Outpatient Psychiatry In The 1970 S

One response to questions about the future of psychology is to attempt an answer to another question: What have we learned from psychology’s past? Originally published in 1984, reissued here with a new preface, this book presents a collection of original papers by authorities with international reputations in various fields of psychology at the time. Contributors were invited to appraise the past of their own research specialties, with an eye toward the future. The emphasis is upon the more scientific areas of psychological research. The catalyst for this book was an international conference honoring Gustav A. Lienert held in 1981. Psychologists from both Western and Eastern Europe, North and South America, and representing fields as different as psychophysics is from clinical psychology, or animal memory from human decision making, described their research and argued the prospects for the future of experimental psychology. Most of the arguments found their way into this book where readers could confront the different viewpoints at the time and those reading it today can see how accurate their predictions were for the future.

Explaining crime by reference to abnormalities of the brain is just one example of how the human and social sciences have influenced the approach to social problems in Western societies since 1880. Focusing on applications such as penal policy, therapy, and marketing, this volume examines how these sciences have become embedded in society.

Thirty years ago, it was estimated that less than five percent of the population had an anxiety disorder. Today, some estimates are over fifty percent, a tenfold increase. Is this dramatic rise evidence of a real medical epidemic? In All We Have to Fear, Allan Horwitz and Jerome Wakefield argue that psychiatry itself has largely generated this "epidemic" by inflating many natural fears into psychiatric disorders, leading to the over-diagnosis of anxiety disorders and the over-prescription of anxiety-reducing drugs. American psychiatry currently identifies disordered anxiety as irrational anxiety disproportionate to a real threat. Horwitz and Wakefield argue, to the contrary, that it can be a perfectly normal part of our nature to fear things that are not at all dangerous--from heights to negative judgments by others to scenes that remind us of past threats (as in some forms of PTSD). Indeed, this book argues strongly against the tendency to call any distressing condition a "mental disorder." To counter this trend, the authors provide an innovative and nuanced way to distinguish between anxiety conditions that are psychiatric disorders and likely require medical treatment and those that are not--the latter including anxieties that seem irrational but are the natural products of evolution. The authors show that many commonly diagnosed "irrational" fears--such as a fear of snakes, strangers, or social evaluation--have evolved over time in response to situations that posed serious risks to humans in the past, but are no longer dangerous today. Drawing on a wide range of disciplines including psychiatry, evolutionary psychology, sociology, anthropology, and history, the book illuminates the nature of anxiety in America, making a major contribution to our understanding of mental health.

During the past several decades, the field of mental health care has expanded greatly. This expansion has been based on greater recognition of the prevalence and treatability of mental disorders, as well as the availability of a variety of forms of effective treatment. Indeed, throughout this period, our field has witnessed the introduction and the wide spread application of specific pharmacological treatments, as well as the development, refinement, and more broadly based availability of behavioral, psychodynamic, and marital and family interventions. The community mental health center system has come into being, and increasing numbers of mental health practitioners from the fields of psychiatry, psychology, social work, nursing, and related professional disciplines have entered clinical practice. In concert with these developments, powerful sociopolitical and socioeconomic forces-including the deinstitutionalization movement of the late 1960s and early 1970s and the cost-containment responses of the 1980s, necessitated by the spiraling cost of health care-have shaped the greatest area of growth in the direction of outpatient services. This is particularly true of the initial assessment and treatment of nonpsychotic mental disorders, which now can often be managed in ambulatory-care settings. Thus, we decided that a handbook focusing on the outpatient treatment of mental disorders would be both timely and useful. When we first began outlining the contents of this book, the third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disor ders (DSM-III) was in its fourth year of use.