This volume contains current evidence-based diagnosis and therapeutic interventions for people with mental disorders. Students and professionals alike will find the mental health field addressed as a whole in a coherent and understandable way. Readers are offered a unified presentation of psychological and sociological approaches to diagnosis and treatment.

Methodological problems have hampered researchers' efforts to understand and control AIDS since the beginning of the epidemic. This practical book addresses these problems by using actual health research case studies to develop strategies regarding design and sampling, measurement, and analysis and modeling issues. Researchers working on both biological and behavioral aspects of the disease will find this work a singularly effective tool to improve their study designs.

Promoting Reproductive Security in Developing Countries provides a comprehensive approach to developing and implementing reproductive health programs in the developing world. It fills a major gap in the literature by responding to the global need for a detailed guide to comprehensive reproductive health services. Promoting Reproductive Security in Developing Countries furnishes an innovative conceptual model - reproductive security - and offers an in-depth analysis of major reproductive health issues. The need for skilled, dedicated professionals is great. Those who choose to pursue the discipline are promised an endlessly rewarding and absorbing profession that will touch upon the most intimate aspects of life while reverberating globally. This book will be of great interest to public health professionals on both a local and global level, international policy makers, and relief workers.

The field of health psychology has grown dramatically in the last decade, with exciting new developments in the study of how psychological and psychosocial processes contribute to risk for and disease sequelae for a variety of medical problems. In addition, the quality and effectiveness of many of our treatments, and health promotion and disease prevention efforts, have been significantly enhanced by the contributions of health psychologists (Taylor, 1995). Unfortunately, however, much of the theo rizing in health psychology and the empirical research that derives from it continue to reflect the mainstream bias of psychology and medicine, both of which have a primary focus on white, heterosexual, middle-class American men. This bias pervades our thinking despite the demographic heterogeneity of American society (U. S. Bureau of the Census, 1992) and the substantial body of epidemiologic evidence that indicates significant group differences in health status, burden of morbidity and mortality, life expectancy, quality of life, and the risk and protective factors that con tribute to these differences in health outcomes (National Center for Health Statistics, 1994; Myers, Kagawa-Singer, Kumanyika, Lex, & M- kides, 1995). There is also substantial evidence that many of the health promotion and disease prevention efforts that have proven effective with more affluent, educated whites, on whom they were developed, may not yield comparable results when used with populations that differ by eth nicity, social class, gender, or sexual orientation (Cochran & Mays, 1991; Castro, Coe, Gutierres, & Saenz, this volume; Chesney & Nealey, this volume).

Globally, action to prevent HIV spread is inadequate. Over 16,000 new infections occur every day. Yet we are not helpless in the face of disaster, as shown by the rich prevention experience analyzed in this valuable new compendium. "Best pr- tice" exists-a set of tried and tested ways of slowing the spread of HIV, of persuading and enabling people to protect themselves and others from the virus. Individually, features of best practice can be found almost everywhere. The tragedy, on a world scale, is that prevention is spotty, not comprehensive; the measures are not being applied on anywhere near the scale needed, or with the right focus or synergy. The national response may concentrate solely on sex workers, for example. Elsewhere, efforts may go into school education for the young, but ignore the risks and vulnerability of men who have sex with men. Action may be patchy geographically. AIDS prevention may not benefit from adequate commitment from all parts and sectors of society, compromising the sustainability of the response. In some countries matters are still worse-there is still hardly any action at all against AIDS and scarcely any effort to make HIV visible. It is no wonder that the epidemic is still emerging and in some places is altogether out of control.

From the President of the Research Society on Alcoholism The sixteenth volume of Recent Developments in Alcoholism contains the latest information on the field of alcoholism treatment research. This scholarly volume includes comprehensive reviews of the methodologies available to evaluate treatment outcome, state-of-the art psychosocial interventions, and recent advances in pharmacological adjuncts to treatment that are currently available and those on the brink of application. Other sections of the book address special issues in the treatment of alcohol dependence, including the treatment of the adolescents and other unique populations, the management of tobacco dependence, and the role of spirituality in recovery, among others. The clinician will find these reviews an important resource for learning about e- dence based treatments for alcoholism, and the researcher will find the synt- sis of recent developments informative and forward looking. The research agenda for the future rests soundly on the progress to date and additional advances in the treatment of alcoholism can be predicted in the near future. Stephanie O'Malley, Ph. D. President, Research Society on Alcoholism xi Preface From the President of the American Society of Addiction Medicine This excellent volume presents investigations covering a wide spectrum of scientific issues. It is also evident that many of these articles have clinical s- nificance, ranging from assessments of disorder, monitoring clinical progress, and behavioral and pharmacological interventions.

This book is a contribution to the understanding of psychosomatic health problems. Inspired by the work of the French phenomenologist Maurice Merleau-Ponty, a phenomenological theory of psychosomatics is worked out as an alternative to traditional, biomedical thinking. The patient who presents somatic symptoms with no clearly discernible lesion or dysfunction presents a problem to the traditional health care system. These symptoms are medically unexplainable, constituting an anomaly for the materialistic understanding of ill health that underlies the practice of modern medicine. The traditional biomedical model is not appropriate for understanding a number of health issues that we call "psychosomatic" and for this reason, biomedical theory and practice must be complemented by another theoretical understanding in order to adequately grasp the psychosomatic problematic. This book establishes a complementary understanding of psychosomatic ill health in terms of a non-reductionistic model allowing for the (psychosomatic) expression of the lived body. A thorough presentation of the work Merleau-Ponty is followed by the author's application of his thinking to the phenomenon of psychosomatic pathology.

This book reflects cutting-edge science that has only recently become available. It is a comprehensive assortment of new approaches to HIV prevention. It describes a set of prevention strategies that do not solely rely on male condoms, including: the use of HIV antibody testing and 'negotiated safety', abstinence, control of sexually transmitted diseases, treatment advances as prevention, and psychopharmacology to assist with behavior change. It is of interest to HIV prevention scientists, health psychologists, health educators, and public health workers in the communities at risk.

There have been dramatic increases in the financial, emotional, and psychological investment in pets over the past four decades. The increasing importance of animal companions in people's lives has resulted in growing emphasis on the human-animal bond within academic literature. This book introduces practicing and emerging professionals to vital subject matter concerning this growing specialty area by providing an essential framework and information through which to consider the unique contextual backdrop of the human-animal bond. Such contexts include a wide array of themes including: issues of attachment and loss, success and frustration with making and sustaining connections, world views regarding animal ethics, familial history of neglect or abuse, and cultural dynamics that speak to the order of things between mankind and nature. Adopting a contextual stance will aid mental health professionals in appreciating why and how this connection has become a significant part of everyday life for many. As with any other important clinical dynamic, training and preparation are needed to gain competence for professional practice and research. To this end, an ensemble of international experts across the fields of psychology and mental health explore topics that will help both new and established clinicians increase and understanding of the various ways the human-animal bond manifests itself. Perspectives from beyond the scope of psychology and mental health such as anthropology, philosophy, literature, religion, and history are included to provide a sampling of the significant contexts in which the human-animal bond is established. What brings these divergent topics together in a meaningful way is their relevance and centrality to the contextual bonds that underlie the human-animal connection. This text will be a valuable resource that provides opportunities to deepen one's expertise in understanding the psychology of the human-animal bond.

The goal of this book is to present the characteristics and underlying assumptions of the behavioral assessment paradigm and to show how they affect the strategies of behavioral assessment. Although all of the concepts and strategies discussed in this book are applicable in the research, this book focuses on the use of behavioral assessment to guide clinical judgments.

In the roughly two decades since Aaron T. Beck published the now classic "Cognitive Therapy of Depression," and Michael J. Mahoney declared the "Cognitive Revolution," much has happened. What was proposed as the "cognitive revolution" has now become the zeitgeist, and Cognitive Therapy (CT) has grown exponentially with each passing year. A treatment model that was once seen as diffe rent, strange, or even alien, is now commonplace. In fact, many people have allied themselves with CT claiming that they have always done CT. Even my psychoanalytic colleagues have claimed that they often use CT. "After all," they say, "Psychoanalysis is a cognitive therapy." Cognitive Therapy (or Cognitive Psychotherapy) has become a kaleidoscope model of treatment, with influences coming from many sources. Some of these contributory streams have been information pro cessing, behavior therapy, Constructivist psychology, and dynamic psychotherapy. Each of these sources have added color, shading, and depth to the CT model. What was originally uni dimensional in terms of the CT focus on depression has become multidimensional as the CT model has been applied to virtually every patient population, treatment setting, and therapy context. CT must now be seen as a general model of psychotherapy that, with modifications, can be applied to the broad range of clinical problems and syndromes. What has tied these various applications of CT together is the emphasis on a strong grounding in cogni tive theory, a commitment to empirical support, and a dedication to broadening the model.

This volume provides comprehensive coverage of interventions for emotional and behavioral problems following all types of brain illnesses and injuries in adults. It is a unique guide to different settings, families, cultures, illnesses and levels of severity. It takes neuropsychotherapy outside the clinic to the real life situations and dilemmas of people with brain illnesses. It contains case studies, summaries of major techniques and principles in frequent tables which can serve as clinical guides.

Introductory texts on psychological testing and evaluation historically are not in short supply. Typically, however, such texts have been relatively superficial in their discussion of clinical material and have focused primarily on the theoretical and psychometric properties of indi vidual tests. More practical, clinically relevant presentations of psychological instruments have been confined to individual volumes with advanced and often very technical information geared to the more sophisticated user. Professors in introductory graduate courses are often forced to adopt several advanced texts to cover the material, at the same time helping students wade through unnecessary technical information in order to provide a basic working knowl edge of each test. Understanding Psychological Assessment is an attempt to address these concerns. It brings together into a single volume a broad sampling of the most respected instruments in the psychologist's armamentarium along with promising new tests of cognitive, vocational, and personality functioning. Additionally, it presents the most updated versions of these tests, all in a practical, clearly written format that covers the development, psychometrics, administra tive considerations, and interpretive hypotheses for each instrument. Clinical case studies allow the reader to apply the interpretive guidelines to real clinical data, thereby reinforcing basic understanding of the instrument and helping to insure that both the student and practi tioner can actually begin to use the test. Understanding Psychological Assessment includes cognitive and personality tests for adults, children, and adolescents, as well as chapters on the theory of psychological measurement and integrated report writing.

William Charles Wells (1757-1817) was one of the foremost, and forgotten, American scientists of the eighteenth century. He should be acknowledged as laying the foundations for modern studies of vestibular function as well as eye movements. This book reprints his Essay on single vision with two eyes (1792) and his own Memoir of his life (1818). Wells' essay on natural selection is reprinted as an Appendix. Wells' experiments and observations on natural phenomena will surprise students of science because of their modernity.

In both developed nations and the developing world, there is a clear trend towards addressing alcohol, tobacco, and other drug problems through health and social services. There are several persuasive arguments for this shift beyond pure economics, which include comorbidity, cost effectiveness, coordination of care and effectiveness. This is the first volume to pull together effective methods that can be used for addressing substance abuse through health and social service systems. It also integrates interventions for a range of drugs of abuse, rather than focusing on only one (such as alcohol). The book's international perspective also makes this a unique contribution to the existing literature.

The field of transplantation has grown exponentially over the last few decades, and leaders in the field may argue that we have seen only the tip of the iceberg. Perhaps in no other discipline is there a need for multidisciplinary dialogue, debate, and approaches to patient care. In preparing this book, we have attempted to introduce readers to a few of the key clinical and ethical issues confronting the field of transplantation today. In so doing, we recognize that the face of transplantation may change dramatically in the years to come. Nevertheless, the issues raised throughout this book will serve as a useful introduction to important clinical issues and as a catalyst for clinicians and researchers to expand the horizons of transplantation. Health professionals involved in evaluating and treating transplant patients must be knowledgeable of the indications for transplantation and patient outcomes and the process of evaluation and management. Chapters 1 and 2, focusing on solid organ transplantation and blood/marrow transplantation, provide this important contextual information. The next two chapters address what is often considered the most significant issue facing the field of transplantation - organ donation. While the number of patients needing transplantation has risen dramatically in recent years, the rate of organ donation has remained relatively stable. Chapter 3 highlights the many ethical issues surrounding the more general concept of organ donation, while Chapter 4 focuses specifically on the burgeoning interest in living organ donation.

Readers have access to legions of books dealing with the molecular, genetic, neurochemical, neurophysiological, neuroanatomical, neuroradiological and psychological aspects of pain as well as with the clinical approaches to pain from various medical disciplines. Why then is it necessary to publish a book on the pathophysiologyofpain perception? Pain can result either from noxious events due to lesions, injuries, diseases, etc. , or from disturbances in the system transducing, transforming, and processing the potential pain signal or from an interaction of both. Under certain pathological conditions, the pain-processing system, which includes both physiological and psychological components, can produce the experience of pain in the absence of any peripheral noxious event. This book primarily ex- amines these pathological alterations in the pain-signalling system, and the authors provide information on the functioning of the pain-processing system under normal and pathological conditions. The understanding of pain perception is essential for optimal diagnosis and treatment of acute and chronic pain. Considerable evidence now indicates that alterations in pain per- ception are characteristic of many clinical pain states. Whether disturbed pain perception is a truly etiological or only a maintaining factor-c-or even a mere epiphenomenon of chronic functional pain-is reviewed in detail by L. Arendt-Nielsen, C. R. Covelli, R. B. Fillingim,]. M. Gillespie, T. Graven-Nielsen, E. Kosek, S. Lautenbacher, M. Peters, A. Pielsticker, DO. Price, G. B. Rollman, P. Svensson and G. N. Verne for headache, back pain, fibromyalgia, myofascial pain, temporomandibular pain disorder, irritable bowel syndrome and menstrual cycle-related pain disorders.

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.

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.

"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.