Psychophysiologic Disorders

Did you know that one in six adults and 30-40% of primary care patients suffer from medically unexplained symptoms, chronic functional syndromes or psychosocial factors linked to chronic pain? Collectively these are known as Psychophysiologic Disorders or PPD. A trauma-informed, evidence-based approach to diagnosis and treatment can transform these patients from among the most frustrating to the most rewarding and give them a far better chance for a full recovery. As one family physician who learned these concepts said: "It put the joy back into my practice." From this innovative book, medical and mental health professionals will learn to relieve (not just manage) physical symptoms by assessing for and treating current life stresses, past traumas, suppressed emotions and the prolonged impact of adverse childhood experiences (ACEs). The sixteen authors from five countries average 20 years of experience in the fields of Adolescent Medicine, Family Medicine, Gastroenterology, Health Journalism, Integrative Medicine, Internal Medicine, Movement Therapy, Neuroscience, Orthopedic Spine Surgery, Pain Medicine, Physiotherapy, Psychiatry, Psychoanalysis, Psychology, Psychotherapy, and Sports Medicine. From this wide range of backgrounds, the authors reached consensus on a core set of practices that were a revelation for them and their patients. These concepts are practical and can readily be implemented by any healthcare professional.In addition to the editors, chapter authors include James Alexander PhD, Mariclare Dasigenis LCSW, David Hanscom MD, Ian Kleckner PhD MPH, Mark Lumley PhD, Daniel Lyman LCSW MPA, Meghan Maguire, Georgie Oldfield MCSP, David Schechter MD, Eric Sherman PsyD, John Stracks MD, and Joel Town DClinPsy.

Pilowsky presents a general introduction to the early recognition and management of abnormal illness behaviour, and suggests ways to identify such behaviour, offer appropriate psychological care and provide specialist psychiatric help.

The interrelationships between somatic and psychiatric complaints involve virtually every major organ system and every psychiatric diagnostic category. Psychiatric distress frequently finds expression in physical ailment or pain, and chronic physical illness or disability is a common exacerbant of psychiatric symptoms. The complexity of the interplay between psychological and physiological disease is profound, and many of the mechanisms involved remain undefined or imperfectly understood. Our intention in assembling this volume, the fifth in the Baylor Psychiatry Series, has been to consolidate the most recent medical and psychiatric opinion on the description and treatment of psychophysiological disorders. We have included reviews and new material on disorders long understood to be in the psychophysiological realm, such as gastrointestinal disease, pulmonary reactions, headache, and hypertension. Additionally, there are contributions on conditions less frequently, but no less clearly, recognized as psychophysiological or psychosomatic, including immune response deficits, epilepsy, stuttering, and sleep disorders. Chapters on Couvade syndrome, menstrually related mood disturbance, obesity, keratoconus, and anorexia nervosa examine the degree to which psychological and physical events interact in conditions usually considered attributable essentially to a single system. Drs. Dowling and Gaitz have written excellent reviews of developmental elements in psychophysiological events, and examine such disorders as they are specific to the very young or the very old. Treatment approaches to the variety of disorders are discussed in chapters by Dr. Decker, who describes multifaceted modalities, Dr. Lomax, who examines psychotherapeutic techniques, and in a final chapter on psychopharmacological mitigation of psychophysiological syndromes.

Argues that the cause of a variety of health problems is stress and offers case studies and information on treating physical symptoms that occur in the body from high levels of stress.

This book could not have been conceptualized or published 20 years ago. Indeed, it is doubtful that we could have organized the material for this handbook 10 years ago. Over the last 20 years, however, the painstaking efforts of many clinical researchers working with a variety of resistive psychopathologies have resulted in specific psychotherapies and pharmacotherapies that are effective with a significant propor tion of patients, at least for some of the disorders. Much clinical research remains to be carried out in the forthcoming decades. But now that we are nearing the 21st century, at least some statement about efficacy can be made. In 1967, Gordon Paul succinctly stated that the ultimate goal of treatment outcome research is to determine "What treatment, by whom, is most effective for this individual with that specific problem, and under which set of circumstances" (p. 111). At that time, empirical evaluations of psychosocial and pharmacologic treatments were few and far between. Methodological strategies for determining treatment effectiveness were also in the formative stage, as exemplified by introduc tion of control groups that received inactive interventions (i. e. , placebo) and the relatively recent practice of comparing two or more treatments in addition to placebo. In the almost three decades since Paul's oft-quoted dictum, both the quantity and the quality of treatment outcome research with adults have increased dramati cally.

Cardiovascular disease continues to be the number ioral medicine" was developed and shaped into the one source of morbidity and mortality in our coun following definition: try. Despite a 35% reduction since 1964, these Behavioral medicine is the interdisciplinary field con diseases, particularly coronary heart disease cerned with the development and integration of behav (CHD), claim nearly 1,000,000 lives each year in ioral and biomedical science knowledge and techniques the United States (Havlik & Feinleib, 1979). relevant to the understanding of health and illness and The Framingham study, among others, has iden the application of this knowledge and these techniques to prevention, diagnosis, treatment and rehabilitation. tified three major risk factors implicated in the de (Schwartz & Weiss, 1978) velopment of CHD: smoking, elevated serum cho lesterol, and high blood pressure (Castelli et at., This concept of "biobehavioral" collaboration 1986). Given that these factors account for less challenged scientists and clinicians of many disci than 50% of the variance associated with CHD plines to consider how they might more effectively (Jenkins, 1976), it has become obvious that addi develop diagnostic, treatment, and prevention tional risk factors must be identified if further pro strategies by merging their perspectives to address gress is to be made in disease prevention and simultaneously, among others, behavioral, psy control.

Bibliography of 8491 references derived from over 4500 current serial titles and over 100 current bibliographic services, books, monographs, and retrospective bibliographies. Arrangement: v. 1, Citations; v. 2, Author index; v. 3, Subject index. Complete entries appear in Citations and are arranged in approximate chronological order. Journal titles might be shortened, but they are not abbreviated in entries. Subject descriptors and identification of kind of study (e.g., clinical, paramedical, popular) are also included in the entries.

With the successful isolation of important behavior-health links and the resulting change in perspectives on the mind-body relationship, health psychology has emerged as an important and lively subdiscipline of clinical exploration and application. "Psychophysiological Disorders" responds to the recent demand for more clinically relevant materials by focusing on the assessment and treatment of some of the major psychophysiological disorders that have provided the traditional research interface between psychology and health. Leading psychologists and health practitioners explore the epidemiology and etiology, as well as the assessment and treatment, of several prevalent physical disorders and conditions, illustrating the vast potential for psychological intervention in [some] traditionally medical areas. The expert contributors provide thorough reviews of the research literature, advance many practical assessment and intervention suggestions, and offer a wealth of useful information and advice to practitioners who serve patients with psychophysiological disorders.