Adam T. Gerstenecker and Benjamin T. Mast
This chapter examines the role of psychologists in the rehabilitation of older adults. The chapter begins with a review of the changes expected to take place in the population demographics of the United States and its impact on geriatric rehabilitation. The next section highlights core concepts in geriatric rehabilitation, as well as predictors of successful outcome. In the final sections of the chapter, psychologists’ roles within geriatric rehabilitation will be examined, with particular emphasis placed upon assessing cognitive impairment and depression, and specific interventions for treating depression in geriatric rehabilitation patients.
Lance M. Rappaport, Sage E. Hawn, Cassie Overstreet, and Ananda B. Amstadter
Given the critical role that emotion dysregulation plays in many psychiatric disorders, there is a need to understand the biological underpinnings of emotion regulation deficits. This chapter opens with a brief overview of emotion regulation and constructs that fall under its broad umbrella. Next, it provides a brief primer of behavioral genetic research methods, summarizes existing literature regarding the heritability of emotional dysregulation, provides an overview of molecular genetic research methods, and reviews extant molecular genetic literature on emotion regulation. Finally, the chapter reviews the limitations of existing research and identifies promising areas of future inquiry that may clarify the underlying structure of emotion dysregulation and identify the role of common genetic loci in associations between emotion dysregulation and psychopathology.
Matt McGue and Brian M. Hicks
We review behavioral and biometrical genetic research aimed at characterizing the nature of the familial aggregation of adolescent substance use and abuse. Twin and adoption studies have shown that genetic factors contribute to individual differences in adolescent substance use phenotypes. These studies have also documented the importance of the shared environment. Biometrical analyses of large samples of twins show that the contributions of genetic and shared environmental factors to substance use phenotypes change markedly between adolescence and early adulthood. The importance of genetic influence increases with age as the importance of shared environmental influences declines. Although only a small number of relevant genetic variants have been identified at this time, they show a similar pattern of increasing association with substance use behavior with age. A major question continues to be how genetic and environmental factors operate jointly to influence the development of complex behavioral phenotypes such as substance use.
Mary Fristad and Elizabeth Nick
This chapter reviews bipolar spectrum disorders (bipolar I, bipolar II, bipolar disorder not otherwise specified, and cyclothymic disorder) in childhood and adolescence. The history of the diagnosis in youth, including recent increased public and professional interest, and surrounding controversy is reviewed. Attention is given to prevalence, incidence, similarities and differences in presentation, course, and comorbidities among child, adolescent, and adult bipolar spectrum disorders. Assessment issues are reviewed, including longitudinal and multiinformant perspectives, instruments, strategies, tools, and assessment challenges with youth. Examples of symptom manifestation in youth are provided. Genetic, cognitive, neuroanatomical, psychosocial, and environmental risks for youth bipolar spectrum disorders are discussed. Evidence-based treatments reviewed include commonly prescribed mood stabilizers and atypical antipsychotics, alternative biological treatments, adjunctive psychotherapies, and complementary and alternative treatments. Finally, future directions for the study, assessment, monitoring, and treatment of youth bipolar spectrum disorders are discussed.
Robert J. McCaffrey, Julie K. Lynch, and Holly James Westervelt
The origins of clinical neuropsychology were founded in the diagnostic methods for identifying cerebral damage and, although this remains an important focus of the field, clinical neuropsychology is also focused upon understanding the functional consequences of neuropsychological dysfunction and on methods of treating or managing neuropsychological dysfunction. Neuropsychological research has also expanded beyond neurology to psychology, where delineating the neuropsychological correlates of psychological disorder has been of particular interest. Following a brief history of neuropsychology, this chapter discusses neuropsychiatric symptoms associated with neurological damage or disease. The discussion will then turn its focus to psychological disorders, with a review of the neuropsychological deficiencies that have been associated with various Axis I and Axis II disorders. The objective of this chapter is to provide information of potential utility to the psychotherapist or psychologist in understanding the neuropsychological underpinnings of psychological disorders, as well as the psychological and behavioral consequences of neurological conditions.
James J. H. Rucker and Peter McGuffin
It has long been known that the human genome is subject to deletion and duplication of genetic material by various molecular mechanisms. Until recently, such events were assumed to be relatively rare phenomena. It is now known that submicroscopic deletions or duplications called copy number variants (CNVs) are a major source of genomic variation. Rare CNVs (defined as occurring in less than 1 percent of the population) have been implicated in schizophrenia and autism. Measured in terms of odds ratios, individual CNVs have been shown to have large effects, some increasing the risk of disorder several-fold. But they are incompletely penetrant, no one CNV is either necessary or sufficient to cause the disorder. The findings are less clear-cut with bipolar disorder but, here, too, rare CNVs probably play a role. In unipolar depression, initial evidence suggests an overall increase in rare CNVs that disrupt exons, the coding regions of genes.
Scott Monroe and Lori Cummins
This chapter examines environmental risk and protection for depression from two seemingly contradictory vantage points: depression commonly arises in response to environmental adversity, but depression also arises without any apparent environmental adversity. Preliminary considerations are reviewed initially to provide a context for evaluating the current empirical evidence on life stress as a risk factor for the onset of depression. Particular attention is paid to the potential importance of recurrences of depression to help explain the presence and absence of major life stress prior to episode onset. Alternative models are then considered that potentially can reconcile the seemingly inconsistent sets of observations regarding life stress and the onset of a depressive episode. The research literature is presented in light of these models. Finally, the relations of other environmental risk and protection factors with life stress and depression are discussed, as well as the implications for future research.
Sheri L. Johnson, Anda Gershon, and Kaja Johnson
In this chapter, we consider the role of the social environment as a predictor of symptoms within bipolar disorder. We begin with a discussion of some conceptual and methodological issues that must be considered in such lines of work. We then highlight some of the strongest research available concerning the role of social support, family predictors, marital variables, traumatic events, life events, culture, race, and ethnicity as predictors of outcomes within bipolar disorder. Taken together, the literature provides rich and compelling evidence that the social environment is of extreme importance for understanding symptoms and treatment patterns within bipolar disorder. We end with a discussion of important future directions for research, including the need for more integrative research on a fuller range of social and biological predictors.
Paul W. Andrews and Zachary Durisko
Depression is a heterogeneous collection of phenotypes sharing partially overlapping genes, neurobiology, and symptoms. This chapter applies an evolutionary perspective to the distinct etiologies and functions of three reliably identified depressive phenotypes: sickness behavior, starvation depression, and melancholia (i.e., depression with melancholic features). Infection and food shortage are evolutionarily ancient problems, and so sickness behavior and starvation depression probably evolved first. Melancholia probably evolved more recently and shows signs of an evolutionary design for a cognitive function. More specifically, evidence suggests that melancholia is an adaptation for promoting analytical reasoning, and probably evolved as an adaptive response to complex problems involving resource management or conflicts with close social partners. These depressive phenotypes, although distinct, are functionally similar, which explains the overlapping genetics, neurobiology, and symptomatology. In all three, depressive symptoms help the body coordinate the reallocation of limited energy resources in response to persistent threats.
Joan P. Gerring and Roma A. Vasa
This article deals with traumatic brain injury (TBI) and its link to externalizing disorders in children, with emphasis on advances in the field that have been driven by new medical and technologic discoveries. It begins with a historical overview of TBI diagnosis and treatment, citing the important role played by neuroimaging. It then looks at the features and correlates of new and persistent externalizing disorders that arise in pediatric patients after TBI, focusing on closed head injury. It also examines attention-deficit/hyperactivity disorders and disruptive behavior disorders, the latter of which include oppositional defiant disorder and conduct disorder. In addition, personality change (aggression, antisocial personality disorder) following TBI is discussed. The article concludes by evaluating pharmacological and psychological treatments available to children with externalizing disorders.
This chapter charts the history of aphasiology from antiquity to the recent past. An arbitrary line is drawn to include paragraphs of only those who passed, to avoid the review of large amounts of currently active research. References are provided for original work as well as other historical reviews, the review groups, scientific and conceptual developments in historical time periods, regions of work, disciplines, and schools of thought. Contemporary aphasiology is part of the neurosciences, both basic and applied, advancing at a pace so precipitous as to be almost disorienting. We are benefiting from today’s incredible advances in MRI, PET, functional MRI, voxel-based morphometry, transcortical stimulation and white matter diffusion imaging, genetic and molecular biology laboratory work, and continuing clinical experience. History is being made at almost every minute and is better recorded than ever before. An update is already overdue.
Victor W. Henderson
In the history of medicine, studies of agraphia and alexia have figured prominently in efforts to understand neural underpinnings of cognition. The central historical figure is Jules Dejerine (1849–1917), whose worked followed pioneering studies on aphasia by Broca and Wernicke. Dejerine identified the left angular gyrus as crucial for reading and writing, and he described syndromes commonly referred to as alexia with agraphia and alexia without agraphia (pure alexia). Models derived from Broca, Wernicke, and Dejerine are based on concepts of specialized cortical centers linked by subcortical nerve fiber pathways. Following his death, Dejerine’s clinical–anatomical formulations were deconstructed by Marie, Head, and Goldstein, only to be resurrected in the second half of the 20th century. Newer varieties of agraphia or alexia were linked to apraxia, impaired body image, spatial misperception, and interhemispheric disconnection; and newer syndromes were identified from information processing approaches focused on error analyses.
Francois Boller, Guido Gainotti, Dario Grossi, and Giuseppe Vallar
Early Italian clinicians and researchers dedicated their work to human neuropsychology mainly through analysis of variations of cognitive and behavioral functions caused by brain damage. The systematic development of neuropsychology in Italy started in the early 1960s in Milan with the neurologist Ennio De Renzi and his collaborators (mainly Luigi A. Vignolo, early on) in the Clinic of Nervous and Mental Diseases. The “Milan group” investigated several neuropsychological deficits caused by focal hemispheric lesions in human brain-damaged patients, developing standardized tests and advanced statistical methods applied to the clinical diagnosis and the rehabilitation of aphasia. It first used the new imaging techniques (CT scan) in the 1970s to correlate lesion sites with behavioral deficits. Since then, neuropsychology and neuropsychological research, both basic and applied, have developed extensively in other parts of Italy and include clinical diagnosis and rehabilitation of patients with brain damage or dysfunction throughout the life span.
Tatia M.C. Lee, Wang Kai, and Simon L. Collinson
Clinical neuropsychology in Asia has emerged from the interactions of multiple processes, including the development of psychology and its subdisciplines worldwide, the entering of psychology into Asia and ongoing intellectual influences from outside of Asia, indigenous responses to those external forces, and homegrown initiatives in studying brain-behavior relationships prior to and since the beginnings of modern neuropsychology. This chapter reviews the history of neuropsychology in China, Hong Kong, Singapore, and other Asian regions. With globalization and increasing ease of information exchange, neuropsychological practice in Asia will continue to be shaped by influence from the West interacting with the indigenization process to shape the development of neuropsychology in Asia. Rapid development of neuroscience leads to cutting-edge findings and discovery of brain-behavior relationships, which has and will continue to be one of the rich sources of information that guides and shapes neuropsychological practice in Asia and worldwide.
The history of the development of neuropsychology in The Netherlands is described. First some early descriptions of the effects of brain lesions on behavior are mentioned. Subsequently the remarkable lack of interest in neuropsychology in the 19th century is described, contrasting with the important changes in France, Germany, and England. Neuropsychology began to blossom in the second half of the 20th century. In the early 1980s neuropsychology courses were developed and a series of textbooks was published. In the 1990s chairs for neuropsychology were founded at most universities. A separate organization for professionals was created, as well as a curriculum for becoming a specialized professional neuropsychologist.
Michael C. Chen and Ian H. Gotlib
Major Depressive Disorder (MDD) is a prevalent and costly disorder with a broad range of cognitive, affective, and behavioral symptoms. Despite the absence of a clear final common molecular pathway in depression, many molecular systems have been implicated in MDD. In particular, disruptions in molecular systems like serotonin, dopamine, glutamate, and other neurotransmitters, as well as in stress hormones, cytokines, neurotrophins, and neuropeptides, may contribute to MDD. To link the symptoms of MDD with molecular dysfunction, this article examines these molecules in the context of three symptom clusters of MDD: cognitive/affective symptoms, volitional/behavioral symptoms, and homeostatic/vegetative symptoms. It examines how these molecules and their receptor, transport, and regulatory systems contribute to MDD and to the development of specific symptom clusters. It presents two possible frameworks of molecular dysfunction in MDD that encompass the interactions between vulnerability phenotypes and biochemical perturbations that may lead to the heterogeneous symptoms of this disorder.
Ian R. Gizer, Jacqueline M. Otto, and Jarrod M. Ellingson
Quantitative behavioral genetics studies provide strong evidence for heritable influences on the development of externalizing spectrum behaviors that cut across traditional diagnostic boundaries, including attention-deficit/hyperactivity disorder, oppositional defiant disorder, conduct disorder, antisocial personality disorder, and substance use and dependence. In contrast, molecular genetic studies have focused largely on individual disorders. This chapter reviews findings from genome-wide linkage studies, candidate gene studies, and genome-wide association studies of externalizing spectrum disorders, highlighting genes and gene categories that show relations with multiple disorders on the spectrum. Although still somewhat limited, these results provide important insights into the genetic architecture of the externalizing spectrum. The authors also note substantial divergence in findings across study designs, provide potential explanations for such findings, and describe how future studies might resolve these discrepancies.
Contemporary social and neuro-sciences highlight many unanswered questions about the ways that music therapy plays a part in the interprofessional rehabilitation for those affected by traumatic brain injury. This chapter begins with detailed descriptions of traumatic brain injury, its causes and the resulting consequences and interlinks these to the processes of referral, assessment, aims and objectives, treatment methods, evaluation and reporting as documented in the literature to date. In contrast to an individualized perspective of neural trauma, traumatic brain injury is considered here as “traumatic social nervous system injury.” An argument is made for the need to consider the individual brain as one part of a social and material structure of cognition, perception, action and regulation. Constituted in this way, the chapter considers how music therapy can contribute to understanding the lives of the traumatically injured and everyone and everything with which they are inseparably intertwined.
Stefan Mainka, Ralph Spintge, and Michael Thaut
Music in the acute medical setting or in neurological rehabilitation is used functionally to facilitate and target specific therapeutic goals. Neurologic music therapy (NMT) and music medicine are described as effective evidence-based treatment approaches in sensorimotor and cognitive rehabilitation, as well as in therapy for acute and chronic pain. There is good clinical evidence for NMT techniques in sensorimotor rehabilitation for various diagnoses such as stroke, Parkinson’s, or traumatic brain injury. Music has also been shown to be an effective medium in the treatment of pain. The direct influence on acute pain is getting more and more attention in the field of surgery. Patients with chronic pain require specially designed and sequential therapeutic strategies. The therapeutic mechanisms for NMT and music medicine are becoming more and more understood, so that the treatment techniques can be refined to meet medical needs in an optimal way.
Kristina M. Jackson and Carolyn E. Sartor
Substance use and substance use disorders show normative epidemiological age-related trends, with typically onset in the late adolescent to young adult years, manifesting peak prevalences in emerging adulthood, and decreasing thereafter. Although less prevalent in older adults, substance misuse is more consequential when present and thus represents a public health concern. Careful examination of the population-based empirical literature indicates the necessity of viewing substance involvement in the context of development, with unique developmental factors associated with its onset, course, and resolution. Many individuals who suffer from a substance use disorder appear to “recover” without formal treatment. Despite normative age-related trends, there is considerable individual course variation, and modern statistical techniques have identified several distinct prototypic courses that appear to differ in their determinants and consequences. Research using a lifespan perspective on substance use and misuse has powerful implications for the design of effective, developmentally informed prevention and intervention programs.