The main aim of this book is to evaluate the concept of stress and provide tools for physicians to identify patients who might benefit from stress management. This will incorporate a detailed description of the physiological and pathophysiological consequences of acute and chronic stress that might lead to cardiovascular disease. The book will aim to critically evaluate interventional research (behavioural and other therapies) and provide evidence based recommendations on how to manage stress in the cardiovascular patient. Our intentions are to define and highlight stress as an etiological factor for cardiovascular disease, and to describe an evidence based "tool box" that physicians may use to identify and manage patients in whom stress may be an important contributing factor for their disease and their risk of suffering cardiovascular complications.
Stress and Health: Biological and Psychological Interactions is a brief and accessible examination of psychological stress and its psychophysiological relationships with cognition, emotions, brain functions, and the peripheral mechanisms by which the body is regulated. Updated throughout, the Third Edition covers two new and significant areas of emerging research: how our early life experiences alter key stress responsive systems at the level of gene expression; and what large, normal, and small stress responses may mean for our overall health and well-being.
An opening address should ask the right questions, which we expect to answer during the coming years. A good opening address should formu late hypotheses for falsification during the conference or in the near fu ture. Mter Dr. Groen's excellent lecture yesterday, I feel better about my task, because I feel I am not alone in asking the ten questions in my ab stract. It is an honor for me to give this short paper largely based on my expe riences during 15 years as medical director of a rehabilitation center in Ba varia, as a teacher at two medical schools in Munich and Innsbruck, and as an old-fashioned holistic cardiologist. However, it also is a difficult task for me because the subject of this conference concerning biobehavioral factors in coronary heart disease is controversial, not only in the medical society, but in my own mind as well. When I organized one of the first conferences on stress and coronary heart disease in West Germany in 1976, followed by conferences in 1979 and 1980, the semantic problems between physicians and psychologists were very significant. However, communication has improved in this area during the last decade. The most encouraging event in this field was a sym posium in May 1984 in Rotenburg/Fulda on the topic "Return to Work af ter Bypass Surgery", organized by a cardiac surgeon, Dr. Walter.
This open access book is a systematic update of the philosophical and scientific foundations of the biopsychosocial model of health, disease and healthcare. First proposed by George Engel 40 years ago, the Biopsychosocial Model is much cited in healthcare settings worldwide, but has been increasingly criticised for being vague, lacking in content, and in need of reworking in the light of recent developments. The book confronts the rapid changes to psychological science, neuroscience, healthcare, and philosophy that have occurred since the model was first proposed and addresses key issues such as the model’s scientific basis, clinical utility, and philosophical coherence. The authors conceptualise biology and the psychosocial as in the same ontological space, interlinked by systems of communication-based regulatory control which constitute a new kind of causation. These are distinguished from physical and chemical laws, most clearly because they can break down, thus providing the basis for difference between health and disease. This work offers an urgent update to the model’s scientific and philosophical foundations, providing a new and coherent account of causal interactions between the biological, the psychological and social.
This ambitious and comprehensive handbook represents an essential contribution to our current understanding of interactions between heart and brain, a research topic generating growing interest. Despite the increasing awareness that neural mechanisms are the primary cause of cardiac disease and its progression, therapy continues to focus on end-organ protection and does not approach the neural core of the problem. Growing public health problems such as heart failure are still treated with autonomic drugs that are 30-40 years old and simply act on cardiac receptors. However, it has now been shown that the progression of ischemic heart disease to heart failure is mainly due to abnormal central responses to incipient cardiac disease, with neural activation the primary cause rather than the consequence of cardiac remodeling. Written by leading international experts in their respective research areas, the book presents a variety of perspectives on the core topic: from social and philosophical to gender-related aspects. It is designed for a broad readership and includes dedicated sections for cardiologists, psychiatrists, neurologists and psychotherapists looking for a more insightful and targeted approach to neuro-cardiovascular disease.
The understanding of how to reduce risk factors for mental disorders has expanded remarkably as a result of recent scientific advances. This study, mandated by Congress, reviews those advances in the context of current research and provides a targeted definition of prevention and a conceptual framework that emphasizes risk reduction. Highlighting opportunities for and barriers to interventions, the book draws on successful models for the prevention of cardiovascular disease, injuries, and smoking. In addition, it reviews the risk factors associated with Alzheimer's disease, schizophrenia, alcohol abuse and dependence, depressive disorders, and conduct disorders and evaluates current illustrative prevention programs. The models and examination provide a framework for the design, application, and evaluation of interventions intended to prevent mental disorders and the transfer of knowledge about prevention from research to clinical practice. The book presents a focused research agenda, with recommendations on how to develop effective intervention programs, create a cadre of prevention researchers, and improve coordination among federal agencies.
This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.
Provides a comprehensive overview of epidemiologic, experimental, and clinical data evidencing the emergence of cardiac psychology as a specialty. It offers a thorough and up-to-date review of the scientific research supporting the relationship between cardiac disease and psychological condition, practical suggestions for developing a clinical practice and directions for future research in this new field of "cardiac psychology". The first part provides an overview of the psychological risk factors for cardiac disease. Emphasis is placed on physiological basis of mind-heart link, depression and anxiety, personality and relational aspects, and on advanced statistical tools for the study of personalities at risk. The second part offers a systematic overview of literature on psychological treatments in cardiac rehabilitation.
Depression is a widespread condition affecting approximately 7.5 million parents in the U.S. each year and may be putting at least 15 million children at risk for adverse health outcomes. Based on evidentiary studies, major depression in either parent can interfere with parenting quality and increase the risk of children developing mental, behavioral and social problems. Depression in Parents, Parenting, and Children highlights disparities in the prevalence, identification, treatment, and prevention of parental depression among different sociodemographic populations. It also outlines strategies for effective intervention and identifies the need for a more interdisciplinary approach that takes biological, psychological, behavioral, interpersonal, and social contexts into consideration. A major challenge to the effective management of parental depression is developing a treatment and prevention strategy that can be introduced within a two-generation framework, conducive for parents and their children. Thus far, both the federal and state response to the problem has been fragmented, poorly funded, and lacking proper oversight. This study examines options for widespread implementation of best practices as well as strategies that can be effective in diverse service settings for diverse populations of children and their families. The delivery of adequate screening and successful detection and treatment of a depressive illness and prevention of its effects on parenting and the health of children is a formidable challenge to modern health care systems. This study offers seven solid recommendations designed to increase awareness about and remove barriers to care for both the depressed adult and prevention of effects in the child. The report will be of particular interest to federal health officers, mental and behavioral health providers in diverse parts of health care delivery systems, health policy staff, state legislators, and the general public.
