Introduction

C linicians from many disciplines have been challenged to provide appro-priate and effective interventions for the diverse behavioral symptoms that defi ne the neurologically degenerative condition known as dementia. From the earliest published reference to “being out of one’s mind” at the time of the Roman poet Lucretius (50 BCE; Berrios, 1987), and even earlier reports that the ancient Egyptians (2000 BCE) observed major memory disorders to accompany advanced age (Boller & Forbes, 1998), the medical community has described changes in cognitive, psychiatric, and intellectual functioning that were not common features of aging. The fi rst documented use of the term dementia by Philippe Pinel (1745-1826), the father of modern psychiatry, coincided with many other terms for similar behavioral symptoms including amentia, dotage, imbecility, insanity, idiocy, organic brain syndrome, and senility (Boller & Forbes; Torack, 1983). Jean Etienne Esquirol’s (1772-1840) description of dementia as “a cerebral disease characterized by an impairment of sensibility, intelligence and will” was eventually documented in the fi rst edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association [APA], 1952) to describe dementia as an organic brain syndrome (OBS) that was differentiated from an acute brain syndrome due to its chronic and irreversible nature (Boller & Forbes). Subsequent editions of the DSM refl ected the evolution of terminology from OBS to senile and presenile dementia to the current dementia, which is defi ned as “a loss of intellectual abilities of suffi cient severity to interfere with social or occupational functioning” (DSM IV; APA, 1994).