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PubMedDate not supplied

Psychosomatic medicine, behavioral medicine, just plain medicine.

Neurally mediated physiologic responses fulfill all of the criteria for behavior and obey all of the laws of behavior subject to the anatomic and physiologic constraints inherent in their structures and functions. It is illogical and wrong to assert that neurally mediated responses interact with behavior. THEY ARE BEHAVIOR. These principles are a legitimate and necessary part of the training of all medical students, residents, and fellows. The conceptual basis of psychosomatic practice does not need to be derived from the dualistic notions of psychoanalysis or from the dualistic notions of biobehaviorism. Psychosomatic medicine is an integral aspect of medical practice. It needs to exist because people act and react differently from one another, and because the same person acts and reacts differently from one situation to another. Psychosomatic medicine is not psychiatry in medicine. Each of the specialties and each of the subspecialties encounters its own set of psychosomatic problems; and treatment strategies to resolve these problems need to be integrated into the clinical practice of that discipline.

Behavior↗
PubMed1992

Role of behavior theory in behavioral medicine.

Behavioral medicine is a multidisciplinary field that combines research methods and findings from behavioral and biomedical sciences. Many investigators in the field have tended to emphasize the contribution of the biomedical more than the behavioral sciences. This is evident in the emphasis on biological rather than behavioral outcomes and on the reductionist approach within the field to reduce mechanisms responsible for behavioral effects and disease to biological influences. There has been a similar shift in psychology toward mechanistic, bottom-up approaches to understanding mechanisms responsible for integrated and dynamic behavior. These shifts in emphasis have stimulated investigators to examine the use of biomedical methods and findings as causes and explanations for behavior, rather than to utilize newer findings in behavioral sciences. New advances in basic research on learning are used to illustrate that findings from behavioral science have implications for the field of contemporary behavioral medicine. Finally, the importance of developing new technologies for measuring behavior is presented.

Behavior Therapy↗
PubMed1999

The third therapeutic revolution: behavioral medicine.

Behavioral medicine--and one of its progenitors, biofeedback--are expanding as the Third Therapeutic Revolution, supplementing surgery and pharmacology in treating human illnesses. Parallel development of nonscience-based therapies is a part of the same revolution. Labeling their positive results as "placebo effects" hides a greater truth: faith and trust play an enormous role in therapy. The successes of both behavioral medicine and unorthodox complementary medicine are the result of the debonafide effect (my Latin for "from good faith"). Readers are urged to adopt this better definition of the "unexplicable" and substantial good results of both the placebos in research and the ministration of unorthodox treatments.

Behavioral Medicine↗
PubMed1987

Behavioral medicine and health psychology in a changing world.

Despite long-established roots in experimental psychophysiology and psychosomatic medicine, behavioral medicine and health psychology have only recently emerged as recognized, highly visible disciplines within medicine and the behavioral sciences. The rapid development of these fields has resulted partly from important scientific advances in the biomedical and behavioral sciences and partly from changing societal concerns and values. The latter include a greater preoccupation with individual self-expression and self-fulfillment, a decline in respect for authority per se, and an increased skepticism about social institutions. Coupled with these changes has been an increasing desire to take responsibility for one's own life and, in matters of health, of one's own body. The ways in which scientific advances and social changes have influenced the shape of contemporary behavioral medicine and health psychology are explored with the aid of two illustrations: the growth of a developmental perspective in behavioral medicine and health psychology; and work and health, including the effects of job stress and unemployment. Finally, the author stresses the need for a greater sense of community and concern for others, if we are to succeed in creating a growth-enhancing, health-producing climate for society as a whole and for each of us as individuals.

Adolescent↗
PubMed1984

Behavioral medicine. Broadening the interface between medicine and behavioral science.

The work of psychotherapists who have a cognitive-behavioral orientation and are trained in time-limited, focused psychotherapy has proved to be beneficial in the setting of a comprehensive medical and health maintenance organization. Group interventions that deal with relaxation, social skills, depression, agoraphobia, smoking cessation, problem drinking, weight modification, and Type A behavior, to mention a few, are conducted on an ongoing basis, allowing staff to treat large numbers of people in a time-efficient and cost-effective way. These groups also help the staff to provide a coordinated set of therapeutic and training experiences for patients through their participation in appropriate group treatment during the course of their individual treatment.

Behavior Therapy↗
PubMed2001

Thought Field Therapy clinical applications: utilization in an HMO in behavioral medicine and behavioral health services.

Thought Field Therapy (TFT) is a self-administered treatment developed by psychologist Roger Callahan. TFT uses energy meridian treatment points and bilateral optical-cortical stimulation while focusing on the targeted symptoms or problem being addressed. The clinical applications of TFT summarized included anxiety, adjustment disorder with anxiety and depression, anxiety due to medical condition, anger, acute stress, bereavement, chronic pain, cravings, depression, fatigue, nausea, neurodermatitis, obsessive traits, panic disorder without agoraphobia, parent-child stress, phobia, posttraumatic stress disorder, relationship stress, trichotillomania, tremor, and work stress. This uncontrolled study reports on changes in self-reported Subjective Units of Distress (SUD; Wolpe, 1969) in 1,594 applications of TFT, treating 714 patients. Paired t-tests of pre- and posttreatment SUD were statistically significant in 31 categories reviewed. These within-session decreases of SUD are preliminary data that call for controlled studies to examine validity, reliability, and maintenance of effects over time. Illustrative case and heart rate variability data are presented.

Adult↗
PubMed1986

Behavioral medicine: treatment and organizational issues.

Behavioral medicine is a newly emerging field dating back to the early 1970s. In this short time, a great deal of controversy and confusion has arisen as to even the definition of the term. Similarly, there are now a variety of different operational applications of this concept in patient care, research, and health care system organizations. It is proposed that the title "behavioral medicine" be used in the most general way, consistent with the definition developed by the Institute of Medicine meeting in 1978. In it, behavioral medicine is a term designating a very large field and is not analogous to a profession, medical specialty, or discipline. This term denotes a body of psychologic and social knowledge and a set of techniques applied to research, prevention, and treatment of medical illness, including psychiatric illness. By this definition, behavioral medicine treatment techniques would include psychotherapy, hypnosis, relaxation, behavior therapy, behavior modification, biofeedback, and pharmacotherapy. One of the cardinal principles of behavioral medicine as a field is that well-defined treatment techniques are used for specific target symptoms or signs of illness. It is proposed that individual behavioral medicine treatment programs be called by the name of either the specific treatment utilized or of the target(s) of the intervention. It is important to ensure collaboration between the variety of treatment and research programs that would fall under this general definition of behavioral medicine, which includes consultation-liaison psychiatry. An organizational model is proposed that would combine all such programs within a multidisciplinary division of a department of psychiatry. This division might be entitled with one or both names, e.g., "consultation-liaison psychiatry and behavioral medicine." Perhaps most importantly, this new field should not promise more than it may be able to provide, particularly in trying to achieve the biopsychosocial model of medicine. Many factors have contributed to the rise of biomedicine and to the decline of personal medicine, most of them far beyond the scope and control of behavioral medicine.

Behavioral Medicine↗
PubMed1996

[The Ostringer (Prevention) Model. Results of family medicine supervised "community behavioral medicine"].

To evaluate the German intervention model of "Community-related Behavioural Medicine" in reducing cardiovascular risk during a major prevention study (phase I) and to investigate the efficiency of a long-term evaluation by establishing a Local Health Information System for which cooperating primary care physicians carry responsibility (phase II). In the intervention city of Bruchsal (GCP evaluation, phase I), the cardiovascular risk factors were reduced: smoking (-9.4%), obesity (-17.1%), hypertension (-51.4%) and hypercholesteremia (-12.8%). In the general practices of Oestringen (LOHIS-evaluation, phase II), the prevalence of smoking, from 1992 to 1994 (-23.8%, p < 0.01) as well as hypertension (-22.2%), p < 0.01) continued to decrease; there was no further reduction of hypercholesteremia and over-weight.

Adult↗
PubMed1983

Behavioral medicine: a new development.

Behavioral medicine had its formal beginnings at a Yale University conference in 1977; thus, as a field, it is still in an embryonic state of development. Behavioral medicine practitioners focus on operationally defined behaviors to set treatment goals, formulate treatment plans, and monitor changes in symptoms. They evaluate a patient's current situation to determine the antecedent and consequence of a defined behavior. The authors review the history of behavioral medicine, discuss its current interpretations, and compare it with psychosomatic medicine. They also discuss potential hazards and the future outlook for this interdisciplinary approach.

Behavior↗
PubMed1987

Behavioral medicine programs in teaching hospitals.

Behavioral medicine is a relatively new interdisciplinary field which combines biomedical and behavioral science knowledge, and applies them to prevention, diagnosis, treatment and rehabilitation. Behavioral medicine programs provide a valuable service to patients with chronic illness, psychosomatic or functional disorders, treatment noncompliance, and behavioral risk factors. Behavioral medicine faculty are also active in teaching and research on patient behavior, interviewing skills, health promotion and counseling, and management of chronic illnesses. However, the survival of behavioral medicine programs in teaching hospitals depends on their economic viability and academic status. Positive action is needed to ensure their continued growth and development.

Behavior Therapy↗
PubMed2000

Behavioral medicine in medical education: report of a survey.

Behavioral medicine has become increasingly important in medical education over the past two decades, but adoption of its principles and methods has been slow. Behavioral medicine stresses the effects of human behavior on health and illness using a biopsychosocial approach. It also focuses on the use of the doctor-patient relationship, which, if developed using appropriate communication skills, can result in greater patient satisfaction and increased compliance. The authors surveyed all 124 American medical schools to assess both national trends and specific efforts in the teaching of behavioral medicine principles and methods. A review of the types of behavioral medicine programs offered reveals that eight percent of U.S. medical schools had integrated programs of behavioral medicine. Several successful and effective programs were identified, as were a number of specific curricular components. There are several options available to medical schools to integrate behavioral medicine into medical education. The authors conclude that medical education must include behavioral medicine in order to improve the health of the public and to meet the demands of a changing health care system.

Behavioral Medicine↗
PubMed1986

Innovations in behavioral medicine.

The chapter begins with a brief history of the behavioral medicine movement along with an overview of contemporary activities in the field. Three subsequent sections review technical innovations in major areas of clinical behavioral medicine: treatment, health care delivery, and preventive health care. The final section describes the methodological characteristics of research in behavioral medicine, discusses the field in light of the psychosomatic medicine and behavior modification movements, and calls for a conceptual integration that is authentically behavioristic. Already the quality of research in behavioral medicine appears comparable to that of research in behavior therapy. Even so, when viewed in terms of contemporary methodological desiderata, most of the work is fairly unimpressive. Possibly needed are "hybrid" experimental approaches in which the inferential power of intrasubject phase manipulations and between-subject outcome comparisons are combined. There is good reason to believe that behavioral medicine will follow the historical course of behavior therapy/modification, not the course of psychosomatic medicine. Behaviorally knowledgeable psychologists can become major service providers in liaison with well-informed medical practitioners. Some potentially deleterious influences on the behavioral medicine movement are (inevitable) mentalistic and dualistic thinking and a retreat toward psychosomatic medicine. Field behaviorism as an organizing schema can, in principle, serve as a safeguard against such untoward influences.

Adolescent↗