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This chapter presents an interdisciplinary study on the physiological mechanisms through which the sociocultural and socioeconomic environments, as well as personal social and psychological experience, affect health trajectories. Within this framework, the focus has been on understanding the protective effects of social and cultural factors on health and aging — especially the effects of social ties, social support, and psychological resources (e.g., beliefs about one's own efficacy and personal mastery). The first section outlines how a program of research evolved from an initial starting point within the tradition of social epidemiology into a broader research approach that encompasses aspects of neuroendocrinology and clinical geriatrics, as well as concepts from sociology and social psychology. The second section outlines major findings from this research. The third section discusses the story behind the interdisciplinary collaboration.

This chapter discusses the current theoretical models that have been developed to explain criminal offending during the transition years between adolescence and adulthood. The chapter first identifies the key aspects of offending that typify the transition years, including desistance from delinquency, persistence in offending from adolescence to adulthood, and late onset offending. The chapter then reviews how major theories of delinquency and crime attempt to explain these divergent patterns of offending. In particular, it discusses static or population heterogeneity models, dynamic or state dependence models, social psychological theories, the developmental psychopathology perspective, and, finally, biopsychosocial theory. In each case the chapter discusses the theory’s assumptions and core propositions with a particular focus on propositions concerning offending during early adulthood. The chapter also reviews the empirical literature that has tested each of these theories. Although there are is considerable overlap across these different theoretical perspectives, each offers a unique perspective about how the transition from adolescence to adulthood influences offending and how, in turn, offending influences the timing and success of the transition to adulthood. It closes by discussing policy implications of these different theoretical orientations.

Chapter 2 introduces the reader to theoretical perspectives which provide the framework for the book and inform all subsequent chapters. Dynamic nonlinear systems theory, based on general systems theory, suggests the continuous interactive and reciprocally influencing nature of individuals and their environments. The developmental perspective includes development from infancy through adulthood and developmental traumatology. Attachment theory is the primary interpersonal perspective of the book. The biopsychosocial perspective incorporates aspects of all of these theories and underscores the importance of considering how each individual young person is situated biologically, psychologically, and socially and where practice and policy interventions might best be made. Finally, resiliency theory assists the reader in developing a strengths-based approach to working with youth. An extended case example of a former foster youth illustrates aspects of the theories.

Chapter 3 describes common spiritual needs as well as unique factors that can shape how the end of life is experienced. The meeting of spiritual needs is essential (Langegard & Ahlberg, 2009), as it supports patients who seek wholeness in the midst of profound vulnerability (Goldberg & Crespo, 2003). Advances in medicine may further extend the time patients have for spiritual challenges to inform life meaning (Grant, 2007). Hospice social workers can support patients in this process provided that they are aware of what patients consider are spiritual needs. This chapter reviews research that suggests spiritual needs may be shaped by personal and contextual factors. Some spiritual needs may not be met due to declining health (Hermann, 2006), but the recognition of spiritual needs may also reveal biopsychosocial needs that can be.

The aim of this chapter is to provide nurses with the knowledge to be able to assess, manage, and care for people with the group of conditions often described as functional bowel disorders (FBD)—see definitions below—in an evidence-based and person-centred way. The chapter will provide an overview of the causes and impact of FBDs, before exploring best practice to deliver care, as well as to prevent or to minimize further ill-health. Nursing assessments and priorities are highlighted throughout, and the nursing management of the symptoms and common health problems associated with FBDs can be found in Chapters 16, 23, 24, and 25, respectively. This chapter discusses the group of conditions often described as functional bowel disorders (FBDs). The term ‘functional gastrointestinal disorders’ is also used in the literature, but, for the purpose of this book, the term FBDs will be adopted. This refers to a group of disorders that are characterized by chronic gastrointestinal symptoms that currently have an unknown structural or biochemical cause that could explain those symptoms. Rome III is an internationally agreed set of diagnostic criteria and related information on functional gastrointestinal disorders (Longstreth et al., 2006). It includes six major domains for adults: oesophageal; gastro/duodenal; bowel; functional abdominal pain syndrome; biliary; and anorectal. This chapter will cover the FBDs that specifically relate to chronic abdominal symptoms. General abdominal symptoms include functional dyspepsia, non-cardiac chest pain, which may mimic functional abdominal symptoms, chronic abdominal pain, functional constipation, functional diarrhoea, functional bloating, and irritable bowel syndrome (IBS). The chapter will concentrate on irritable bowel syndrome. Coeliac disease and Crohn’s disease are included: to give an understanding of these disorders, and to differentiate between inflammatory and non-inflammatory conditions; to highlight the impact of the symptoms on the people who suffer from them; and to give an insight into the contribution that effective nursing makes. The amount of research and the number of publications concerning FBDs has risen considerably since the mid 1990s, and has contributed to the increasing legitimacy of these conditions as disorders in their own right and not simply by virtue of exclusion of all other possibilities.

This chapter explores anxiety, providing a clinical description of its impact on patients with guidance for evidence-based assessment and management. Anxiety has a defined physiological mechanism and merits a planned management approach. Every nurse should possess the knowledge and skills to identify patients with and/or at risk of anxiety, to select and implement evidence-based strategies to manage anxiety, and to review the effectiveness of these to inform any necessary changes in care. It can be useful to think of most mental and emotional phenomena as being a combination of four systems: autonomic, behavioural, cognitive, and environmental (Box 14.1). Emotions that we experience, such as happiness, sadness, anxiety, and anger, depend on how the systems interact with each other. These four systems combine to form a common model in mental health, known as the ABC-E model of emotion (Briddon et al., 2008) (also see Chapter 8), which will be used as a framework for the chapter. An ABC-E-based assessment helps to clarify nursing interventions in each one of these four areas. An intervention in one of these systems can often help to alleviate distressing emotions. A commonly used classification system for mental disorders is the International Classification of Diseases version 10 (ICD-10) (World Health Organization (WHO), 2010). An alternative classification system is the Diagnostic and Statistical Manual of Mental Disorders (DSM) (American Psychiatric Association, 1994). The main types of anxiety are listed in Box 14.2. Many features of anxiety disorder also present in the patient who is agitated. Agitation is a form of anxiety that can raise particular concerns about safety. As illustrated in Table 14.1, the main difference is in the cognitive and behavioural domains, i.e. what the person is thinking and doing. The descriptions in Table 14.1 apply to anxiety as a clinical problem, as in the case of David, whose story is described in Case study 14.1. The difference between non-clinical and clinical anxiety is explained in the ‘Making a clinical assessment’ section. There are other approaches to defining anxiety.

This chapter examines the concept of peace from a biopsychosocial perspective. It reviews available knowledge concerning gene-environment regulatory interactions and their consequences for neurodevelopment, particularly during sensitive periods early in life. The hypothesis is explored that efforts on the part of parents to protect, nurture, and stimulate their children can lead to physically, psychologically, and socially healthier developmental trajectories and support the emergence of more peaceful families and communities. Clearly, adverse environments (e.g., structural violence) may result in lower parental investment in child rearing and negative outcomes for social harmony and health over the course of life. More research is thus needed to understand the potential positive impact that interventions will have on societal peace. The role of groups in shaping human behavior toward conflict or conflict resolution and peace is examined. Published in the Strungmann Forum Reports Series.

This chapter examines theoretical models of suicide and nonfatal suicidal behaviors. The models of suicidal behavior include sociological, psychological, biological, family, and biopsychosocial models. Sociological models are categorized into egoistic, altruistic, anomic, and fatalistic suicides. Psychological models include psychodynamic, cognitive, social learning, and psychological and interpersonal models. The chapter also discusses the developmental theories that are applicable for constructing models of suicidal processes.

Bishop locates the early origins of bioethics in theological critiques of reductionist medicine in the works of Joseph Fletcher, Paul Ramsey, and Richard McCormick. He argues that these critiques were quickly diluted; in an attempt to grow more influential, they became less oppositional. The end result was a new bioethics of principlism, which was from the beginning a concession to the language and ends of biomedicine. Given such subservient origins, it is unsurprising that principlism has never been able to direct medical discourse or govern medical practice. Subsequent holistic efforts from the social sciences and humanities have attempted merely to reform and govern the practice of medicine, not to redefine it. In Bishop’s view, if bioethics is ever to become a strong counter-balancing force to biomedicine, it must recover a critique that starts from different premises.

This introductory chapter discusses the importance of studying human sexuality from a life course perspective. Until recently, theory, research, and public policy discussions on sexual topics have tended to focus on childhood, adolescence, young adulthood, or adulthood. With some reflection, however, one realizes that what happens in adulthood is not unrelated to what took place in adolescence or even childhood. Thus, there is a need for serious exploration of how events at one stage in life affect sexual attitudes, behavior, and relationships at other, later stages. Another contribution to be made by the life course theory is the development of transdisciplinary perspectives, incorporating biological, psychological, social, and cultural dimensions; these are often referred to as biopsychosocial models.

This chapter outlines the Capabilities Approach, developed by Amartya Sen in the 1980s as a more empowering, less paternalistic approach to welfare economics. It argues that, applied to mental distress, the Capabilities Approach offers a conceptual framework which service users, survivors and allies need to mount a serious challenge to the dominance of the medical model. That is because it supplies what is usually missing in even expanded medical models (like the biopsychosocial model) – a profound understanding of structural constraints and enablements as they relate to individual agency. Focusing on recovery from ‘schizophrenia’ and early intervention in psychosis, the chapter demonstrates how the Capabilities approach might be applied, concluding that it represents an important framework for strengthening links between the social model of disability and mental health.

Chapter two draws on the extant literature, to deconstruct dementia and to show whilst it has been conventionally described as a biomedical cognitive disorder, dementia can also be contextualised as a disability. It provides an in-depth discussion of the biopsychosocial and social model for deconstructing dementia and the accompanying tools associated with both models that is the ICF (WHO, 2001) and the UN Convention (CRPD, 2006). In this chapter it will be shown how the biopsychosocial model has significantly shaped how disability is described and understood in the UN Convention (CRPD, 2006), the prism through which dementia will be critically reviewed in this volume. Demonstrating why dementia qualifies as a disability in accordance with the UN Convention’s (CRPD, 2006) description of disability is most important, given this book explores the rights of people living with dementia to claim entitlements enshrined in the CRPD.

The historical roots of the term patient-centeredness are presented. The point is made that, although the term possesses considerable rhetorical power, in reality many institutions that wave the banner of patient-centeredness remain resolutely disease focused. This has been the case since the early nineteenth century, when clinicopathologic correlation became an imperative of medical practice. That the doctor’s primary mandate is to ferret out disease remains a tenacious precept in contemporary medical practice as well as in medical education. This chapter argues that a medicine anchored in a new and bold definition of sickness, one with a laser-sharp focus on a person’s functioning, necessarily opens many avenues for a practice centered on the person.

Intimate partner violence (IPV) is associated with an array of negative health consequences that can include poor general health status, increased health service utilization, stress-related conditions, physical injuries, and death. Common mental health consequences include depression and posttraumatic stress disorder. Many factors, at biological, psychological, and social levels of influences, are correlated with IPV perpetration, yet prominent theoretical models are narrow in focus. This chapter explicates the need for a biopsychosocial model of IPV that is integrative and coherent, and it argues that the social information processing approach can provide an organizing framework for this effort. Factors such as neurocognitive deficits, trauma exposure, and acute alcohol intoxication influence risk for IPV by altering the decoding and interpretation of relationship events and the generation, selection, and evaluation of responses. A more integrative approach to IPV will enhance our ability to understand, prevent, and treat this vexing public health concern.

This chapter puts forward an interactive, biopsychosocial model of aging, tested and illustrated through a synthesis of findings from the National Social Life, Health and Aging Project (NSHAP). Using these findings, this chapter demonstrates that many older Americans have large and strong social networks, and they tend to be sexually active into old age as long as their physical health remains good. Therefore, it seems that old age does not necessarily precipitate disengagement from meaningful social relations. Furthermore, having a large, close social network does not always lead to better health: characteristics of network structure and information sharing among network contacts may also be crucial for well-being. The chapter then closes with future possibilities for investigating biopsychosocial perspectives on aging, with the promise of longitudinal and dyadic data through NSHAP.

This introductory chapter places substance use research within the broader contexts of the social work profession and social work research. The chapter directs specific attention to how social work research in substance use embodies multiple dimensions of a translational science framework, as well as a complementary line of “research for and about research.” In addition, the chapter explores the dynamic contexts of substance use research, issues from the molecular to the global in scope, and a few “great debate” topics.