Although considerable progress has been made in the understanding
and treatment of a range of medical disorders, it had recently been
pointed out that 85 percent of the population will be stricken by
chronic disorders which may be accompanied by many years of
suffering. This volume deals with issues of both cure and risk in
chronic illnesses which are among the group of disorders associated
with the leading causes of death in the United States at this time
-- Alzheimer's disease, AIDS, and cancer. A consideration of the
role of brain and behavior in relation to the cure and prevention
of these disorders is the central focus of the various chapters in
this book. Several chapters discuss the neuropsychological aspects
of chronic illnesses including the underlying pathophysiology of
changes in the brain which may be associated with both behavioral
and physical signs and symptoms in these disorders. Considerable
evidence suggests that a range of psychosocial or behavioral
factors, such as stressful life events and depression, are
associated with increased morbidity or mortality. Complex
neurobiological pathways involving the brain, neurotransmitter, and
neuroendocrine systems have been implicated. Other chapters
consider some of the links among brain, behavior and chronic
illnesses, as well as psychological factors such as coping and
depression in relation to chronic disorders. The three leading risk
factors known to be associated with both chronic illnesses and
death -- diet, tobacco, and alcohol -- are all related to
behavioral choices. Sexual behavior can be added to the list in
terms of HIV infection and acquired immunodeficiency disease
(AIDS). Several chapters deal specifically with a consideration of
sexual behavior and HIV infection which clearly highlight the need
for scientific knowledge in human sexuality if effective long term
preventive measures are to be developed while waiting for a vaccine
or cure. The search for cures must continue to have the highest
priority in the scientific and clinical struggle against disease.
Nonetheless, the value of psychosocial interventions on the quality
of life and mental states of seriously ill persons should not be
underestimated.
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