Toward Precision Assessment and Psychotherapy: Understanding Individual Differences through Neurobiology, Genetics, and Epigenetics

Thomas G. Arizmendi, PhD
Clinical Psychologist (Ph.D.), Self – employed (teacher – psychology, neurobiology, genetics, and epigenetics), Longmont, CO, USA

Series: New Developments in Medical Research
BISAC: MED056000

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Volume 10

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Special issue: Resilience in breaking the cycle of children’s environmental health disparities
Edited by I Leslie Rubin, Robert J Geller, Abby Mutic, Benjamin A Gitterman, Nathan Mutic, Wayne Garfinkel, Claire D Coles, Kurt Martinuzzi, and Joav Merrick

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“Toward Precision Assessment and Psychotherapy: Understanding Individual Differences through Neurobiology, Genetics, and Epigenetics” provides a transformative approach to the understanding of mental health in the 21st century. It does so by encouraging the replacement of traditional subjective techniques with more precise and objective measures that are designed to discover individual differences in our patients. Just as in personalized medicine, where diagnostic and treatment techniques are becoming more targeted toward the specific conditions of a particular patient, so to in the mental health field we need to develop targeted and focused methods through the use of clinical science concepts and through the adoption of an agnostic, unassuming posture where the presentation of each patient is viewed as unique.

For example, treatments may draw from an integrative approach that incorporates genomic and epigenomic analyses of the patient to inform a more targeted medication regimen or psychotherapy approach (some psychiatrists are beginning to use genomic analysis to aid in the choice of a specific antidepressant, for example, that would most likely be effective for a certain patient). Diagnostically, paper and pencil questionnaires leading to current diagnostic labels, long the standard, must be replaced, for the most part, by objective measures of stress that prioritize “reports from the body”. Additionally, research methods of extremely complex psychological disorders can be enhanced by breaking them down into smaller subtypes (or endophenotypes) versus large phenomenologically-based symptom clusters (i.e. DSM diagnoses). Individual differences, a consistent focus throughout the book, may be the product of genetic variants and/or epigenetic mechanisms. The latter mediate gene X environment interaction that is now the primary paradigmatic lens through which we investigate and seek to explain resultant behavioral profiles.

A major focus of the book is on the effects of early adversity, particularly trauma, and how they contribute to a “re-programming” of the brain through epigenetic alterations of gene expression. This results in increased vulnerability to possible psychological disorders, such as various anxiety conditions, depression, and character disorders which may manifest later in life. By identifying the epigenetic effects caused by early stressors, that is, how gene expression is altered, we can eventually make significant advances in primary prevention.

This book represents an attempt to move us into a transitional domain and beyond, where causes and the treatment of psychological disorders are re-conceptualized through our developing insights from neurobiology, genetics, and epigenetics.
(Imprint: Nova Medicine and Health)

Introduction

A Neurobiological View of Clinical Process

Chapter 1. Trauma Begets Trauma. Contagious Traumatization in the Treatment Process - A Neurobiological Perspective.

Epigenetics, Stress States, and Assessment – An Objective Approach

Chapter 2. Who Am I? Where Am I? What Time Is It? Neurobiological Insights into the Relationship Between Stress States and Levels of Consciousness in Psychotherapy

Chapter 3. Early Attachment and Epigenetics: Their Mutual Influence on Stress Reactivity

Chapter 4. Allostasis, Allostatic Load, and Resilience: A Clinical Science Model of Psychological Assessment

Chapter 5. Brain-Derived Neurotrophic Factor – A Protein Vital for Understanding Mental Health Conditions

Chapter 6. The Central Role of Endophenotypes in the Deconstruction of Psychiatric Disorders and Key Mental Health Constructs

Neurogenetics and Complexity – Individual Differences

Chapter 7. Layers of Complexity: The Interacting Factors of Signaling Pathways, MicroRNAs, and the Influence of Nutrition

Chapter 8. The Mediating Role of Epigenetics in the Relationship Between Early Life Stressors and the Immune System.

Chapter 9. Individualizing Psychotherapy Process. A Neurogenetics Model

Chapter 10. Speaking in Plain English: Toward a Neurogenetics Language for Patient and Therapist

Chapter 11. A Plea for Change

Appendix A: List of Abbreviations

Appendix B: Amino Acids

Appendix C: Histone Modifications

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