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There is a need to refine our current psychiatric nosology to
produce diagnostic criteria and disorder categories that keep pace
with advances in neuroscience while at the same time enhance
clinical utility. Furthermore, dimensional aspects of psychiatric
disorders require greater recognition so as to improve our
understanding of boundaries between disorders and underscore the
heterogeneous nature of psychopathology. The Conceptual Evolution
of DSM-5 provides a framework for the evolution of the forthcoming
diagnostic system in the fifth edition of Diagnostic and
Statistical Manual of Mental Disorders (DSM-5), which will help
advance clinical practice and facilitate ongoing development of
diagnostic criteria. This manual: • Highlights recent progress in
our understanding of cross-cutting factors relevant to psychiatric
diagnosis and symptom presentation • Includes detailed
discussions on the role of factors such as age, gender, culture,
and disability in the expression of mental disorders • Provides a
review of genetic evidence supporting a cross-cutting approach to
nosology • Offers suggestions for integrating cross-cutting
factors with DSM-5. The Conceptual Evolution of DSM-5 was written
to impart a theoretical context for understanding potential
revisions to DSM-5. The authors reevaluate the structure of the
current manual and discuss cross-cutting approaches to facilitate
clinical practice and refine research approaches that will guide
clinical trials, genetics, imaging, and treatment guidelines. The
authors provide the following insights: • Detailed descriptions
of age-, gender-, and culture-specific aspects relevant to
psychiatric diagnosis and the need for sensitivity to these factors
when making diagnoses • Discussions on the dimensional aspects of
mental disorders, including overlapping symptoms relevant to many
or most diagnoses • Consideration of alternative classifications
of disorders that recognize disorders sharing validating features
• Presentation of neuroscientific and epidemiologic evidence to
expand understanding of disorders beyond that of the categorical
organization presented in DSM-IV • A review of clinical
implications, including how clinicians may shift their
conceptualization of previously reified diagnostic criteria and
their consequences. As presented to the 99th Annual Meeting of the
American Psychopathological Association, The Conceptual Evolution
of DSM-5 explores the rapidly changing research base for the
understanding of neurodevelopmental, neurocognitive, addictive, and
other psychiatric disorders. The contributions in this volume
confirm that DSM-5 is intended to be a living document that can
accommodate revisions to specific diagnostic areas based on new
evidence that is replicable and subject to review. This efficient
updating process will help researchers and clinicians keep abreast
of the latest protocols for the research, diagnosis, and treatment
of mental illness.
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& mdash;gleaned from the
overlapping areas or areas of mutual pathogenesis linking disparate
realms of knowledge& mdash;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
duringdevelopment, 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.
Personality and Psychopathology compiles the conclusions of more
than 30 internationally recognized experts who each carefully
examine the link between personality traits and psychopathology.
Recent findings have clarified the importance of personality in the
development and expression of psychopathology.
In light of such discoveries, this reference examines the
relationship of personality traits with psychopathology from
several interlocking perspectives -- descriptive, developmental,
etiological, and therapeutic. It successfully tackles - A
description of the frequency and patterns of overlap between
personality and psychopathology- The structure and stability of
normal personality traits across the life span and their relation
to psychopathology- An analysis of personality disorders from three
different approaches- The causes of individual differences in
personality and psychopathology from genetic, psychosocial, and
neurobiological perspectives- The role of personality in the
treatment of psychopathology
Complete with illustrative charts, this all-inclusive resource
provides invaluable information on the link between personality and
psychopathology.
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.
Researchers in schizophrenia are beginning to uncover the
secrets that have long puzzled clinicians and scientists alike.
Research continues and treatment progresses to improve and
stabilize the lives of patients with schizophrenia.
"Schizophrenia: From Mind to Molecule" presents a change in the
scientific understanding and outlook regarding this devastating
disorder. It provides a thorough look at schizophrenia that
includes neurobehavioral studies, traditional and emerging
technologies, psychosocial and medical treatments, and future
research opportunities.
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