This chapter helps readers to understand the main characteristics of the three major types of eating disorders: anorexia nervosa, bulimia nervosa, and binge eating. It also examines each disorder from a neurobiological perspective, including genetic factors when known, neuroimaging results, the understanding of neurotransmitter dysregulation, cognitive performance, and various types of treatment. The chapter then presents the consideration of the unique challenges associated with comorbidity, societal pressure, and medical implications. Eating disorders are increasingly common, debilitating, and potentially life-threatening disorders that are clearly linked in their neurobiological basis. Mental health professionals should be aware of the signs and symptoms of eating disorders, as individuals might not disclose their eating habits as readily as their mood, anxiety level, or other symptoms. Treatment is complex, as no medication has been shown to be consistently effective, and each eating disorder will bring with it specific goals.

This chapter provides a brief historical overview to explain how neuroscience has evolved to what we know it as today. It focuses on the modern history of some of the most relevant aspects of neuroscience. The chapter examines specific, important clinical cases, significant neuroscience milestones, and important treatment modalities that have been implemented and that have led us to this point in our history. Modern neuroscientists have strongly influenced the collective understanding of brain-based functioning and have guided the field to where it stands today. The chapter discusses important ethical considerations in the neurosciences, as well as special areas of focus that generate an increased level of consideration, from the public and often from the media. There are thousands of individual cases that have contributed to neuroscientific understanding throughout history. Examination of behavior and follow-up analysis of brain tissue have helped neuroscientists understand brain-based functioning.

The brain plays a role in influencing the immune system, controlling our sleep, and developing our personality. This chapter provides a straightforward overview of our current knowledge and understanding of normal brain functioning. The nervous system is divided into the central nervous system and peripheral nervous system. The peripheral nervous system communicates with the central nervous system to allow for interaction with the environment. The somatic nervous system is responsible for responding to environmental stimuli by connecting the voluntary skeletal muscles with cells that are responsive to sensations, such as touch, vision, and hearing. It comprises afferent nerve cells that connect the eyes, ears, skin, and skeletal muscles to the central nervous system, allowing sensory information to be transmitted to the brain. Healthy brain functioning requires a multitude of stable neurochemicals, structural anatomy, communication among different brain regions in different hemispheres, and an overall healthy nervous system.

Mood disorders are collectively one of the most common psychiatric disorders. Of these, the most frequent disorders are depression and bipolar disorder. This chapter aims to help us better understand the two most common mood disorders, depression and bipolar disorder, by reviewing the genetic, neuroanatomical, and cognitive findings of the disorders. Advancements in neuroscience have led to the development of technology, including deep brain stimulation and transcranial magnetic stimulation (TMS), as an effective form of treatment. The most common treatments, cognitive behavioral therapy (CBT) and psychotropic medications, have been well validated and are highly efficacious. Indeed, these two types of treatments appear nearly equivalent in decreasing the acute symptoms for depression. However, several other forms of treatment, such as deep brain stimulation (DBS), vagus nerve stimulation (VNS), and electroconvulsive therapy (ECT), can be used to ameliorate depression as well.

This chapter assists the clinician in understanding the various techniques, beyond clinical case examples, that have helped advance neuroscience research. It provides a discussion of how some of the original research methods are now used for clinical purposes. Advances in imaging techniques have been extremely useful in understanding brain-based functioning, studies utilizing animals are numerous, and they cannot merely be replaced with advanced technology. An electroencephalogram (EEG) records electrical activity of the brain in a noninvasive manner by placing electrodes, small flat metal discs, on the scalp in order to record extracellular current flow of neurons. EEGs can be used to examine whether a patient has epilepsy, sleep disorders, mental disorder, or delirium. Clinicians need to maintain awareness and general understanding of these advances in order to better serve their patients as well as to assist in advancing the practice of psychotherapy.

A traumatic brain injury (TBI) is an insult to the brain involving an external force that leads to impairment in cognitive, emotional, behavioral, or physical functioning for at least a brief, and at times a sustained, period of time. A TBI occurs as a result of either a closed-head or open-head injury. Recognition of the symptoms associated with TBI and persistent persistent postconcussion syndrome (PPCS) is necessary for a clinician dealing with patients of various populations, ages, and settings. Neuroimaging is used to examine the severity and extent of brain damage due to TBI. There is no one set standard of treatments for TBI. The goal is for patients who suffer TBI to receive immediate, careful medical evaluation and follow-up management. Cognitive rehabilitation works to improve upon cognitive dysfunction either by aiming to achieve improved postinjury cognitive status or by developing skills to overcome permanent cognitive impairment.

This chapter examines the more prevalent disorders associated with medical conditions. It also explores several dementias and movement disorders often resulting in dementia, along with the effects of tumors, strokes, and seizures. The chapter then examines how providers can assess for and assist in areas of determining capacity, particularly for independent living and driving. It further discusses the complexities of determining whether patients should use genetic and neurobiological knowledge to become aware of their own risk for inherited diseases, such as Huntington’s disease, and the effects of these decisions. Medical diseases do not occur exclusively from cognitive, emotional, and behavioral symptoms. The neurobiological aspects of the disease, including the neurochemical changes, structural brain abnormalities, and functional changes in glucose metabolism are evident in these disorders. The clinician needs to assist the client not only in coping with the illness, but also by explaining the processes that occur with medical illness.

The human brain is a very complex system of chemicals, electrical charges, and anatomical structures that interact with one another and with the environment to elicit behaviors, emotions, and cognitions. This chapter focuses on the most relevant brain systems, or neuropath-ways, of the brain, as they relate to psychiatric disorders. Although there are several ways to understand the brain’s microanatomy, the clinical- and counseling-level student and practitioner should have a clear understanding of those brain systems that play a central role in behavior, emotions, and cognitions. The somatosensory and auditory pathways are well-defined and important for human behavior. Yet, from a mental health perspective, disruption of these pathways is not thought to play a central role in most mental health disorders. The chapter helps the general clinician to become familiar with common neuropathways that are disrupted in various psychiatric disorders and focuses on the most pertinent neurobiological systems in psychiatry.

Schizophrenia has been associated with higher occurrences of obesity, cardiovascular disease, minor physical problems, sociality, cigarette smoking, and violent behaviors. Understanding the clinical symptoms and neurobiological factors helps determine how to increase the likelihood of a positive outcome. At the very least, a clinician’s neurobiologi-cal and cognitive understanding of schizophrenia will allow for a better prognosis and help guide treatment planning. This chapter aims to help us understand the clinical characteristics of schizophrenia by providing the most consistent as well as the most interesting neurobiological findings concerning the disorder. The clinical characteristics of schizophrenia are distinguished from those of most other disorders by psychotic symptoms. Hallucinations, paranoia, disorganized behavior, delusions, cognitive decline, and significant social dysfunction are all symptoms of the disorder. The functional deterioration within subsets of patients who have been diagnosed with schizophrenia is remarkable when compared to other psychiatric disorders.

This chapter provides evidence of how personality is also, at least partially, explained neurobiologically. It is clear that experience plays a role in developing one’s personality. The chapter examines the evidence of the neurobiologically underpinnings of personality, help link experiences with personality, and explore the neurobiological evidence concerning two major personality disorders. Examining the evidence, including cognitive studies, imaging studies, and even genetic studies, will help the clinician conceptualize personality disorders as brain-based disorders. When considered in this way, the rationale for treatment and understanding of the effectiveness of treatment becomes clearer. The two specific personality disorders are antisocial personality disorder and borderline personality disorder. The overlap of personality disorders, including obsessive-compulsive personality disorder (oCPD), avoidant personality disorder, and schizotypal personality disorders, with other psychiatric disorders, makes examination of these disorders challenging and limited.