Minimizing Complications of Aging That Lead to Dry Mouth and Poor Oral Health

Poor oral health causes severe pain and untreated infections to spread throughout the body. For older adults, the prevalence of root decay exceeds that of any other medical condition. Our research shows tooth loss and edentulousness were associated with increased mortality and inversely associated with BMI, waist circumference, blood pressure, and fasting blood glucose. Our Stop-it study found people who lost bone density had fewer teeth, problems chewing, and involuntary weight loss and frailty. 88% of the elderly take medications that cause loss of saliva. Sjögren’s and radiation therapy for head and neck cancer patients heighten risk. Without saliva, patients have increased tooth decay, periodontal disease and fungal infections, salivary gland blockage, and problems swallowing and speaking. Dry mouth leads people to suck on candy that further increase caries. Substituting sugarfree gum for candy increases salivary flow and reduces dental caries. Brushing, flossing, and limiting sugar also lessen tooth decay.

Cognitive Behavioral Therapy for Insomnia: A Promising Treatment for Insomnia, Pain, and Depression in Patients With IBD

Over 75% of people with active inflammatory bowel diseases (IBDs) report sleep disturbances, which heighten risk for IBD relapse and flares. Despite mounting evidence for sleep disturbances in IBD, discussion of treatment is severely limited. The most common sleep disturbance, insomnia, occurs in over 50% of adults with chronic health conditions. Herein we describe the gold standard treatment for insomnia, Cognitive Behavioral Therapy for Insomnia (CBT-I). Although yet to be studied in IBD, CBT-I reduces a number of IBD-related comorbidities, including chronic pain, depression, and systemic inflammation. We describe treatment with CBT-I, the impact of CBT-I on these comorbidities, and recommendations for providers.

Alcohol Use Disorders

Chapters in this volume reflect, to one degree or another, eight critical aspects of contemporary research attempting to understand the etiologic processes that heighten risk or resilience factors for substance use disorders: (1) a focus on systemic frameworks for understanding developmental process, (2) the heterogeneity of developmental pathways, (3) the role of genes and epigenetic–experience transactions, (4) risk cumulative/cascade models of the effects of exposure to adverse childhood experiences, (5) negotiating developmental transitional periods, (6) neurobiological embodiment of adverse childhood experiences, (7) links between alcohol use disorder and tobacco addictive behaviors, and (8) longitudinal studies and data analysis within and between studies.

Biting the hand that feeds: current opinion on the interpersonal causes, correlates, and consequences of borderline personality disorder

Borderline personality disorder (BPD) is a complex psychiatric diagnosis characterized by dysregulated behaviors, emotions, cognitions, and interpersonal relationships. In recent years, developmental psychopathologists have sought to identify early origins of BPD, with the ultimate goal of developing and providing effective preventative interventions for those at highest risk. In addition to heritable biological sensitivities, many scholars assert that environmental and interpersonal risk factors contribute to the emergence and maintenance of key borderline traits. Nonetheless, many BPD researchers examine only affected individuals, neglecting the family, peer, couple, and other dynamic contextual forces that impinge upon individual-level behavior. In the past decade, however, theoretical and empirical research has increasingly explored the interpersonal causes, correlates, and consequences of BPD. Such work has resulted in novel research and clinical theories intended to better understand and improve interpersonal dynamics among those with borderline traits. A major objective for the field is to better characterize how interpersonal dynamics affect (and are affected by) the behaviors, emotions, and thoughts of vulnerable individuals to either reduce or heighten risk for BPD.

Coercion, Invalidation, and Risk for Self-Injury and Borderline Personality Traits

Self-inflicted injury (SII) is defined as a deliberate act in which a person seeks to cause bodily harm or death. The etiology and developmental course of SII are unclear. Converging evidence suggests coercive family processes may heighten risk for SII and related clinical problems among vulnerable youth. This chapter outlines a developmental theory of SII with particular attention to contextual risk factors. It proposes that risk for SII is highest when vulnerable youth are exposed repeatedly to coercive and invalidating family environments. Evidence in support of this theory is drawn from longitudinal studies of SII and borderline personality traits. The chapter also reviews data involving conflict discussion tasks with self-injuring and depressed adolescents and their mothers. Accumulating evidence suggests that coercive processes are a leading contextual mechanism that shapes behavioral and physiological dysregulation, ultimately heightening risk for self-injury and borderline personality disorder.