Thomas A. Ban - Böcker

Conditioning is one of the core methods of psychiatry. It is a behavioral method, with a stimulus-response constellation. The stimulus itself can be measured, changed, and combined, and the responses can be measured qualitatively and quantitatively. Conditioning uses the conditional reflex phenomenon. During the conditioning procedure, responses to certain stimuli are acquired where no responses existed previously. Over time behavioral conditioning expanded to include neurophysiological aspects and has been correlated with psychic manifestations. This comprehensive work deals with the conditioning method, covering fully its behavioral, neurophysiological, and psychiatric aspects.The volume is divided into five parts. Part I summarizes present-day knowledge on the neurophysiology of conditioning. Part II sets out the historical sequence in the correlation between psychopathology and pathological brain functions. Part III describes the best-known conditioning techniques applied in human testing, particularly those which are applicable for diagnostic purposes, is discussed. Part IV is concerned with clinical applications of the method and discusses the findings and the implications that it has for psychopathology and therapy or, in general, for psychiatry. Part V contains a critical evaluation of the matter presented, followed by a bibliography and index."Conditioning Behavior and Psychiatry" describes the development of conditioning procedures since the concept was first introduced. It is primarily concerned with the analysis of elementary and complex behavioral observations, of neurophysiological and neuropathological discoveries as seen from the standpoint of psychiatric disorders. The psychiatric view presented is, not purely the Pavlovian, but a modern approach to psychiatry stemming from a Pavlovian orientation.

Conditioning is one of the core methods of psychiatry. It is a behavioral method, with a stimulus-response constellation. The stimulus itself can be measured, changed, and combined, and the responses can be measured qualitatively and quantitatively. Conditioning uses the conditional reflex phenomenon. During the conditioning procedure, responses to certain stimuli are acquired where no responses existed previously. Over time behavioral conditioning expanded to include neurophysiological aspects and has been correlated with psychic manifestations. This comprehensive work deals with the conditioning method, covering fully its behavioral, neurophysiological, and psychiatric aspects.The volume is divided into five parts. Part I summarizes present-day knowledge on the neurophysiology of conditioning. Part II sets out the historical sequence in the correlation between psychopathology and pathological brain functions. Part III describes the best-known conditioning techniques applied in human testing, particularly those which are applicable for diagnostic purposes, is discussed. Part IV is concerned with clinical applications of the method and discusses the findings and the implications that it has for psychopathology and therapy or, in general, for psychiatry. Part V contains a critical evaluation of the matter presented, followed by a bibliography and index."Conditioning Behavior and Psychiatry" describes the development of conditioning procedures since the concept was first introduced. It is primarily concerned with the analysis of elementary and complex behavioral observations, of neurophysiological and neuropathological discoveries as seen from the standpoint of psychiatric disorders. The psychiatric view presented is, not purely the Pavlovian, but a modern approach to psychiatry stemming from a Pavlovian orientation.

Among the more frequently quoted epidemiological facts in current public health discussions are: (a) the elderly today represent about 10% of the population of the industrialized world; (b) the third world nations are moving in the same direction; (c) the trend toward a growing proportion of the aged in the world population will continue over the next few decades; (d) people over 80 now represent the fa. stest growing sector in North America; (e) in the elderly, general morbidity - and particularly morbidity of the central nervous syste- is many times that in the younger popUlation; (f) 5% of those over 65 years of age and 20% of those over 80 suffer from some degree of dementia. A global tidal wave of patients suf­ fering from Alzheimer's disease (or senile dementia) is threat­ ening to engulf us by the year 2000. This disease, which is, at our present state of knowledge, ir­ reversible, and other age-related dementias are perhaps the most sinister forms of any disability. They deprive their vic­ tims not only of their physical capacities but also of their autonomy and their ability to think and to make decisions for themselves. The future cost of psychogeriatric diseases in terms of suffering for individuals, stress for families, demand for manpower, and budgetary requirements for governments could become astronomical.

The development of modern psychopharmacology was triggered by two major discoveries: the psychomimetic effects of lysergic acid diethylamide (LSD-25) in 1943 and the therapeutic effects of chlorpromazine in 1952. In his opening address to the 1st CINP Congress in Rome, Rothlin pointed out that these discoveries gave "a great impetus for any kind of scientific approach to brain research" and had "revolutionary consequences in the treatment of psychotic patients". The incentive they provided "was not limited to theoretical and practical medical sciences but caused an even greater stimulus to the imagination of chemists, leading to the production of new compounds with a speed that neither pharmacological, biochemical nor clinical investigations could equitably follow. " The possibility to induce psychopathology by the administration of pharmacological agents and to control naturally occurring psychopathol­ ogy by drugs opened unforeseen possibilities for brain research and a new era in psychiatry. In psychiatry, the new psychotropic drugs with their increasingly better defined behavioral, neurophysiological and biochemi­ cal actions have provided a new means for therapeutically influencing and systematically studying psychopathological conditions, whereas in the basic sciences, neuropharmacological research, directed to reveal the action mechanism of new drugs, brought about unprecedented progress in the identification of the morphological substrate of different brain func­ tions. It also set the stage for the exploration of possible correlations between behavioral, including psychopathological, and neurochemical events.

Depressive illnesses, as epidemiological studies have consistently shown, are amongthe most frequent psychicdisorders encountered in hospital and everyday practice. Moreover, during the last few decades the prevalence of depression has definitely been increas- ing. Its alarming frequency - especially among women - has re- cently been confirmed once again by epidemiologicalfindings pub- lished in the United States of America. The World Health Organi- zation estimates the world-wide prevalence of depression at 3% to 5%. Amongthefactors contributingtothecurrentincreaseareexces- sively abrupt changes in social structures and living conditions, as well as a departure from traditional values which is often accompa- nied by disruptionofthe family unit and loss ofreligious faith. Fur- ther factors include the unfettered materialism ofthe modern age, the hectic pace of technological progress, and the loneliness to which elderly people in particular are exposed.Finally, the increas- ing life expectancy ofthe population in almost all countries ofthe world raises the incidence of cardiovascular disorders, brain dis- ease, and malignanttumors,thusinevitably addingtothe riskofde- pressive illness in old age. The prominent position occupied by the diagnosis and treat- ment of depression in everyday medical practice is apparent from the results ofan enquiry conducted among some 15000 doctors in Austria,the Federal RepublicofGermany, France, Italy, Spain,and Switzerland. This enquiry disclosed that ofall patients consulting a doctor,upto 10% - and sometimesmore - couldbeclassifiedas de- pressed, and that in more than one-halfofthe patients a so-called masked form ofdepression was found. Duringthe last 15years, biological psychiatricresearchfocusing on depression has made more significant progress than everbefore.