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Abnormal Psychology, Third Canadian Edition

by Davison, Gerald C., Univ. of Southern California, Los Angeles; Blankstein, Kirk R., University of Toronto; Flett, Gordon L., York University; Neale, John M., State Univ. of New York at Stonybrook

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Copyright, ii
About the Authors, iv
Preface, vii
Chapter 1. Introduction: Definitional and Historical Considerations, and Canada’s Mental Health System, 1
What Is Abnormal Behaviour?, 3
Statistical Infrequency, 3
Violation of Norms, 4
Personal Distress, 4
Disability or Dysfunction, 4
Unexpectedness, 4
History of Psychopathology, 6
Early Demonology, 6
Somatogenesis, 7
The Dark Ages and Demonology, 7
Development of Asylums, 9
Asylums in Canada, 11
The Beginning of Contemporary Thought, 16
Current Attitudes Toward People with Psychological Disorders, 20
Canada’s Mental Health Care System, 23
Medicare, 24
Mental Health of Canadians: First View, 24
Treatment and Prevention, 25
The Future, 28
Summary, 30
Chapter 2. Current Paradigms and the Role of Cultural Factors, 32
The Role of Paradigms, 33
The Biological Paradigm, 33
Contemporary Approaches to the Biological Paradigm, 33
Biological Approaches to Treatment, 39
Evaluating the Biological Paradigm, 40
The Psychoanalytic Paradigm, 40
Classical Psychoanalytic Theory, 40
Neo-Freudian Psychodynamic Perspectives, 42
Psychoanalytic Therapy, 42
Evaluating the Psychoanalytic Paradigm, 45
Humanistic and Existential Paradigms, 46
Carl Rogers’s Client-Centred Therapy, 46
Existential Therapy, 47
Gestalt Therapy, 48
Evaluating the Humanistic and Existential Paradigms, 50
Learning Paradigms, 50
The Rise of Behaviourism, 50
Mediational Learning Paradigms, 53
Behaviour Therapy, 54
Evaluating Learning Paradigms, 56
The Cognitive Paradigm, 57
The Basics of Cognitive Theory, 57
Cognitive Behaviour Therapy, 57
Evaluating the Cognitive Paradigm, 61
Consequences of Adopting a Paradigm, 61
Different Perspectives on a Clinical Problem: J. Brett Barkley, 61
Different Perspectives on a Clinical Problem: Cathy: A Case of Trichotillomania, 62
Eclecticism in Psychotherapy: Practice Makes Imperfect, 62
Diathesis—Stress and Biopsychosocial: Integrative Paradigms, 63
The Diathesis—Stress Paradigm, 63
The Biopsychosocial Paradigm, 64
Cultural Considerations, 68
J. Brett Barkley: A Question of Culture?, 68
Mental Health Implications of Cultural Diversity in Canada, 71
Summary, 75
Chapter 3. Classification and Diagnosis, 78
A Brief History of Classification, 79
Early Efforts at Classification, 79
Development of the WHO and DSM Systems, 79
The Diagnostic System of the American Psychiatric Association (DSM-IV AND DSM-IV-TR), 80
Definition of Mental Disorder, 80
Five Dimensions of Classification, 80
Diagnostic Categories, 81
Issues in the Classification of Abnormal Behaviour, 91
General Criticisms of Classification, 91
The Value of Classification and Diagnoses, 92
Specific Criticisms of Classification, 92
Reliability: The Cornerstone of a Diagnostic System, 93
How Valid Are Diagnostic Categories?, 93
The DSM and Criticisms of Diagnosis, 94
Summary, 98
Chapter 4. Clinical Assessment Procedures, 99
Reliability and Validity in Assessment, 100
Reliability, 100
Validity, 100
Psychological Assessment, 101
Clinical Interviews, 101
Psychological Tests, 104
Behavioural and Cognitive Assessment, 109
Specialized Approaches to Cognitive Assessment, 113
Family Assessment, 115
Biological Assessment, 118
Brain Imaging: “Seeing” the Brain, 118
Neurochemical Assessment, 120
Neuropsychological Assessment, 120
Psychophysiological Assessment, 122
A Cautionary Note, 123
Cultural Diversity and Clinical Assessment, 125
Cultural Bias in Assessment, 125
Strategies for Avoiding Cultural Bias in Assessment, 127
Summary, 130
Chapter 5. Research Methods in the Study of Abnormal Behaviour, 132
Science and Scientific Methods, 133
Testability and Replicability, 133
The Role of Theory, 133
The Research Methods of Abnormal Psychology, 134
The Case Study, 134
Epidemiological Research, 137
The Correlational Method, 140
The Experiment, 143
Single-Subject Experimental Research, 147
Mixed Designs, 149
Summary, 152
Chapter 6. Anxiety Disorders, 154
Phobias, 156
Specific Phobias, 157
Social Phobias, 157
Etiology of Phobias, 158
Therapies for Phobias, 161
Panic Disorder, 164
Etiology of Panic Disorder, 167
Therapies for Panic Disorder and Agoraphobia, 170
Generalized Anxiety Disorder, 171
Etiology of Generalized Anxiety Disorder, 172
Therapies for Generalized Anxiety Disorder, 173
Obsessive-Compulsive Disorder, 174
Etiology of Obsessive-Compulsive Disorder, 176
Therapies for Obsessive-Compulsive Disorder, 178
Post-Traumatic Stress Disorder, 180
Etiology of Post-traumatic Stress Disorder, 184
Therapies for Post-traumatic Stress Disorder, 185
Summary, 191
Chapter 7. Somatoform and Dissociative Disorders, 193
Somatoform Disorders, 194
Conversion Disorder, 196
Somatization Disorder, 199
Etiology of Somatoform Disorders, 199
Therapies for Somatoform Disorders, 202
Dissociative Disorders, 204
Dissociative Amnesia, 205
Dissociative Fugue, 206
Depersonalization Disorder, 207
Dissociative Identity Disorder, 208
Etiology of Dissociative Disorders, 209
Therapies for Dissociative Disorders, 212
Summary, 217
Chapter 8. Psychophysiological Disorders and Health Psychology, 219
Stress and Health, 221
Defining the Concept of Stress, 221
Efforts to Measure Stress, 225
Assessing Coping, 227
Moderators of the Stress-Illness Link, 229
Theories of the Stress-Illness Link, 230
Biological Theories, 231
Psychological Theories, 233
Cardiovascular Disorders, 235
Essential Hypertension, 235
Coronary Heart Disease, 238
Socio-Economic Status, Ethnicity, and Health, 241
Therapies for Psychophysiological Disorders, 242
Treating Hypertension and Reducing CHD Risk, 242
Biofeedback, 243
Changing Type A Behaviour, 244
Cardiac Rehabilitation Efforts, 244
Stress Management, 247
The Management of Pain, 248
Summary, 252
Chapter 9. Eating Disorders, 254
Clinical Description, 256
Anorexia Nervosa, 256
Bulimia Nervosa, 259
Binge Eating Disorder, 260
Etiology of Eating Disorders, 261
Biological Factors, 262
Socio-cultural Variables, 263
Gender Influences, 265
Cross-Cultural Studies, 266
Psychodynamic Views, 267
Family Systems Theory, 267
Characteristics of Families, 268
Child Abuse and Eating Disorders, 268
Personality and Eating Disorders, 268
Cognitive-Behavioural Views, 270
Treatment of Eating Disorders, 271
Biological Treatments, 271
Psychological Treatment of Anorexia Nervosa, 272
Psychological Treatment of Bulimia Nervosa, 273
Summary, 278
Chapter 10. Mood Disorders, 280
General Characteristics of Mood Disorders, 281
Depression: Signs and Symptoms, 281
Mania: Signs and Symptoms, 281
Formal Diagnostic Listings of Mood Disorders, 282
Heterogeneity within the Categories, 287
Chronic Mood Disorders, 290
Psychological Theories of Mood Disorders, 290
Psychoanalytic Theory of Depression, 290
Cognitive Theories of Depression, 291
Interpersonal Theory of Depression, 298
Psychological Theories of Bipolar Disorder, 299
Biological Theories of Mood Disorders, 299
The Genetic Data, 299
Neurochemistry, Neuroimaging, and Mood Disorders, 300
The Neuroendocrine System, 302
Therapies for Mood Disorders, 302
Psychological Therapies, 302
Biological Therapies, 306
Suicide, 310
Epidemiology and Facts about Suicide in Canada, 311
Suicide and Psychological Disorders, 312
Perspectives on Suicide, 313
Preventing Suicide, 318
Clinical and Ethical Issues in Dealing with Suicide, 320
Treating the Suicidal Person, 321
Summary, 322
Chapter 11. Schizophrenia, 324
Clinical Symptoms of Schizophrenia, 326
Positive Symptoms, 327
Negative Symptoms, 329
Other Symptoms, 330
History of the Concept of Schizophrenia, 331
Early Descriptions, 331
The Historical Prevalence of Schizophrenia, 332
The DSM-IV-TR Diagnosis, 332
Categories of Schizophrenia in DSM-IV-TR, 333
Etiology of Schizophrenia, 335
The Genetic Data, 335
Biochemical Factors, 338
Schizophrenia and the Brain: Structure and Function, 341
Psychological Stress and Schizophrenia, 344
Developmental/High-Risk Studies of Schizophrenia, 346
Therapies for Schizophrenia, 347
Biological Treatments, 349
Psychological Treatments, 355
Case Management/Assertive Community Treatment, 358
General Trends in Treatment, 358
Further Issues in the Care of People with Schizophrenia, 361
Summary, 365
Chapter 12. Substance-Related Disorders, 367
Alcohol Abuse and Dependence, 368
Prevalence of Alcohol Abuse and Comorbidity with Other Disorders, 370
Course of the Disorder, 372
Costs of Alcohol Abuse and Dependence, 372
Short-Term Effects of Alcohol, 373
Long-Term Effects of Prolonged Alcohol Abuse, 374
Inhalant Use Disorders, 375
Nicotine and Cigarette Smoking, 375
Prevalence and Health Consequences of Smoking, 376
Consequences of Second-Hand Smoke, 377
Marijuana, 378
Effects of Marijuana, 378
Sedatives and Stimulants, 381
Sedatives, 381
Stimulants, 383
LSD and Other Hallucinogens, 385
Effects of Hallucinogens, 386
Etiology of Substance Abuse and Dependence, 386
Social Variables, 387
Psychological Variables, 388
Biological Variables, 391
Therapy for Alcohol Abuse and Dependence, 392
Admitting the Problem, 393
Traditional Hospital Treatment, 393
Biological Treatments, 393
Alcoholics Anonymous, 394
Couples and Family Therapy, 396
Cognitive and Behavioural Treatment, 396
Clinical Considerations in Treating Alcohol Abuse, 398
Therapy for the Use of Illicit Drugs, 402
Biological Treatments, 402
Psychological Treatments, 403
Treatment of Cigarette Smoking, 404
Biological Treatments, 404
Psychological Treatments, 406
Relapse Prevention, 406
Prevention of Substance Abuse, 407
Summary, 408
Chapter 13. Personality Disorders, 410
Classifying Personality Disorders: Clusters, Categories, and Problems, 411
Assessing Personality Disorders, 413
Personality Disorder Clusters, 414
Odd/Eccentric Cluster, 414
Paranoid Personality Disorder, 414
Schizoid Personality Disorder, 415
Schizotypal Personality Disorder, 415
Etiology of the Odd/Eccentric Cluster, 415
Dramatic/Erratic Cluster, 415
Borderline Personality Disorder, 416
Histrionic Personality Disorder, 418
Narcissistic Personality Disorder, 419
Anti-social Personality Disorder and Psychopathy, 421
Anxious/Fearful Cluster, 426
Avoidant Personality Disorder, 426
Dependent Personality Disorder, 427
Obsessive-Compulsive Personality Disorder, 427
Etiology of the Anxious/Fearful Cluster, 429
Therapies for Personality Disorders, 429
Therapy for the Borderline Personality, 430
Therapy for Psychopathy, 432
Summary, 435
Chapter 14. Sexual and Gender Identity Disorders, 438
Gender Identity Disorder, 439
Characteristics of Gender Identity Disorder, 439
Causes of Gender Identity Disorder, 441
Therapies for Gender Identity Disorder, 443
The Paraphilias, 446
Fetishism, 446
Transvestic Fetishism, 446
Pedophilia and Incest, 447
Voyeurism, 453
Exhibitionism, 453
Frotteurism, 454
Sexual Sadism and Sexual Masochism, 454
Paraphilias Not Otherwise Specified, 455
Etiology of the Paraphilias, 455
Therapies for the Paraphilias, 456
Rape, 458
The Crime, 458
The Victim, the Attack, and the Aftermath, 459
The Rapist, 459
Therapy for Rapists and Rape Victims, 460
Sexual Dysfunctions, 462
Sexual Dysfunctions and the Human Sexual Response Cycle, 463
Descriptions and Etiology of Sexual Dysfunctions, 464
General Theories of Sexual Dysfunctions, 467
Therapies for Sexual Dysfunctions, 469
Summary, 472
Chapter 15. Disorders of Childhood, 475
Classification of Childhood Disorders, 477
Disorders of Undercontrolled Behaviour, 479
Attention-Deficit/Hyperactivity Disorder, 479
Conduct Disorder, 486
Learning Disabilities, 494
Learning Disorders, 495
Communication Disorders, 495
Motor Skills Disorder, 496
Etiology of Learning Disabilities, 496
Treatment of Learning Disabilities, 497
Mental Retardation, 497
Traditional Criteria for Mental Retardation, 498
Classification of Mental Retardation, 499
The Approach of the American Association of Mental Retardation, 499
Etiology of Mental Retardation, 500
Prevention and Treatment of Mental Retardation, 502
Autistic Disorder, 506
Characteristics of Autistic Disorder, 506
Etiology of Autistic Disorder, 510
Treatment of Autistic Disorder, 512
Disorders of Overcontrolled Behaviour, 515
Childhood Fears and Anxiety Disorders, 515
Separation Anxiety, 515
School Phobia, 515
Social Phobia, 517
Treatment of Childhood Fears and Phobias, 517
Depression in Childhood and Adolescence, 521
Symptoms and Prevalence of Childhood and Adolescent Depression, 521
Etiology of Depression in Childhood and Adolescence, 522
Treatment of Childhood and Adolescent Depression, 523
Summary, 525
Chapter 16. Aging and Psychological Disorders, 528
Issues, Concepts, and Methods in the Study of Older Adults, 530
Diversity in Older Adults, 530
Age, Cohort, and Time-of-Measurement Effects, 530
Diagnosing and Assessing Psychopathology in Later Life, 531
Range of Problems, 532
Old Age and Brain Disorders, 532
Dementia, 532
Delirium, 539
Old Age and Psychological Disorders, 540
Overall Prevalence of Mental Disorders in Late Life, 540
Depression, 541
Anxiety Disorders, 544
Delusional (Paranoid) Disorders, 545
Schizophrenia, 546
Substance-Related Disorders, 547
Hypochondriasis and Somatization, 548
Sleep Disorders, 549
Suicide, 551
Treatment and Care of Older Adults, 553
Nursing Homes, 553
Alternative Living Settings, 555
Community-Based Care, 555
Issues Specific to Therapy with Older Adults, 559
Content of Therapy, 560
Process of Therapy, 560
Summary, 562
Chapter 17. Outcomes and Issues in Psychological Intervention, 564
General Issues in Evaluating Psychotherapy Research, 565
Therapy as Researched and Therapy as Practised, 565
The Challenge of Managed Care, 568
Review of Psychoanalytic Therapies, 571
Basic Concepts and Techniques in Classical Psychoanalysis and Its Variations, 571
Evaluation of Classical Psychoanalysis, 572
Evaluation of Brief Psychodynamic and Interpersonal Therapies, 573
Review of Client-Centred Therapy, 575
Basic Concepts and Techniques of Client-Centred Therapy, 575
Evaluation of Client-Centred Therapy, 575
Review of Gestalt Therapy, 577
Basic Concepts and Techniques of Gestalt Therapy, 577
Evaluation of Gestalt Therapy, 578
Review of Behavioural and Cognitive Therapies, 578
Evaluation of Counterconditioning and Exposure Methods, 578
Evaluation of Operant Methods, 578
Evaluation of Cognitive Behaviour Therapy, 579
Review of Couples and Family Therapy, 585
Basic Concepts and Techniques in Couples and Family Therapy, 585
The Normality of Conflict, 585
From Individual to Conjoint Therapy, 585
The Approaches to Couples and Family Therapy, 586
General Issues and Special Considerations, 589
Evaluation of Couples and Family Therapy, 590
Psychotherapy Integration, 590
Psychoanalysis and CBT: A Rapprochement?, 590
Eclecticism and Theoretical Integration in Psychotherapy, 591
Arguments Against Premature Integration, 592
An Integrative Approach: Meichenbaum’s Constructivist Cognitive-Behavioural Treatment Model, 592
Review of Community Psychology, 593
Basic Concepts and Techniques of Community Psychology, 593
Evaluation of Community Psychology, 596
Political and Ethical Factors in Community Psychology, 597
Summary, 598
Chapter 18. Legal and Ethical Issues, 600
Criminal Commitment, 601
The Not Criminally Responsible Defence, 602
Fitness to Stand Trial, 605
Civil Commitment, 606
Community Commitment: Community Treatment Orders, 609
Preventive Detention and Problems in Risk Assessment, 612
Trends Toward Greater Protection, 618
Deinstitutionalization, Civil Liberties, and Mental Health, 620
Ethical Dilemmas in Therapy and Research, 625
Ethical Restraints on Research, 625
Informed Consent, 627
Confidentiality and Privileged Communication, 628
Who Is the Client or Patient?, 628
Choice of Goals, 628
Choice of Techniques, 629
The Right to Competent Treatment, 630
The Ethical and Legal Dimensions of Recovered Memories, 631
Concluding Comment, 631
Summary, 632
Glossary, G1
References, R1
Photo Credits, PC1
Name Index, N1
Subject Index, S1

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