Clarissa S. Holmes – författare

Behavioral medicine has blossomed as an area of systematic investiga­ tion during the past 10-20 years. Throughout its steady growth, there have been increasing interest and specialization in the study of neuro­ psychological and behavioral aspects of diabetes. This book attempts to capture and report exciting new developments in the study of both insulin-dependent (Type I) and non-insulin-dependent (Type II) dia­ betes mellitus. Accordingly, it is divided into two major sections. Physiological aspects of each disease, which differ significantly in pathophysiology and course, are discussed in separate medical over­ views that introduce each major section. These overviews are written by Drs. Tsalikian and Zimmerman, leading medical researchers in insulin­ and non-insulin-dependent diabetes, respectively. Each section also contains chapters describing neuropsychological and cognitive disease correlates, psychosocial patterns of adjustment, and treatment adher­ ence issues. Psychological aspects of insulin-dependent diabetes have been studied more extensively than non-insulin-dependent diabetes, perhaps because it is more often associated with graver medical compli­ cations. Therefore, there is a larger body of research to review and the first section has been divided into chapters on cognitive disease se­ quelae in populations of children and adults, separately. In his chapter, Dr. Ryan discusses developmental factors related to the unique sensi­ tivity of the brain to metabolic derangement. Dr. Holmes reviews studies of adults with diabetes and the cognitive correlates of both acute and chronic blood glucose disruption. Developmental disease is­ sues are further covered in Dr.

more intuitive study to greater empiricism. Frequently, chapters are di­ vided into discrete sections to discuss each rather distinct era of inquiry. This approach, when used, can provide a valuable historical overview of the early clinical formulations about each disease. Even though many of the earlier research philosophies and techniques may seem so simplistic as to mitigate against their inclusion, early research hypotheses were often generated from astute observation of clinical findings and relationships. In addition to shaping later empirical questions, a review of historical ante­ cedents provides a yardstick by which to measure the progress of more current studies, even though much is yet to be learned. As is true of any refinement of knowledge, the juxtaposition of the two approaches of study reveals that some of the early postulations about patient attributes and disease consequences have been confirmed, while other suppositions have been discarded. Although the generally subjective assessment methods used in the early studies may not have provided an optimal data base, it is interesting to note which clinical impressions were able to withstand greater empirical rigor and which were not. The book at its inception was intended to provide a succinct introduc­ tion to psychoneuroendocrinology research for practitioners and scientists who might be relatively unfamiliar with the area. However, it quickly became apparent that the sophistication of the information could not be readily reduced without vast oversimplification and loss of substance.

Behavioral medicine has blossomed as an area of systematic investiga­ tion during the past 10-20 years. Throughout its steady growth, there have been increasing interest and specialization in the study of neuro­ psychological and behavioral aspects of diabetes. This book attempts to capture and report exciting new developments in the study of both insulin-dependent (Type I) and non-insulin-dependent (Type II) dia­ betes mellitus. Accordingly, it is divided into two major sections. Physiological aspects of each disease, which differ significantly in pathophysiology and course, are discussed in separate medical over­ views that introduce each major section. These overviews are written by Drs. Tsalikian and Zimmerman, leading medical researchers in insulin­ and non-insulin-dependent diabetes, respectively. Each section also contains chapters describing neuropsychological and cognitive disease correlates, psychosocial patterns of adjustment, and treatment adher­ ence issues. Psychological aspects of insulin-dependent diabetes have been studied more extensively than non-insulin-dependent diabetes, perhaps because it is more often associated with graver medical compli­ cations. Therefore, there is a larger body of research to review and the first section has been divided into chapters on cognitive disease se­ quelae in populations of children and adults, separately. In his chapter, Dr. Ryan discusses developmental factors related to the unique sensi­ tivity of the brain to metabolic derangement. Dr. Holmes reviews studies of adults with diabetes and the cognitive correlates of both acute and chronic blood glucose disruption. Developmental disease is­ sues are further covered in Dr.