Peter W. Halligan - Böcker

Many patients with brain damage are left with a range of neuropsychological deficits that impair normal cognitive process. It is generally recognised that these less obvious cognitive deficits (including memory, language, perception, attention and executive disorders) militate against full recovery often to a greater extent than more traditional medical deficits (e.g. paralysis, sensory loss, etc). Recognition of this has helped fuel the exponential growth in cognitive neuropsychology and neuroscience over the past 30 years. In turn, this theoretical approach has been used to guide and inform the development of cognitive therapies designed to remediate cognitive impairments and their functional consequences.Cognitive rehabilitation has over the last decade grown to become an established and influential therapeutic approach. There is now a considerable body of knowledge describing the principles and theoretical basis for analysing and directing treatments to selective cognitive deficits. Despite this, the clinical effectiveness and extent to which cognitive theory can inform therapeutic treatment has been questioned. It is timely, therefore, to evaluate and discuss the type and quality of evidence used in support of cognitive rehabilitation.In this book, some of the most influential clinicians and cognitive neuroscientists in the world critically review and discuss the effectiveness of rehabilitation methods currently used to treat patients with cognitive impairments following acquired brain damage. It provides a much needed critique and consensus about what should constitute best practice. The book will be valuable for all those who have to deal with the neuropsychological and neurological effects of brain damage, including, neuropsychologists, neuropsychiatrists, neurologists, experimental pscyhologists, and neuroscientists.

Over the past two decades, a widening gulf has emerged between illness presentation and the adequacy of traditional biomedical explanations. Currently, the UK is experiencing an "epidemic of common health problems" among people in receipt of State incapacity benefits and those who consult their general practitioners. Most do not demonstrate a recognisable pathological or organic basis which would account for the subjective complaints they report. As a result, the causes of many illnesses remain a mystery for both patient and physician, with the result that increasing numbers of people are opting for alternative or complementary medicines. To bridge this gap between illness and its explanation, without abandoning the clear benefits of the biomedical approach, many healthcare professionals have begun to consider a biopsychosocial approach. Central to this approach is the belief that illness is not just the result of discrete pathological processes but involves and can be meaningfully explained in terms of personal, psychological and socio-cultural factors.In particular, the beliefs held by patients about their health are considered central to the way they behave and respond to treatment. However, such beliefs are not specific to patients only - they can greatly influence the behaviour and reasoning of health professionals as well. Psychosocial influences such as beliefs are also relevant when considering society's views regarding the aetiology of illness, recovery and potential for treatment. At a time when public trust in doctors and science is undoubtedly diminishing, a better understanding of patients' beliefs is clearly a priority for clinical practice and research.The Power of Belief brings together a range of experts from neuroscience, rehabilitation and disability medicine and provides a unique account of the role and influence that belief plays in illness manifestation, medical training, promising biopsychosocial interventions and society at large.

Over the past two decades, a widening gulf has emerged between illness presentation and the adequacy of traditional biomedical explanations. Currently, the UK is experiencing an "epidemic of common health problems" among people in receipt of State incapacity benefits and those who consult their general practitioners. Most do not demonstrate a recognisable pathological or organic basis which would account for the subjective complaints they report. As a result, the causes of many illnesses remain a mystery for both patient and physician, with the result that increasing numbers of people are opting for alternative or complementary medicines. To bridge this gap between illness and its explanation, without abandoning the clear benefits of the biomedical approach, many healthcare professionals have begun to consider a biopsychosocial approach. Central to this approach is the belief that illness is not just the result of discrete pathological processes but involves and can be meaningfully explained in terms of personal, psychological and socio-cultural factors.In particular, the beliefs held by patients about their health are considered central to the way they behave and respond to treatment. However, such beliefs are not specific to patients only - they can greatly influence the behaviour and reasoning of health professionals as well. Psychosocial influences such as beliefs are also relevant when considering society's views regarding the aetiology of illness, recovery and potential for treatment. At a time when public trust in doctors and science is undoubtedly diminishing, a better understanding of patients' beliefs is clearly a priority for clinical practice and research.The Power of Belief brings together a range of experts from neuroscience, rehabilitation and disability medicine and provides a unique account of the role and influence that belief plays in illness manifestation, medical training, promising biopsychosocial interventions and society at large.

In clinical neuropsychiatry, case studies provide invaluable demonstrations of the range and types of unusual psychological states that can occur after brain damage. In the pursuit of objectivity and scientific respectability, however, many academic reports of neuropsychiatric disorders appear cold, contrived and impersonal. The essence and character of the patient's experience and behaviour is easily obscured or even lost - a fact that cannot help researchers, therapists and other practitioners to relate their conceptual knowledge to the flesh-and-blood people they meet in their professional lives. In practice, much of the actual discourse of such patients has been ignored as unworthy of scientific interest. This book describes real patients in a clear and jargon-free way. These cases should serve to reduce the discrepancy between the formal representations of psychiatric illness in the mainstream literature and the reality of people struggling to make sense of their own predicament in everyday life.

Spatial neglect is a profound clinical problem as well as intriguing scientific problem. In the last ten years, there has been an explosion of interest in this disorder, which as a result is no longer viewed as a single entity, but rather as a number of different disorders. This book is an attempt to bring the reader up to date with the latest advances in understanding neglect, at least insofar as this contributes to better clinical assessment, management and treatment. This is not a book for the specialist researcher in the neuropsychology of neglect and attention. Rather, it is a book aimed at clinicians - student and trained - from all disciplines involved in the assessment, management and treatment of neglect.The book begins with the description of four cases manifesting different types of unilateral neglect. The reader is introduced to different aspects of neglect through these patients. These distinctions include those between personal and extrapersonal neglect, motor versus sensory neglect and many others. The reader is also introduced to other phenomena that are closely related to neglect, including ansognosia and impaired sustained attention. The latest methodes of assessment of neglect are also described, as are methods of treatment, again with reference to the four introductory specimen cases.

Spatial neglect is a profound clinical problem as well as intriguing scientific problem. In the last ten years, there has been an explosion of interest in this disorder, which as a result is no longer viewed as a single entity, but rather as a number of different disorders. This book is an attempt to bring the reader up to date with the latest advances in understanding neglect, at least insofar as this contributes to better clinical assessment, management and treatment. This is not a book for the specialist researcher in the neuropsychology of neglect and attention. Rather, it is a book aimed at clinicians - student and trained - from all disciplines involved in the assessment, management and treatment of neglect.The book begins with the description of four cases manifesting different types of unilateral neglect. The reader is introduced to different aspects of neglect through these patients. These distinctions include those between personal and extrapersonal neglect, motor versus sensory neglect and many others. The reader is also introduced to other phenomena that are closely related to neglect, including ansognosia and impaired sustained attention. The latest methodes of assessment of neglect are also described, as are methods of treatment, again with reference to the four introductory specimen cases.

Conversion is very common but often misdiagnosed; even when diagnosed, treatment is difficult. It is critical for physicians to have the necessary knowledge to manage these patients in the most effective way. This volume gives all of the available, up-to-date information on when to think about conversion in movement disorders, how to make a diagnosis, how to use the laboratory to support a clinical diagnosis and how to develop a therapeutic plan. Written by experts in neurology, psychiatry, psychology, neuroimaging, neurophysiology and genetics, this book covers psychogenic movement disorders and other conversion disorders from all of the most relevant clinical angles. An accompanying CD-ROM with a video library featuring over 100 real-life examples of movement disorders will aid diagnosis. Neurologists and psychiatrists, as well as others interested in brain pathophysiology at the boundary of neurology and psychiatry, will find this a useful aid to both clinical practice and research.

This special issue of Neuropsychological Rehabilitation provides an opportunity to characterise some of the key clinical issues concerned with assessing and managing pathologies of subjective or conscious awareness. Elucidating the cognitive processes underlying awareness, and their corresponding phenomenological experiences, provides the necessary theoretical platform to inform assessments and justify interventions aimed at compensating for, and/or reducing the functional consequences of, impaired awareness. This special issue represents an attempt to bring together previously disparate research findings and conceptual issues from relevant fields within medicine and the psychological sciences and, in so doing, provide for a more coherent, comprehensive account which clinicians and theoreticians can use to better understand the apparently obvious but unwieldy construct of awareness.

What happens when the physical body and the subjective sense of self part company? How do we explain phantom limbs and alien abduction? What are the cognitive, neurobiological mechanisms that support such phenomena? In this special issue of Cognitive Neuropsychiatry, Spence and Halligan explore all these issues and more, with contributions drawn from an internationally renowned panel of authors, most of whom contributed to a symposium held in Sheffield, England in June 2001 ('The Neuropsychiatry of the Body in Space'). That meeting was primarily concerned with those bizarre and disturbing syndromes that arise when 'body' and 'self', soma and psyche are dissociated from each other, within or beyond the body's surface. Some disorders constrain the space of the body (as in neglect and dissociation syndromes), others seem to extend the boundaries (as with phantom limbs and autoscopy). Still others suggest a permeability of those boundaries (as in alien control and thought insertion, each occurring in schizophrenia). Finally, the body may itself be perceived as having passed into space, the most extreme exemplar being 'alien abduction'. Each paper contains a description of disturbed phenomenology and an account and critique of current cognitive neuropsychiatric findings.

This special issue of Neuropsychological Rehabilitation provides an opportunity to characterise some of the key clinical issues concerned with assessing and managing pathologies of subjective or conscious awareness. Elucidating the cognitive processes underlying awareness, and their corresponding phenomenological experiences, provides the necessary theoretical platform to inform assessments and justify interventions aimed at compensating for, and/or reducing the functional consequences of, impaired awareness. This special issue represents an attempt to bring together previously disparate research findings and conceptual issues from relevant fields within medicine and the psychological sciences and, in so doing, provide for a more coherent, comprehensive account which clinicians and theoreticians can use to better understand the apparently obvious but unwieldy construct of awareness.