Seeking to integrate the large volume of clinical research on relational processes and mental health disorders with other scientific advances in psychiatry, Relational Processes and DSM-V builds on exciting advances in clinical research on troubled relationships. These advances included marked improvements in the assessment and epidemiology of troubled relationships as well the use of genetics, neuroscience, and immunology to explore the importance of close relationships in clinical practice. Advances in family-based intervention, and prevention are also highlighted to help practitioners and researchers find common ground and begin an empirically based discussion about the best way to revise the DSM. Given the overwhelming research showing that relationships play a role in regulating neurobiology and genetic expression and are critical for understanding schizophrenia, conduct disorder, and depression among other disorders, relational processes must be a part of any empirically based plan for revising psychiatric nosology in DSM-V.
The chapters in this book counter the perspective that we can safely discard the biopsychosocial model that has guided psychiatry in the past. The contributors examine the relevance of close relationships in such issues as the basic psychopathology of mental disorders, factors influencing maintenance and relapse, sources of burden for family members, and guiding family-based interventions. By tying relational processes to basic research on psychopathology, they demonstrate the value of integrating basic behavioral and brain research with a sophisticated understanding of the self-organizing and self-sustaining characteristics of relationships.
• research linking relational processes to neuroscience, neurobiology, health outcomes, intervention research, prevention research, and genetics
• consideration of specific circumstances, such as promoting healthy parenting following divorce and relational processes in depressed Latino adolescents
• optimal approaches to the assessment of relational processes with clinical significance, such as child abuse, partner abuse, and expressed emotion.
• a simple introduction to the methodology of taxometrics, offering insight into whether key relational processes are distinct categories or continuously distributed variables
• an overview of the links between relational processes and psychiatric outcomes, providing a theoretical foundation for the discussion of links to psychopathology
Together, these contributions seek to develop a shared commitment among clinicians, researchers, and psychopathologists to take seriously the issue of relational processes as they relate to diagnoses within DSM-and to encourage mental health care workers at all levels to harness the generative and healing properties of intimate relationships and make them a focus of clinical practice. It is a book that will prove useful to all who are interested in integrating greater sensitivity to relational processes in their work.
This exciting volume provides us with a biopsychosocial blueprint for understanding the effect of relational processes on the development of mental health and psychopathology. In addition to reviewing cutting edge research from animal models to immune function and marriage, this volume makes the translation from science to practice, with important implications for primary care and mental health clinicians and researchers. This volume is not just a small step, it represents a giant leap forward for the field.—Susan H. McDaniel, Ph.D., Professor of Psychiatry & Family Medicine, Director, Wynne Center for Family Research, University of Rochester School of Medicine & Dentistry, Rochester, New York
Preface. Introduction. Acknowledgments. Relational processes and mental health: a bench-to-bedside dialogue to guide DSM-V. Biological Underpinnings. Neurobiology of the social brain: lessons from animal models about social relationships. Refining the categorical landscape of DSM: role of animal models. Marriage, health, and immune function. Family expressed emotion prior to onset of psychosis. Genetic strategies for delineating relational taxons: origins, outcomes, and their relation to individual psychopathology. Assessment. Childhood maltreatment and adult psychopathology: some measurement options. Taxometrics and relational processes: relevance and challenges for the next nosology of mental disorders. Relational diagnoses: from reliable rationally derived criteria to testable taxonic hypotheses. Defining relational disorders and identifying their connections to Axes I and II. Expressed emotion and DSM-V. Prevention and Treatment. Prevention as the promotion of healthy parenting following parental divorce. Cultural and relational processes in depressed Latino adolescents. Role of couples relationships in understanding and treating mental disorders. Summary and Implications for Future Research. Recommendations for research on relational disorders and processes: a roadmap for DSM-V. Index.
About the Editors:
Steven R. H. Beach, Ph.D., is Director of the Institute for Behavioral Research at the University of Georgia in Athens, Georgia.
Marianne Z. Wamboldt, M.D., is Vice Chair for Child Psychiatry, University of Colorado at Denver and Health Sciences Center, and Chair of Psychiatry and Behavioral Science at The Children’s Hospital of Denver in Denver, Colorado.
Nadine J. Kaslow, Ph.D., is Professor and Chief Psychologist in the Department of Psychiatry and Behavioral Sciences at Emory School of Medicine/Grady Health System in Atlanta, Georgia.
Richard E. Heyman, Ph.D., is Research Professor in the Department of Psychology at the State University of New York at Stony Brook in Stony Brook, New York.
Michael B. First, M.D., is Associate Professor of Clinical Psychiatry at the New York State Psychiatric Institute/Columbia University, in New York, New York.
Lynn G. Underwood, Ph.D., is Professor of Biomedical Humanities and Director of the Center for Literature, Medicine and the Health Care Professions at Hiram College in Hiram, Ohio.
David Reiss, M.D., is Vivian Gill Distinguished Professor of Research in the Department of Psychiatry and Behavioral Sciences at George Washington University Medical Center in Washington, D.C.