Stigma and discrimination of people with substance use disorders (SUD) contribute massively to the harm done by their condition: stigma has negative effects on service engagement, life opportunities, and personal shame, both for those who struggle with substance abuse and their families. Overcoming the stigma of substance use disorders is essential to aid recovery in those with SUD. This book provides an in-depth understanding of the stigma of SUD, and proposes ways to overcome it in different settings from the criminal justice system to healthcare. Combining a multitude of viewpoints within a consistent theoretical framework, this book both summarizes the latest evidence and gives hands-on advice and future directions on how to combat the stigma of SUD. People with lived experience of SUD, advocates, family members, policy makers, providers and researchers in the field of addiction stigma will greatly benefit from reading this book.

The persistence of stigma of mental illness and seeking therapy perpetuates suffering and keeps people from getting the help they need and deserve. This volume, analysing the most up-to-date research on this process and ways to intervene, is designed to give those who are working to overcome stigma a strong, research-based foundation for their work. Chapters address stigma reduction efforts at the individual, community, and national levels, and discuss what works and what doesn't. Others explore how holding different stigmatized identities compounds the burden of stigma and suggest ways to attend to these differences. Throughout, there is a focus on the current state of the research knowledge in the field, its applications, and recommendations for future research. The Handbook provides a compelling case for the benefits reaped from current research and intervention, and shows why continued work is needed.

This book provides a practical guide to crisis intervention. It emphasizes the role of violence, patient suicide, long-term sequelae of trauma, clinical assessment and risk management, professional boundaries and burn-out, and the neurophysiology of trauma, as well as the needs of underserved patient populations including minority group members, older adults, gays and lesbians, and children. It features critical reviews of controversial topics, including EMDR, critical incident stress debriefing, recovered memories, dissociative identity disorder, and alternative medicine.

HIV Treatment as Prevention: Primer for Behavior-Based Implementation provides the first practical guide to integrating behavioral prevention with antiretroviral therapies for people living with HIV infection. This brief book discusses the historical and social context embedding the shifting landscape in HIV prevention, where the use of effective treatments have become the focus of HIV prevention. While using treatments for prevention is promising, the history of HIV prevention offers several important pitfalls that must be avoided if HIV treatments are to ultimately succeed in preventing new HIV infections. Lessons learned from the successes and failures of other biomedical technologies used in HIV prevention, specifically syringes, condoms, and HIV testing are critical to the success of using HIV treatments for prevention. HIV Treatment as Prevention: Primer for Behavior-Based Implementation summarizes the scientific evidence for advancing the use of antiretroviral therapies for HIV prevention. The evidence makes clear that HIV treatments can prevent HIV transmission, but will fail if behavioral aspects of treatment and HIV transmission are ignored. Of greatest concern are medication adherence and risks for contracting other sexually transmitted infections. Placing HIV treatment within the context of behavioral interventions for maintaining medication adherence and reducing sexual risk behaviors is therefore essential to the future of HIV prevention. HIV Treatment as Prevention: Primer for Behavior-Based Implementation highlights two pioneering behavioral interventions aimed at maximizing the effects of antiretroviral therapies for preventing HIV transmission. One of the interventions, developed by the Author's research team, is discussed in detail and the intervention manual is included as an Appendix."

Health experts independently state that the most critical urban problems are preventable. This brings an added challenge to public health practitioners working in inner cities with predominately minority communities. In addition to deadly diseases - including transmittable diseases - violence, whether it is physical, sexual or child abuse, is the other predominant morbidity factor that urban areas confront. Because of these concerns, there is a need for health professionals working with the communities to critically examine health behavior theories and prevention methodologies. Additionally, new prevention practices and programs need to be developed for community-based interventions to better serve the populations in need including programs in: -HIV Prevention; -Evaluation and Policy Research; -Cancer Prevention and Screening; -Urban Public Health Policy; -Youth Violence Prevention.

Life expectancy in countries of Central and Eastern Europe is substantially shorter than in Western Europe, and a similar divide exists in self-rated health. This exhaustive study of populations in seven Central and European countries - Russia, Lithuania, Latvia, Estonia, Poland, Czech Republic and Hungary - examines the social and psychosocial determinants of this divide. Practitioners and graduate students of public health and social psychology will find this an invaluable resource.

This Handbook provides a comprehensive overview of the theories, methods and approaches for reducing HIV-associated risk behaviors. It represents the first single source of information about HIV prevention research in developed and developing countries. It will be an important resource for students, researchers and clinicians in the field.

The essential role of the psychiatrist as consultant and educator of primary care physicians is increasing in importance as the American health care system faces fundamental restructuring. In a recent workshop during the annual meeting of the American Psychiatric Association, a number of prominent consultation-liaison psychiatrists reviewed major developments in consultation-liaison psychiatry during the past decade and looked toward the future. This book is based on these presentations, but it is not simply a proceedings book. A number of additional experts have contributed important chapters, and all the chapters based on the presentations are expanded and updated. Thus, this book reviews the current state of consultation-liaison psychiatry and anticipates future challenges. It also informs the reader about the state-of-the-art knowledge and skills in consultation-liaison psychiatry as of 1994. This book should be a valuable up-to-date overview/refresher for both consultation liaison psychiatrists and general psychiatrists who wish to update and formulate his/her consultant role. It should be especially valuable for psychiatric residents for whom the role as consultant to primary physicians assumes increasing importance, and for primary physicians and medical students who are interested in learning about commonly encountered complex biopsychosocial problems of their patients and integrating these dimensions in patient care. I am grateful to Mary Safford and Eileen Bermingham of Plenum for their help with the preparation and production of this book. I am also thankful to Anita Shaw for her secretarial help. Hoyle Leigh, M. D.

Despite medical technological advances, the major killers with which we must currently contend have remained essentially the same for the past few decades. Stroke, cancer, and heart disease together account for the vast majority of deaths in the United States. In addition, due to improved medical care, many Americans who would previously have died now survive these disorders, necessitating that they receive appropriate rehabilitation efforts. One result of our own medical advances is that we must now accept the high costs associated with providing quality care to individuals who develop one of these problems, and we must avail ourselves to assist of afflicted individuals. families Despite the relative stability of causes of death and disability, the health-care field is currently experiencing tremendous pressures, both from professionals with in the field, who desire more and better technology than is currently available, and from the public and other payers of health care (e.g., insurance companies), who seek an end to increasing health-care costs. These pressures, along with an increased emphasis on providing evidence of cost-effectiveness and quality assurance, are substantially changing the way that health-care professionals perform their jobs.

This book, with contributions emanating from the 21st World Congress of Psychosomatic Medicine held in Seoul in August 2011, presents the latest evidence-based information about the mechanisms, assessment, and management of psychosomatic disorders from a biopsychosociocultural perspective. Somatization is a process characterized by excessive or inappropriate focus on physical symptoms that are medically unexplained. It is highly prevalent in primary care medicine, as somatoform (psychosomatic) disorders tend to be chronic and can cause significant personal suffering and social problems as well as financial burden.

"Adapt or perish, now as ever, is Nature's inexorable imperative. " -H. G. Wells, Mind at the End of Its Tether (1946) Doctors are trained to treat people suffering from various diseases. This is the main form of their activity and usually the reason for which they selected medicine as their profession. The notion that they should become managers and engage in activi ties such as programming, calculating cost, assessing cost-benefit ratios, and thinking about pricing in accordance with the social utility of their intervention, is both foreign and abhorrent to them. They are sometimes willing to say how much they need in order to have a well-functioning service: usually they prefer to state what specific apparatus and other things they require without specifying the price of their demand. They can be persuaded to add a price tag to what they think is necessary for their work: but that was about as far as they would go, until recently. The growing emphasis on human rights over the past few decades, the greater emphasis on quality of life and the public's heightened expectations about their health led, in many industrialized countries, to a greater demand for health services. This, com bined with improved possibilities of diagnosis and treatment (at higher cost!), led to a significant increase in financial demands which made governments and health-care systems uneasy and ready to accept any solution that would stop the spiral of seem ingly endless cost augmentation.

This volume provides an overview of the important health promotion and disease prevention theories, methods, and policy issues. Applications of these theories and methods are reviewed to promote health through a variety of channels, for a variety of disease outcomes, and among a variety of populations. It can be used as a text for introductory causes to the field of health promotion and disease prevention, as well as a reference for researchers and practitioner's actively working in this area.

TItis volume is the first effort to compile representative work in the emerging research area on the relationship of disability and physical environment since Barrier-Free Environments, edited by Michael Bednar, was published in 1977. Since that time, disability rights legislation like the Americans, with Disabilities Act in the United States, the worldwide growth of the independent-living move ment, rapid deinstitutionalization, and the maturation of functional assessment methodology have all had their impact on this research area. The impact has been most noticeable in two ways-fostering the integration of environmental vari ables in rehabilitation research and practice, and changing paradigms for environ mental interventions. As the contributions in this volume demonstrate, the relationship of disabil ity and physical environment is no longer of interest primarily to designers and other professionals concerned with managing the resources of the built environ ment. The physical environment has always been recognized as an important variable affecting rehabilitation outcome. Until recently, however, concepts and tools were not available to measure its impact in clinical practic~ and outcomes research. In particular, lack of a theoretical foundation that integrated environ ment with the disablement process hampered development of both research and clinical methodology. Thus, the physical environment received little attention from the mainstream rehabilitation research community. However, this situation is changing rapidly.

"I'm like a whirling leaf in the wind," said one of Dr. Lena Nilsson SchOnnesson' s patients, and another "I'm in the claws of HIV." Their voices and those of other HIV-positive patients frame the humanistic and scholarly discussion in this impor tant book. Dr. SchOnnesson, a Fulbright scholar at the HIV Center for Clinical and Behavioral Studies, Columbia University in 1995, has unusually extensive clinical experience in counseling HIV-positive gay men. Her work with 38 such patients treated between 1986 and 1995 is discussed in the pages that follow. Dr. SchOnnesson's longitudinal approach to clinical data is extremely unusual in the psychotherapy literature generally, and in the literature on counseling HIV positive men in particular. Building upon the experience of such recent scholar clinicians as Klitzman, Isay, Schaffner, and others, Dr. SchOnnesson adds some thing unique by analyzing her ongoing detailed notes of the psychotherapeutic process in a systematic quantitative as well as qualitative manner. The analysis of her data is further informed by her coauthor, Dr. Michael Ross, a therapist and investigator whose contribution to the clinical and research literature on the psychotherapeutic treatment of gay men has already been substantial.

Traditionally, neuroscience and public health have been considered strange bedfellows. Now a new collection of studies shows the two fields as logical collaborators with major potential for the evolution of both fields.

"Social Neuroscience and Public Health" assembles current theoretical viewpoints, research findings in familiar and emerging areas, and updates on assessment methods to give readers a unique in-depth guide to the social brain and its central role in health promotion. This stimulating reference spans the intersection of two disciplines, offering new insights into the mechanics of risks, rewards, and willpower, revisiting the developmental effects of adversity and the impact of exercise on brain health, and applying epidemiology to cognitive science. Accessibly written for researchers and professionals within and outside both fields, the chapters include bullet-point and policy implication features for ease of retention. The book's innovative ideas lend themselves to a variety of applications, from fine-tuning disease prevention strategies to deeper understanding of addictions. Included in the coverage:

Latest theoretical perspectives on health behavior (e.g., picoeconomics, MCII, and temporal self-regulation theory)Updates on health communications and their effects on the brain.New research on cognitive resources and health behavior execution.Leading-edge studies on the brain, the social world, and stress.Findings from the forefront of exercise neuroscience.A concise introduction to neuroscience methods for the non-technical reader.

A rich resource pointing to a promising future in research and prevention efforts, "Social Neuroscience and Public Health" benefits professionals and researchers in public health, medicine, cognitive neuroscience, health psychology, epidemiology, sociology and affiliated fields."

Providing detailed information on structural HIV prevention interventions, this book is intended for health care practitioners and researchers to plan, implement, and evaluate such interventions in their own communities. As defined by the CDC, structural interventions focus on the physical, social, cultural, political, economic, legal, and/or policy aspects of the environment. Designed to reach a large number of individuals, structural interventions usually occur across entire communities, cities, or countries. As a result, the resources required to initiate structural interventions can far exceed those required for smaller-scale behavioral programs. However, changes from structural interventions have the potential to last over time, even after the programs have ended, resulting in effective use of public and private prevention resources. Because the reach of structural interventions is typically larger than that of individual- or group-focused interventions (for example, the 100% Condom Use Program, which was implemented countrywide in Thailand), their influence may be equally-if not more-significant.This book is a resource for health practitioners, educators, and researchers who seek HIV/AIDS structural prevention programs that have been shown to be effective in their regions or for their target populations (e.g. injection drug users, commercial sex workers, or the general public). With extensive case studies, the book classifies interventions according to the desired outcomes (specific behavior or policy changes) so that the reader may focus on examples of programs with similar goals and target populations to their own. Addresses the quintessential public health ethical dilemma regarding which types of environmental changes should be mandatory via legislation and which should be voluntary, promoted via programmatic, practice, and policy change.

This volume brings together two parallel fields of interest. One is the understanding among psychologists and other social scientists of the limits to psychometric measurement, and the challenges in generating information about quality of life and wellbeing that enable comparison across time and place, at both individual and population levels. The second is the interest among anthropologists and others in the lived experience of chronic illness and disability, including the unpredictable fluctuations in perceived health and capability. Chronic conditions and physical impairments are assumed to impact negatively on people's quality of life, affecting them psychologically, socially and economically. While some of these conditions have declined in prevalence, as a result of prenatal diagnosis, early successful interventions, and changes in medical technology and surgery, many of these conditions are on the increase as a consequence of improved life-saving medication and technology, and greater longevity. 'Quality of life' is often used as an indicator for successful and high quality health services, and good access to medical attention and surgery - for hip replacements or laser surgery to improve vision, for instance. But it is also used as an argument against interventions, when such interventions are seen to prolong life for its own sake. Yet we also know that people vary their idea of quality as a result of the context of fluctuations in their own health status, the presence or absence of pain or discomfort, and as a result of variations in social and economic contextual factors. In exploring these questions, this volume contributes to emerging debates related to individual health outcomes, but also to the social and other individual determinants that influence everyday life. Understanding these broader contextual factors will contribute to our knowledge of the kinds of services, support systems, and infrastructure that provide people with good 'quality of life' and a sense of wellbeing, regardless of their physical health, capability and functioning. The volume includes scholars from all continents who have been encouraged to think critically, and to engage with the descriptive, methodological, social, policy and clinical implications of their work.

'There is nothing stronger than a broken woman who has rebuilt herself.' Hannah Gadsby, Nanette Multi-awardwinning Hannah Gadsby transformed comedy with her show Nanette, even as she declared that she was quitting stand-up. Now, she takes us through the defining moments in her life that led to the creation of Nanette and her powerful decision to tell the truth - no matter the cost. Gadsby's unique stand-up special Nanette was a viral success that left audiences captivated by her blistering honesty and her ability to create both tension and laughter in a single moment. But while her worldwide fame might have looked like an overnight sensation, her path from open mic to the global stage was hard-fought and anything but linear. Ten Steps to Nanette traces Gadsby's growth as a queer person from Tasmania - where homosexuality was illegal until 1997 - to her ever-evolving relationship with comedy, to her struggle with adult diagnoses of autism and ADHD, and finally to the backbone of Nanette - the renouncement of self-deprecation, the rejection of misogyny, and the moral significance of truth-telling. Equal parts harrowing and hilarious, Ten Steps to Nanette continues Gadsby's tradition of confounding expectations and norms, properly introducing us to one of the most explosive, formative voices of our time.

Over the years, in our teaching of diagnostic interviewing to graduate students in clinical psychology, psychology interns, medical students, and psychiatric residents, we have searched for appropriate reading materials that encompass theoretical rationale, clinical description, and the pragmatics of "how to. " However, surprising as it may seem, there is no one work that includes the theoretical, the clinical, and the prac tical under one cover. This being the case, we thought it would be useful to us in our pedagogic efforts if we could put together such a text. And it is to this end that we developed the outline for our multiauthored text and presented it to Plenum Press for their review. We felt then, as we do now, that the material in this book simply does not represent "the cat being skinned in yet another way. " We sincerely believe that our stu dents really do need this one, and it is to them that we dedicate Diag nostic Interviewing. Our book is divided into three parts. In the first part (General Issues), basic interviewing strategies and the mental status examination are cov ered. The bulk of the book (Parts II and III) is devoted to examination of diagnostic interviewing for the major psychiatric disorders and for spe cial populations."

In recent years, there has been an explosion of research on the early origins of adult health. A growing body of evidence documents that maternal health before conception, prenatal and perinatal exposures, and conditions in childhood play critical roles in health over the life course. Scientific understanding of the multiple and interacting influences on child health and their role in later health continues to evolve rapidly, but greater attention to how families shape the conditions of early life that underlie childhood health is needed. This volume aims to advance understanding of this topic, with attention to mechanisms through which health disparities emerge and are sustained across the lifespan.

This birefs examines mortality among young children in the period from the seventeenth to the nineteenth century. It does so using several types and sources of information from the census unit England and Wales, and from Ireland. The sources of information used in this study include memoirs, diaries, poems, church records and numerical accounts. They offer descriptions of the quality of life and child mortality over the three centuries under study. Additional sources for the nineteenth century are two census-derived numerical indexes of the quality of life. They are the VICQUAL index for England and Wales, and the QUALEIRE index for Ireland. Statistical procedures have been applied to the numbers provided by the sources with the aim to identify effects of and associations between such variables as gender, age, and social background. The briefs examines the results to consider the impact of children's deaths upon parents and families, and concludes that there are differences and continuities across the centuries.

In this compelling new book, Gillian Bendelow provides an accessible account of the complex interplay between mind, body and society. Contemporary critiques of biomedicine and the process of medicalisation have long emphasised the limitations of traditional western scientific medicine in the separation of mind and body. The subsequent turn to more holistic models of health and illness is now beginning to permeate medical education and healthcare practice. For Bendelow, a key aspect of this paradigm shift is the development of more sophisticated concepts of stress, which address the intertwining of emotion and embodiment, and emphasise social and material factors alongside biopsychological components. These theoretical and conceptual issues are explored first through an emphasis on contemporary health practices, and then through developments in illness and medicine. Examining the ways in which 'healthism', rather than 'medicalisation', pervades most areas of everyday life, attention is drawn to the bodily practices we pursue in the name of health. These include concerns with sexual health, health promotion, the use of complementary or alternative medicine, and the notion of emotional health. The book then considers the implications of being diagnosed as ill, and charts the limits of the divisions between 'mental' and 'physical' illness, examining a range of conditions, including chronic pain, eating disorders and other illnesses of the contemporary world. Health, Emotion and the Body combines clarity of expression with careful scholarship and originality, making it appeal to students and scholars with a wide range of interests, including the sociology of health and illness, the body, and mental illness, as well as health psychology.

Americans are "healing themselves" (Heckler, 1985) and prevention has taken root (McGinnis, 1985a). We are altering our lifestyle to reduce physical and mental health risks. Perhaps as important is the fact that the science of prevention is beginning to catch up with the practices of prevention, although some might argue that the popularity of these practices far outstrips sound theoretical and empirical foundations. The chapter authors in this volume examine the theoretical and empirical foundations of many current prevention practices and, where data exist, discuss the status of prevention efforts. Where substantial prevention is not yet on the horizon, the authors attempt to point us in the right direction or at least share with the reader some of the risk factors that should be addressed in our research. We hope that readers will be stimulated to discuss the issues raised, advance the current research, and, where possible, adopt the prevention and health promotion strategies that are supported by sound theoretical and empirical work. This volume can in no way be comprehensive with respect to the current work in prevention; however, we hope that we have provided a sampling of prevention activities and issues that appear together in one volume for perhaps the first time. The primary intent of this volume is modest, and the reader should not attempt to find continuity among the various chapters. The only binding among these contributions is their focus on prevention.

A "New Looking Glass" for Behavioral Medicine In 1984, John Briggs, a science writer and specialist in interdisciplinary studies teaching at the New School for Social Research, and F. David Peat, a physicist who was for many years a fellow with the National Research Council of Canada, published a book about the revolutions that were taking place in physics, mathematics, chemistry, biology, and neu rophysiology and about the scientists whose new theories were changing our understanding about the nature of the universe. The title of their book was Looking Glass Universe, after Lewis Carroll's classic story of Alice and her friends, Through the Looking Glass. Briggs and Peat's book is a well-written, challenging volume about human beings and how they think about old problems in new and sometimes startling ways. I mention Briggs and Peat's book only partially because I happen to have a personal interest in the potential applications of new ways of looking at and thinking about nature and data derived from modern physics and systems theory for health psychology and behavioral medi cine (e. g., Schwartz, 1984). In a letter Wolfgang Linden wrote to me on January 23,1987, he shared with me (at my request) his rough thoughts about his personal goals for this book."

This book is primarily based on the proceedings of a confer en.::: e entitled -Health Psychology: A workshop in Behavioral Medi cine, Treatment and Research Issues, - held April 8-9, 1983 at the University of Oklahoma Health Sciences Center and Oklahoma Chil drens Memorial Hospital, Oklahoma City, Oklahoma. This conference brought together researchers from pediatric psychology, pedia tri cs, clinical psychology, developmental psychology, 1eurology, and psychiatry as part of a continuing medical education eries. While Health Psychology and Behavioral Medicine are the fastest growing segments of Psychology, relatively little atten tion has been paid to the pediatric segment of the life cycle. Yet, if we are serious about risk factor reduction and prevention of chronic diseases, it is precisely intervention with the young which will give the largest, most cost-effective results. Thus, the primary focus of the conference was on the pedia tric aspects of health and disease. Chapter 1 deals with the problems of behavioral health and sets forth some goals for our nation by the year 1990. Chapters 2 and 3 present an overview of behavioral medicine and the research trends current and predictive of the future for the field. Chapter 4 takes on issues about psychology, child health, and human deve lopment. Chapter 5 addresses issues in pediatric medical compl i ance and how this situation might be improved. Chapter 6 deals wi th prematurity and the family, and Chapter 7 addresses pain management problems in the young."