well-being. Clinical Characteristics covers the symptoms and sequelae of pathological gambling and the differences among adolescents, older adults, and men and women, and shows that pathological gambling – rather than being categorized as a single disorder – shares important features with many disorders, among them obsessive-compulsive spectrum disorders, affective spectrum disorders, addiction, and impulse-control disorder. Etiology details the realms of both psychology (behavioral, cognitive, and dispositional theories) and neurobiology (noradrenergic, serotonergic, dopaminergic, and opioidergic systems as well as familial and inherited factors) to explain the behavior of pathological gambling – knowledge that may prove useful in understanding a range of addictive and impulsive disorders. Prevention and Treatment emphasizes the vital role of the clinician in prevention efforts, including a prevention strategy tailored specifically for adolescents and young adults; discusses a variety of behavioral and pharmacological interventions for patients including self-help and professional-based interventions for family members; and concludes with assessments useful in diagnosing pathological gambling and monitoring symptom change. Psychiatrists, psychiatric researchers, and other mental health care professionals will welcome this book as their most up-to-date source for invaluable knowledge about and research from the world's recognized experts on pathological gambling.

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