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Preface, xvii
A Guide to Using Your Text, xxii
Chapter 1. Understanding Abnormality: A Look at History and Research Methods, 2
CASE REPORT: Rebecca Hasbrouck, 3
What Is Abnormal Behavior?, 4
Defining Abnormality, 5
Distress, 5
Impairment, 5
Risk to Self or Other People, 5
Socially and Culturally Unacceptable Behavior, 6
Challenges Involved in Characterizing Abnormal Behavior, 6
What Causes Abnormality?, 7
Biological Causes, 7
REAL STORIES: Kelsey Grammer: Recovering from Trauma, 8
Psychological Causes, 9
Sociocultural Causes, 9
Abnormality: A Biopsychosocial Perspective, 10
Abnormal Psychology Throughout History, 10
Prehistoric Times: Abnormal Behavior as Demonic Possession, 11
Ancient Greece and Rome: The Emergence of the Scientific Model, 11
The Middle Ages and Renaissance: The Re-emergence of Spiritual Explanations, 12
Europe and the United States in the 1700s: The Reform Movement, 14
The 1800s to the 1900s: Development of Alternative Models for Abnormal Behavior, 16
The Twenty-First Century: The Challenge of Providing Humane and Effective Treatment, 18
Research Methods in Abnormal Psychology, 21
The Scientific Method, 21
The Experimental Method, 23
The Correlational Method, 25
The Survey Method, 25
The Case Study Method, 26
Single-Subject Design, 27
Studies of Genetic Influence, 27
The Human Experience of Psychological Disorders, 28
Impact on the Individual: Stigma and Distress, 28
Impact on the Family, 30
Impact on the Community and Society, 31
Reducing Stigma, 32
Bringing It All Together: Clinical Perspectives, 32
RETURN TO THE CASE, 33
Summary, 34
Key Terms, 35
Answers to Review Questions, 35
Internet Resource, 35
Chapter 2. Classification and Treatment Plans, 36
CASE REPORT: Peter Dickinson, 37
Psychological Disorder: Experiences of Client and Clinician, 38
The Client, 38
Definitions, 38
Prevalence of Psychological Disorders, 38
The Clinician, 40
The Diagnostic and Statistical Manual of Mental Disorders, 40
How the DSM Developed, 41
Controversial Issues Pertaining to the DSM, 42
Definition of Mental Disorder, 43
Assumptions of the DSM-IV-TR, 44
Medical Model, 44
Atheoretical Orientation, 44
Categorical Approach, 44
Multiaxial System, 45
The Five Axes of the DSM-IV-TR, 45
Axis I: Clinical Disorders, 45
Axis II: Personality Disorders and Mental Retardation, 48
Axis III: General Medical Conditions, 48
Axis IV: Psychosocial and Environmental Problems, 48
Axis V: Global Assessment of Functioning, 50
The Diagnostic Process, 50
The Client's Reported and Observable Symptoms, 51
Diagnostic Criteria and Differential Diagnosis, 51
Final Diagnosis, 52
Case Formulation, 53
Cultural Formulation, 53
Treatment Planning, 57
Goals of Treatment, 57
REAL STORIES: Patty Duke: Mood Disturbance, 58
Treatment Site, 59
Psychiatric Hospitals, 59
Outpatient Treatment, 60
Halfway Houses and Day Treatment Programs, 60
Other Treatment Sites, 60
Modality of Treatment, 61
Determining the Best Approach to Treatment, 61
Treatment Implementation, 62
The Course of Treatment, 63
The Clinician's Role in Treatment, 63
The Client's Role in Treatment, 63
The Outcome of Treatment, 63
RETURN TO THE CASE, 64
Summary, 65
Key Terms, 66
Answers to Review Questions, 66
Internet Resource, 67
Chapter 3. Assessment, 68
CASE REPORT: Ben Robsham, 69
What Is a Psychological Assessment?, 70
Clinical Interview, 70
Unstructured Interview, 70
Structured and Semistructured Interviews, 71
Mental Status Examination, 74
Appearance and Behavior, 74
Orientation, 75
Content of Thought, 75
Thinking Style and Language, 76
Affect and Mood, 77
Perceptual Experiences, 78
Sense of Self, 79
Motivation, 79
Cognitive Functioning, 79
Insight and Judgment, 79
Psychological Testing, 79
What Makes a Good Psychological Test?, 80
Intelligence Testing, 81
Stanford-Binet Intelligence Test, 82
Wechsler Intelligence Scales, 83
Cultural Considerations in Intelligence Testing, 84
Personality and Diagnostic Testing, 84
Self-Report Clinical Inventories, 84
Projective Testing, 87
Behavioral Assessment, 89
Behavioral Self-Report, 90
Behavioral Observation, 91
Multicultural Assessment, 91
REAL STORIES: Frederick Frese: Psychosis, 92
Environmental Assessment, 93
Physiological Assessment, 94
Psychophysiological Assessment, 94
Brain Imaging Techniques, 95
Neuropsychological Assessment, 97
Putting It All Together, 98
RETURN TO THE CASE, 99
Summary, 100
Key Terms, 101
Answers to Review Questions, 101
Internet Resource, 101
Chapter 4. Theoretical Perspectives, 102
CASE REPORT: Meera Krishnan, 103
The Purpose of Theoretical Perspectives in Abnormal Psychology, 104
Psychodynamic Perspective, 104
Freudian Psychoanalytic Theory, 104
Freud's Background, 104
Freud's Structural Model of Personality: The Id, Ego, and Superego, 104
Defense Mechanisms, 105
Psychosexual Development, 105
Freud's Place in History, 108
Post-Freudian Psychodynamic Views, 109
Attachment Styles, 110
Treatment, 110
Evaluation of Psychodynamic Theories, 111
Humanistic Perspective, 113
Person-Centered Theory, 113
Self-Actualization Theory, 114
Treatment, 114
Evaluation of Humanistic Theories, 115
Sociocultural Perspective, 116
Family Perspective, 116
Social Discrimination, 116
REAL STORIES: William Styron: Depression, 117
Social Influences and Historical Events, 117
Treatment, 118
Family Therapy, 118
Group Therapy, 118
Multicultural Approach, 118
Milieu Therapy, 119
Evaluation of the Sociocultural Perspective, 119
Behavioral and Cognitively Based Perspectives, 120
Classical Conditioning, 120
Operant Conditioning, 121
Social Learning and Social Cognition, 123
Cognitively Based Theory, 123
Treatment, 124
Conditioning Techniques, 124
Contingency Management Techniques, 125
Modeling and Self-Efficacy Training, 125
Cognitive Therapies, 125
Evaluation of the Behavioral and Cognitively Based Perspectives, 126
Biological Perspective, 126
The Nervous System and Behavior, 127
Neurons, Synapses, and Neurotransmitters, 127
Genetic Influences on Behavior, 128
Basic Concepts in Genetics, 128
Models of Genetic Transmission, 129
Genes, Environment, and Psychological Disorders, 129
Treatment, 130
Psychosurgery, 130
Electroconvulsive Therapy, 130
Transcranial Magnetic Stimulation, 130
Deep Brain Stimulation, 131
Medication, 131
Biofeedback, 131
Evaluation of the Biological Perspective, 134
Biopsychosocial Perspectives on Theories and Treatments: An Integrative Approach, 135
RETURN TO THE CASE, 136
Summary, 139
Key Terms, 140
Answers to Review Questions, 140
Answers to Perspective Box Questions, 141
Internet Resource, 141
Chapter 5. Anxiety Disorders, 142
CASE REPORT: Barbara Wilder, 143
The Nature of Anxiety Disorders, 144
Panic Disorder and Agoraphobia, 144
Characteristics of Panic Disorder, 145
Theories and Treatment of Panic Disorder and Agoraphobia, 146
Biological Perspective, 146
Psychological Perspective, 147
Specific Phobias, 148
Characteristics of Specific Phobias, 148
Theories and Treatment of Specific Phobias, 149
Biological Perspectives, 149
Psychological Perspectives, 149
Social Phobia, 151
Characteristics of Social Phobia, 151
Theories and Treatment of Social Phobia, 152
Biological Perspectives, 152
REAL STORIES: Donny Osmond: Social Phobia, 153
Psychological Perspectives, 154
Generalized Anxiety Disorder, 154
Characteristics of Generalized Anxiety Disorder, 154
Theories and Treatment of Generalized Anxiety Disorder, 155
Obsessive-Compulsive Disorder, 156
Characteristics of Obsessive-Compulsive Disorder, 156
Theories and Treatment of Obsessive-Compulsive Disorder, 158
Treatment, 159
Acute Stress Disorder and Post-Traumatic Stress Disorder, 161
Characteristics of Post-Traumatic Stress Disorder, 161
PTSD and Combat, 161
Theories and Treatment of Post-Traumatic Stress Disorder, 163
Biological Perspectives, 164
Psychological Perspectives, 165
Can People Grow from the Experience of Trauma?, 165
Anxiety Disorders: The Biopsychosocial Perspective, 166
RETURN TO THE CASE, 167
Summary, 169
Key Terms, 170
Answers to Review Questions, 171
Answers to Mini Case Questions, 171
Internet Resource, 171
Chapter 6. Somatoform Disorders, Psychological Factors Affecting Medical Conditions, and Dissociative Disorders, 172
CASE REPORT: Rose Marston, 173
Somatoform Disorders, 174
Conversion Disorder, 175
Somatization Disorder and Related Conditions, 176
Body Dysmorphic Disorder, 178
Hypochondriasis, 180
Conditions Related to Somatoform Disorders, 181
Theories and Treatment of Somatoform Disorders, 184
Psychological Factors Affecting Medical Conditions, 185
Characteristics of the DSM-IV-TR Category of Psychological Factors Affecting Medical Conditions, 185
Theories and Treatment of the DSM-IV-TR Category of Psychological Factors Affecting Medical Conditions, 186
Stress, 186
Emotional Expression, 190
Personality Style, 190
Sociocultural Factors, 191
Treatment, 191
Dissociative Disorders, 193
Dissociative Identity Disorder, 193
Characteristics of Dissociative Identity Disorder, 193
Theories and Treatment of Dissociative Identity Disorder, 195
REAL STORIES: Anne Heche: Dissociative Symptoms, 197
Dissociative Identity Disorder and the Legal System, 199
Other Dissociative Disorders, 200
Dissociative Amnesia, 200
Dissociative Fugue, 201
Depersonalization Disorder, 202
Theories and Treatment of Dissociative Amnesia, Dissociative Fugue, and Depersonalization Disorder, 202
Somatoform Disorders, Psychological Factors Affecting Medical Conditions, and Dissociative Disorders: The Biopsychosocial Perspective, 203
RETURN TO THE CASE, 204
Summary, 207
Key Terms, 207
Answers to Review Questions, 208
Answers to Mini Case Questions, 208
Internet Resource, 209
Chapter 7. Sexual Disorders, 210
CASE REPORT: Shaun Boyden, 211
What Is Abnormal Sexual Behavior?, 212
Paraphilias, 212
Characteristics of Paraphilias, 212
Pedophilia, 213
Exploitation of Youth on the Internet, 216
Exhibitionism, 217
Fetishism, 218
Frotteurism, 219
Sexual Masochism and Sexual Sadism, 219
Transvestic Fetishism, 221
Voyeurism, 223
Theories and Treatment of Paraphilias, 223
Gender Identity Disorders, 224
Characteristics of Gender Identity Disorders, 224
Theories and Treatment of Gender Identity Disorders, 226
Sexual Dysfunctions, 228
Characteristics of Sexual Dysfunctions, 228
Hypoactive Sexual Desire Disorder, 231
Sexual Aversion Disorder, 231
Female Sexual Arousal Disorder, 232
Male Erectile Disorder, 232
Female Orgasmic Disorder, 232
Male Orgasmic Disorder, 233
Premature Ejaculation, 234
Sexual Pain Disorders, 234
Theories and Treatment of Sexual Dysfunctions, 234
Biological Perspective, 235
Psychological Perspective, 237
REAL STORIES: Richard Berendzen: Enduring Effects of Sexual Abuse, 238
Sexual Disorders: The Biopsychosocial Perspective, 240
RETURN TO THE CASE, 241
Summary, 242
Key Terms, 243
Answers to Review Questions, 244
Answers to Mini Case Questions, 244
Internet Resource, 245
Chapter 8. Mood Disorders, 246
CASE REPORT: Janice Butterfield, 247
General Characteristics of Mood Disorders, 248
Depressive Disorders, 248
Major Depressive Disorder, 248
Characteristics of a Major Depressive Episode, 248
Types of Depression, 249
Prevalence and Course of the Disorder, 250
Dysthymic Disorder, 250
Disorders Involving Alternations in Mood, 252
Bipolar Disorder, 252
Characteristics of a Manic Episode, 252
Types of Bipolar Disorder, 253
Prevalence and Course of the Disorder, 253
REAL STORIES: Kay Redfield Jamison: Bipolar Disorder, 254
Cyclothymic Disorder, 255
Theories and Treatments of Mood Disorders, 256
Biological Perspectives, 256
Genetics, 256
Biochemical Factors, 257
Psychological Perspectives, 258
Psychodynamic Theories, 258
Behavioral and Cognitively Based Theories, 258
Sociocultural and Interpersonal Perspectives, 260
Treatment, 260
Biological Treatment, 260
Psychological Treatment, 264
Sociocultural and Interpersonal Intervention, 265
Suicide, 266
Who Commits Suicide?, 266
Why Do People Commit Suicide?, 267
Biological Perspective, 267
Psychological Perspective, 267
Sociocultural Perspective, 269
Assessment and Treatment of Suicidality, 269
Mood Disorders: The Biopsychosocial Perspective, 271
RETURN TO THE CASE, 272
Summary, 274
Key Terms, 274
Answers to Review Questions, 275
Answers to Mini Case Questions, 275
Internet Resource, 275
Chapter 9. Schizophrenia and Related Disorders, 276
CASE REPORT: David Marshall, 277
Characteristics of Schizophrenia, 278
Phases of Schizophrenia, 279
Symptoms of Schizophrenia, 279
Disturbance of Thought Content: Delusions, 279
REAL STORIES: John Forbes Nash: Schizophrenia, 280
Disturbance in Perception: Hallucinations, 281
Disturbance of Thinking, Language, and Communication: Disorganized Speech, 281
Disturbed Behavior, 281
Negative Symptoms, 282
Social and Occupational Dysfunction, 282
Types of Schizophrenia, 283
Dimensions of Schizophrenia, 284
Courses of Schizophrenia, 285
Gender, Age, and Cultural Features, 285
Other Psychotic Disorders, 286
Brief Psychotic Disorder, 286
Schizophreniform Disorder, 287
Schizoaffective Disorder, 288
Delusional Disorders, 288
Shared Psychotic Disorder, 290
Theories and Treatment of Schizophrenia, 291
Biological Perspectives, 291
Brain Structure and Function, 291
Genetic Explanations, 292
Biological Stressors and Vulnerability, 293
Psychological Perspective, 293
Sociocultural Perspective, 295
Treatment of Schizophrenia, 296
Biological Treatments, 296
Psychological Treatments, 297
Sociocultural Treatments, 298
Schizophrenia: The Biopsychosocial Perspective, 299
RETURN TO THE CASE, 300
Summary, 303
Key Terms, 303
Answers to Review Questions, 304
Answers to Mini Case Questions, 304
Internet Resource, 305
Chapter 10. Personality Disorders, 306
CASE REPORT: Harold Morrill, 307
The Nature of Personality Disorders, 308
Antisocial Personality Disorder, 309
Characteristics of Antisocial Personality Disorder, 309
Theories and Treatment of Antisocial Personality Disorder, 312
Biological Perspectives, 312
Psychological Perspectives, 312
Sociocultural Perspectives, 313
Treatment of Antisocial Personality Disorder, 314
Borderline Personality Disorder, 314
Characteristics of Borderline Personality Disorder, 314
Theories and Treatment of Borderline Personality Disorder, 316
Biological Perspectives, 316
REAL STORIES: Susanna Kaysen: Borderline Symptoms, 317
Psychological Perspectives, 318
Sociocultural Perspectives, 318
Treatment of Borderline Personality Disorder, 319
Histrionic Personality Disorder, 321
Narcissistic Personality Disorder, 322
Paranoid Personality Disorder, 324
Schizoid Personality Disorder, 325
Schizotypal Personality Disorder, 326
Avoidant Personality Disorder, 327
Dependent Personality Disorder, 328
Obsessive-Compulsive Personality Disorder, 330
Personality Disorders: The Biopsychosocial Perspective, 331
RETURN TO THE CASE, 333
Summary, 335
Key Terms, 336
Answers to Review Questions, 337
Answers to Mini Case Questions, 337
Internet Resource, 337
Chapter 11. Development-Related Disorders, 338
CASE REPORT: Jason Newman, 339
Introductory Issues, 340
Mental Retardation, 340
Characteristics of Mental Retardation, 340
Theories and Treatment of Mental Retardation, 340
Inherited Causes, 340
Environmental Causes, 341
Treatment, 343
Pervasive Developmental Disorders, 344
Characteristics of Autistic Disorder, 344
Impairment in Social Interaction, 344
Impairment in Communication, 344
Oddities of Behavior, Interests, and Activities, 344
Theories of Autistic Disorder, 345
Treatment of Autistic Disorder, 345
Other Pervasive Developmental Disorders, 347
Asperger's Disorder, 347
Attention Deficit and Disruptive Behavior Disorders, 348
Attention-Deficit/Hyperactivity Disorder (ADHD), 349
ADHD in Adults, 349
REAL STORIES: Edward Hallowell: Attention Deficit Symptoms, 350
Conduct Disorder, 351
Oppositional Defiant Disorder, 352
Theories and Treatment of ADHD and Disruptive Behavior Disorders, 353
Theories, 353
Treatment, 354
Learning, Communication, and Motor Skills Disorders, 356
Learning Disorders, 356
Communication Disorders, 357
Motor Skills Disorders, 358
Theories and Treatment of Learning, Communication, and Motor Skills Disorders, 358
Separation Anxiety Disorder, 358
Characteristics of Separation Anxiety Disorder, 358
Theories and Treatment of Separation Anxiety Disorder, 359
Other Disorders that Originate in Childhood, 359
Childhood Eating Disorders, 359
Tic Disorders, 359
Elimination Disorders, 360
Reactive Attachment Disorder, 360
Stereotypic Movement Disorder, 360
Selective Mutism, 360
Development-Related Disorders: The Biopsychosocial Perspective, 360
RETURN TO THE CASE, 361
Summary, 363
Key Terms, 363
Answers to Review Questions, 364
Answers to Mini Case Questions, 364
Internet Resource, 365
Chapter 12. Aging-Related and Cognitive Disorders, 366
CASE REPORT: Irene Heller, 367
The Nature of Cognitive Disorders, 368
Delirium, 368
Amnestic Disorders, 369
Traumatic Brain Injury, 370
Dementia, 371
Characteristics of Dementia, 372
Memory Loss, 372
Aphasia, Apraxia, and Agnosia, 372
Disturbance in Executive Functioning, 372
Alzheimer's Disease (Dementia of the Alzheimer's Type), 372
Dementia Caused by Other Conditions, 374
Physical Conditions, 374
REAL STORIES: John Bayley and Iris Murdoch: Caring for a Person with Alzheimer's Disease, 375
Depression, 378
Diagnosis of Alzheimer's Disease, 379
Theories and Treatment of Alzheimer's Disease, 380
Biological Perspective, 380
Environmental Perspective, 382
Medical Treatment of Alzheimer's Disease, 383
Behavioral Management of Symptoms, 384
Cognitive Disorders: The Biopsychosocial Perspective, 385
RETURN TO THE CASE, 386
Summary, 387
Key Terms, 388
Answers to Review Questions, 388
Answers to Mini Case Questions, 389
Internet Resource, 389
Chapter 13. Substance-Related Disorders, 390
CASE REPORT: Carl Wadsworth, 391
The Nature of Substance Abuse and Dependence, 392
Behaviors Associated with Substance-Related Disorders, 393
Substance-Induced Disorders, 393
Substance Use Disorders, 394
Alcohol, 395
Patterns of Use and Abuse, 395
Effects of Alcohol Use, 395
Immediate Effects, 395
REAL STORIES: Ben Affleck: Substance Abuse, 396
Long-Term Effects, 398
Theories of Alcohol Dependence, 398
Biological Perspective, 398
Psychological Perspective, 399
Sociocultural Perspective, 399
Treatment of Alcohol Dependence, 401
Biological Treatment, 401
Psychological Treatment, 402
Alcoholics Anonymous, 404
Substances Other Than Alcohol, 406
Stimulants, 407
Amphetamines, 408
Cocaine, 409
Caffeine, 411
Cannabis, 412
Hallucinogens, 413
MDMA, 415
Heroin and Opioids, 415
Sedatives, Hypnotics, and Anxiolytics, 417
Barbiturates, 417
Barbiturate-Like Substances, 417
Anxiolytics, 417
Other Drugs of Abuse, 418
Treatment for Substance Abuse and Dependence, 422
Biological Treatment, 422
Nonmedical Therapies, 422
Substance Abuse and Dependence: The Biopsychosocial Perspective, 423
RETURN TO THE CASE, 423
Summary, 425
Key Terms, 425
Answers to Review Questions, 426
Answers to Mini Case Questions, 426
Internet Resource, 427
Chapter 14. Eating Disorders and Impulse-Control Disorders, 428
CASE REPORT: Rosa Nomirez, 429
Eating Disorders, 430
Characteristics of Anorexia Nervosa, 430
REAL STORIES: Tracey Gold: Eating Disorder, 433
Characteristics of Bulimia Nervosa, 434
Theories and Treatment of Eating Disorders, 437
Theories, 437
Treatment, 438
Impulse-Control Disorders, 439
Kleptomania, 440
Characteristics of Kleptomania, 440
Theories and Treatment of Kleptomania, 440
Pathological Gambling, 441
Characteristics of Pathological Gambling, 441
Theories and Treatment of Pathological Gambling, 443
Pyromania, 444
Characteristics of Pyromania, 444
Theories and Treatment of Pyromania, 445
Sexual Impulsivity, 446
Characteristics of Sexual Impulsivity, 446
Theories and Treatment of Sexual Impulsivity, 447
Trichotillomania, 447
Characteristics of Trichotillomania, 447
Theories and Treatment of Trichotillomania, 448
Intermittent Explosive Disorder, 449
Characteristics of Intermittent Explosive Disorder, 449
Theories and Treatment of Intermittent Explosive Disorder, 449
Internet Addiction, 450
Characteristics of Internet Addiction, 450
Theories and Treatment of Internet Addiction, 450
Self-Injurious Behaviors, 451
Characteristics of Self-Injurious Behaviors, 451
Theories and Treatment of Self-Injurious Behaviors, 451
Eating Disorders and Impulse-Control Disorders: The Biopsychosocial Perspective, 451
RETURN TO THE CASE, 452
Summary, 455
Key Terms, 456
Answers to Review Questions, 456
Answers to Mini Case Questions, 457
Internet Resource, 457
Chapter 15. Ethical and Legal Issues, 458
CASE REPORT: Mark Chen, 459
Ethical Issues, 460
Roles and Responsibilities of Clinicians, 460
Therapist Competence, 460
Informed Consent, 460
Confidentiality, 462
Relationships with Clients, 465
The Business of Psychotherapy, 466
Health Insurance Portability and Accountability Act (HIPAA), 466
Special Roles for Clinicians, 466
Commitment of Clients, 467
Right to Treatment, 469
Refusal of Treatment, 469
Forensic Issues in Psychological Treatment, 470
Insanity Defense, 470
REAL STORIES: John Hinckley: Insanity Defense, 472
Competency to Stand Trial, 476
Understanding the Purpose of Punishment, 476
Concluding Perspectives on Forensic Issues, 477
RETURN TO THE CASE, 478
Summary, 480
Key Terms, 481
Answers to Review Questions, 481
Internet Resource, 481
Glossary, G-1
References, R-1
Credits, C-1
Name Index, I-1
Subject Index, I-8

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