The Handbook of Diabetes provides concise and efficient coverage of the diagnosis, epidemiology, and management of diabetes and its complications. Containing hundreds of attractive colour diagrams, illustrations, and clinical photographs, this popular quick-reference guide focuses on the management and measurement of diabetes mellitus with highly visual references.
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Cancer Pharmacology: An Illustrated Manual of Anticancer Drugs provides a one-stop guide to the essential basic and clinical science of all the effective, life-prolonging drug therapies in oncology. From traditional cytotoxic agents to targeted genomic, epigenomic, hormonal, and immunotherapeutic agents, this pharmacology book covers the staggering advances in cancer pharmacology that are propelling new standards of care for common and uncommon malignancies.
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Current AUD research has a heavy emphasis on understanding the neurobiological and behavioral underpinnings of AUD and interactions between them. Such approaches have proven utility in novel treatment development efforts. However, advanced neurobiological measures and techniques, which have proven useful in treatment development efforts with individuals, have not yet been applied to couples. For example, clinically relevant AUD biomarkers are rarely examined in epidemiological or treatment research with couples.
Similarly, although functional magnetic resonance neuroimaging is widely used in laboratory and treatment research in the alcohol field, there is a scarcity of literature examining resting state or task-related neural functioning in romantic couples. Some novel directions include hyperscanning, in which two participants are scanned simultaneously in response to shared stimuli, and adapting imaging paradigms to address relational behaviors relevant to AUD.
Another area of potential for future research is applying the existing literature on dyadic physiological and neuroendocrine co-regulation to the alcohol field, an effort that has begun but needs to be extended. Data collected from samples of couples experiencing relationship distress and who enrolled in treatment trials for problems other than AUD indicate that discordant dyadic autonomic dysregulation is associated with acute and more severe couple conflict, 97 whereas synchrony in autonomic functioning is indicative of constructive couple therapy processes such as working alliance and improved health outcomes.
Identifying pathways to successfully treat AUD and co-occurring conditions among individual participants remains an area of intense scientific inquiry.
However, far less attention has been dedicated to understanding how partners and family members might contribute to adjunct or conjoint therapies. Despite the abundance of rigorously conducted studies and findings supporting the efficacy of dyadic AUD treatment, evidence-based couple and family therapies are rarely applied in frontline treatment settings.
Literature identifying barriers to provider uptake and patient utilization is also limited. The scant data available suggest that a lack of familiarity with modalities such as BCT among treatment providers and administrators of treatment clinics are among the most commonly cited challenges.
The majority of individuals with AUD who change successfully do so on their own, without any formal treatment. Community-based studies of these dissemination efforts also are needed to advance provider education and training efforts and to promote utilization of the full scope of couple and family treatments for AUD that are both available and efficacious.
Although efficacious couple and family treatments for AUD have been developed and tested, knowledge regarding behavioral mechanisms of action underlying treatment response largely remains untested. It is possible that both individual and relational mechanisms specific to family and couple interactions might facilitate improved treatment outcomes, maintenance of recovery programs and sobriety, and long-term health.
Thus, studies examining the mechanisms of action underlying effective couple and family treatments for AUD—as well as secondary analyses of extant data sets and studies combining data sets from multiple randomized controlled trials—are warranted. One avenue to addressing this gap in the literature is the use of observational coding schemes to examine within-session behaviors indicative of treatment response.
A recent study examined the association between pronoun utilization i. One specific mechanistic aspect of this literature that has not been thoroughly explored is the role of specific conflict behaviors and dyadic processes both adaptive and maladaptive in influencing alcohol craving as well as risk for lapse and relapse in AUD. The daily process and micro-longitudinal research designs and methods that have proven essential to understand some individual and dyadic mechanisms linking alcohol with couple conflict behaviors, such as intimate partner violence, have not been extended to nonviolent dyadic processes and recovery-related cognitions and behaviors.
This literature could be advanced through innovative intersections of multi-method approaches that link laboratory, neurobiological, and naturalistic data, such as incorporating traditional clinical trial designs with micro-longitudinal and remote assessment methods. Such data might be used to inform novel and accessible adjunct interventions and tailored treatment modifications to insulate people with AUD and their families from high-risk situations.
Future large-scale and multisite studies examining nationally representative samples such as the National Epidemiologic Survey on Alcohol and Related Conditions [NESARC] data set, etiological processes such as the Adolescent Brain Cognitive Development study [ABCD] , and treatment development such as the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence [COMBINE study] have the ability to leverage rich infrastructures and diverse resources, often in a longitudinal fashion, to measure dyadic and family functioning using reliable and valid measures.
To date, measurement of partner- and family-related variables has been limited in existing efforts. Increased collaboration between investigators and treatment providers with dyadic and family expertise pertaining to AUD is warranted in future integrated and large-scale efforts. As brief and empirically sound measurement approaches become more widely available, such collaborative efforts have the potential to reduce existing silos between fields of expertise within the AUD research community and ultimately to provide critical new information to drive the AUD field forward.
The existing literature suggests that families play a key role in motivating persons with AUD to recognize the need to change, providing support for change, and supporting long-term recovery and that AUD recovery is good for families. Most of our current knowledge, however, has come from studies of relatively small clinical samples or from treatment studies. The lack of community-based research, multisite randomized controlled trials, research on integration of partners and family members in recovery-oriented systems of care, conduct of AUD treatment-specific meta-analyses, and the exclusion of couple- and family-level variables in large-scale longitudinal studies of the onset and course of AUD remain important areas for future research.
Similarly, the lack of research on the role of the family in AUD recovery in diverse populations is a major gap in the current literature. The existing literature from treatment studies suggests that integrating partners and family members into AUD treatment is a highly effective way to maximize positive treatment outcomes and to facilitate long-term AUD recovery and health of individuals with AUD and their families.
Several manual-guided approaches have proven efficacy, but efforts to improve provider education and increase uptake of evidence-supported couple- and family-based AUD treatment modalities are needed to improve access and maximize the reach of available interventions.
Challenges also might emerge if social relationships are persistently strained, if it is not safe or appropriate to include partners and family members in these modalities, or if individuals with an alcohol problem are navigating additional challenges such as incarceration or homelessness that are likely to influence day-to-day social contact and implementation of currently available modalities. There is an abundance of new opportunities to integrate emerging novel scientific methods—such as multimodal, multidisciplinary assessment and intervention approaches—into research focused on couples and families with a family member with AUD.
The literature also is clear that improved access to AUD treatments among diverse populations is needed. It is crucial to improve synergy between existing alcohol research and the treatment community as well as the vast population of individuals in need of AUD treatment and their partners and families. Progress toward meeting these goals can be facilitated through increased collaboration with community partners to develop culturally informed modifications to research inclusion, AUD assessment, and intervention.
Increased collaboration between investigators, administrators, and clinical providers to maximize existing federal funding investments in couple and family AUD treatment and recovery processes also holds potential to reduce treatment barriers and improve long-term outcomes for couples and families.
McCrady is the author of a therapist manual and a client workbook on Alcohol Behavioral Couple Therapy, a treatment that is discussed briefly in this paper. She receives royalties from the sale of these publications and also receives payments for workshops to train practitioners in the use of Alcohol Behavioral Couple Therapy.
There are no other competing financial interests or other conflicts of interest to declare. Opinions expressed in contributed articles do not necessarily reflect the views of the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health. The U. Any trade or proprietary names appearing in Alcohol Research: Current Reviews are used only because they are considered essential in the context of the studies reported herein.
London: Public Health England; Stanley S. Interpersonal violence in alcohol complicated marital relationships A study from India. J Fam Violence. Psychological distress among female spouses of male at-risk drinkers. Family members of people with alcohol or drug dependence: Health problems and medical cost compared to family members of people with diabetes and asthma.
Parental alcohol use disorders and child delinquency: The mediating effects of executive functioning and chronic family stress. J Stud Alcohol Drugs. Chen Y, Weitzman ER. Depressive symptoms, DSM-IV alcohol abuse and their comorbidity among children of problem drinkers in a national survey: Effects of parent and child gender and parent recovery status. J Stud Alcohol.
Leonard KE, Mudar P. Peer and partner drinking and the transition to marriage: A longitudinal examination of selection and influence processes. Psychol Addict Behav. Relationships on the rocks: A meta-analysis of romantic partner effects on alcohol use.
Whisman MA. J Abnorm Psychol. Intimate partner violence and specific substance use disorders: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions.
Exploring bidirectional couple violence in a clinical sample of female alcoholics. Alcohol-related intimate partner violence among white, black, and Hispanic couples in the United States. Alcohol Res Health. Drugs Abingdon Engl. The process of recovery from alcoholism. Comparing spouses of alcoholic patients and matched community controls.
Children of alcoholics during the recovery process: Alcoholic and matched control families. Addict Behav. Comparing functioning in families of alcoholics and matched control families. Get Your Loved One Sober. Alternatives to Nagging, Pleading, and Threatening. Center City, MN: Hazelden; Efficacy of the Community Reinforcement and Family Training for concerned significant others of treatment-refusing individuals with alcohol dependence: A randomized controlled trial.
Drug Alcohol Depend. The role of family expressed emotion and perceived social support in predicting addiction relapse. Relapse precipitants and behavioral marital therapy. The influence of partner status, relationship quality and relationship stability on outcomes following intensive substance-use disorder treatment.
The 5-Step Method: Principles and practice. Landau J, Garrett J. Alcohol Treat Q. Do you have the quality to make it one more day without using drugs? As a man who has plied that same route, I can talk from that viewpoint. My knowledge of your reality is a full-fledged one. I do not wish to stroll in those shoes anymore, although I can disclose to you what it resembles sailing in my new life, in the event that you are not kidding about recuperation. However, I offer this book as a resource to you youth, teenagers and loved ones that want to walk themselves or the people around them, out of addiction.
Since I have foreknowledge of what it is to be addicted, how it feels and the cravings, I felt I will do more good in affecting lives with my piece. While much has been written about the physical and emotional benefits of writing, little has been written specifically for mental health professionals detailing how to use therapeutic journaling with their clients.
Therapeutic journaling—any type of writing or related expressive process used for the purpose of psychological healing or growth—can be an extremely helpful adjunctive therapy. It provides concrete and specific steps for introducing journaling to psychotherapy clients and answers questions about structure and logistics.
For example, engaging your client in writing a biographical statement will not only help focus the treatment plan but also provide a vast amount of background information.
This section also introduces two very beneficial mnemonic devices to help clients focus and organize journaling between sessions. Key diagnoses are covered: adjustment disorders, anxiety, depression, grief, low self-esteem, couple and relationship issues, addictions, disordered eating, and post-traumatic stress disorder. Importantly, it also reviews those circumstances in whic. Score: 5. They show that there is no gap between physical, mental, and spiritual aspects of health; all aspects are interrelated and it's powerfully helpful to see this way.
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