Abnormal & Clinical Psychology

525 Pages·2007·3.747 MB·525 p.\525

by  Paul Bennett

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Abnormal and
Abnormal and Clinical Psychology
An Introductory Textbook
Second Edition A Clinical Psychology
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(cid:2) What are the causes of mental health problems?
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(cid:2) What are the best treatments for mental health problems?
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(cid:2) How do the experiences of people with mental health problems compare with
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the academic models of disorders?
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An Introductory Textbook
Building on the success of the first edition, this textbook has been extensively
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updated to include the latest research and therapeutic approaches as well as
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developments in clinical practice.
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This book now contains:
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(cid:2) Expanded coverage of the aetiology of conditions

(cid:2) Assessment of the DSM-IV diagnostic criteria C
(cid:2) Analysis of cross-cultural issues
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(cid:2) Case studies that include patient perspectives i
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(cid:2) A new chapter on somatoform disorders
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(cid:2) Improved pedagogy such as research boxes and thinking about features that c
encourage readers to think critically about what they are learning a
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The book maintains the structure of the first edition with two main sections: the
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first introduces and critically evaluates the conceptual models of mental health
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problems and their treatment; the second contains in-depth analyses of a variety
of disorders such as schizophrenia, trauma-related conditions and addictions. In y
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the second section, chapters are now restructured to give a comprehensive
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aetiology of the disorder as well as analysis of treatments for the condition. Each
disorder is viewed from psychological, social, and biological perspectives and o
different intervention types are investigated. l
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Abnormal and Clinical Psychology provides the most comprehensive European
alternative to the long-established US texts for undergraduates in this field. y

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Paul Bennett is Professor of Psychology at Cardiff University and also works as
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a clinical psychologist. He has authored a number of books including Introduction u
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to Clinical Health Psychology (Open University Press, 2000). B
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Cover design: Fielding Design Second
ISBN 0-335-21943-8
Edition
9 780335 219438
Second Edition Paul Bennett
Cyan Magenta Yellow Black
Abnormal and Clinical Psychology
SECOND EDITION

Abnormal and
Clinical Psychology
AN INTRODUCTORY TEXTBOOK
SECOND EDITION
Paul Bennett

Open University Press
Open University Press
McGraw-Hill Education
McGraw-Hill House
Shoppenhangers Road
Maidenhead
Berkshire
England
SL6 2QL
email: [email protected]
world wide web: www.openup.co.uk
and Two Penn Plaza, New York, NY 10121–2289, USA
First edition published 2003
Reprinted 2005
Copyright © Paul Bennett 2006
All rights reserved. Except for the quotation of short passages for the
purposes of criticism and review, no part of this publication may be
reproduced, stored in a retrieval system, or transmitted, in any form or by
any means, electronic, mechanical, photocopying, recording or otherwise,
without the prior permission of the publisher or a licence from the
Copyright Licensing Agency Limited. Details of such licences (for
reprographic reproduction) may be obtained from the Copyright Licensing
Agency Ltd of 90 Tottenham Court Road, London, W1T 4LP.
A catalogue record of this book is available from the British Library
ISBN10: 0 335 21943 8 (pb)
ISBN13: 978 0 335 21943 8 (pb)
Library of Congress Cataloging-in-Publication Data
CIP data applied for
Typeset by RefineCatch Limited, Bungay, Suffolk
Printed in Poland EU, by OZGraf S.A., www.polskabook.pl
Contents
Illustrations xiii
Acknowledgements xv
PART I
Background and methods 1
1 Introduction 3
Modern concepts of abnormality 3
Historical overview 5
Somatogenic and psychogenic perspectives 6
Care in the community 7
Issues of diagnosis 8
The medical model 8
Alternatives to the medical model 13
The aetiology of mental health problems 18
Genetic models 18
Biological mo dels 21
Psychological models 21
Socio-cultural models 23
Systemic models 25
Biopsychosocial models 26
Diathesis-stress model 26
Chapter summary 27
For discussion 27
Further reading 28
2 The psychological perspective 29
The psychoanalytic approach 29
Freud 29
Freud’s contemporaries and descendants 33
vi CONTENTS
The practice of psychoanalysis 34
Behavioural approaches 36
Classical conditioning 36
Operant conditioning 37
Combining classical and operant conditioning 38
Behaviour therapy 38
Classical conditioning-based interventions 39
Cognitive approaches 42
A network model of emotions 43
Cognitive behavioural therapy 44
Emerging cognitive therapies 52
Humanistic approaches 54
Models of the individual and neurosis 54
Humanistic therapy 57
How effective are the therapies? 59
Meta-analyses 59
Chapter summary 59
For discussion 60
Further reading 61
3 Biological explanations and treatments 62
The behavioural anatomy of the brain 62
Hindbrain, midbrain and forebrain 62
Cerebrum 63
The synapse 66
The neurotransmitters 67
The autonomic nervous system 68
Drug therapies 69
Treating depression 70
Treating anxiety 75
Treating schizophrenia 76
Adherence to drug treatments 77
Electroconvulsive therapy (ECT) 79
Use of ECT 79
The ECT controversy 80
Psychosurgery 81
Availability of psychosurgery 82
Post-operative effects 83
Chapter summary 84
For discussion 84
Further reading 85
4 Beyond the individual 86
Family models of mental health disorders 86
Systemic therapy 87
How effective is systemic therapy? 91
CONTENTS vii
Psychosocial explanations of mental health problems 93
Socio-economic status 93
Gender differences 95
Minority status 96
Wider cross-cultural issues 97
Presentation of problems 98
Help seeking 102
Treatment 102
Psychological therapy across cultures 103
Preventing mental health problems 104
Health promotion 104
Therapeutic interventions 104
Psychosocial interventions 104
Using the media 106
Public education 106
Organizational interventions 107
Chapter summary 108
For discussion 109
Further reading 109
PART II
Specific issues 111
5 Somatoform disorders 113
Somatization disorder 113
Prevalence 114
Aetiology of somatization disorder 116
Treatment of somatization disorder 119
Hypochondriasis 119
Prevalence of hypochondriasis 120
Aetiology of hypochondriasis 120

Treatment of hypochondriasis 123
Body dysmorphic disorder 124
Aetiology of body dysmorphic disorder 128
Psychological treatment 131
Conversion disorder (hysteria) 131
Aetiology of conversion disorder 133
Treatment of conversion disorder 137
Chapter summary 138
For discussion 139
Further reading 140
6 Schizophrenia 141
The nature of schizophrenia 141
Personal experiences 142
viii CONTENTS
DSM diagnostic criteria for schizophrenia 143
Alternative view of the symptoms 144
Deconstructing schizophrenia 145
Aetiology of schizophrenia 146
Genetic factors 146
Biological mechanisms 148
Substance abuse 151
Psychosocial factors 152
A psychobiological model 154
Psychological models 154
Treatment of schizophrenia 161
Antipsychotic medication 161
Electroconvulsive therapy 164
Psychological approaches 164
Chapter summary 167
For discussion 168
Further reading 168
7 Anxiety disorders 170
Generalized anxiety disorder 170
Aetiology of generalized anxiety disorder 171
Treatment of generalized anxiety disorder 175
Simple phobias 177
Aetiology of phobias 179
Treatment of phobias 183
Panic disorder 185
Aetiology of panic disorder 186
Treatment of panic disorder 190
Obsessive-compulsive disorder (OCD) 194
Aetiology of obsessive-compulsive disorder 196
Treatment of obsessive-compulsive disorder 199
Chapter summary 202
For discussion 204
Further reading 204
8 Mood disorders 205
Major depression 205
Aetiology of major depression 206
Treatment of major depression 212
Suicide 216
Aetiology of suicide 219
Treatment of attempted suicide 220
Seasonal affective disorder (SAD) 221
Aetiology of seasonal affective disorder 222
Treatment of seasonal affective disorder 224
Bipolar disorder 224
CONTENTS ix
Aetiology of bipolar disorder 226
Treatment of bipolar disorder 228
Chapter summary 230
For discussion 231
Further reading 232
9 Trauma-related conditions 233
Post-traumatic stress disorder (PTSD) 233
9/11 and PTSD 235
Aetiology of post-traumatic stress disorder 236
Treatment of post-traumatic stress disorder 243
Recovered memory 245
Explanations of recovered memory 246
Evidence of recovered memory 247
Overview of the evidence 250
Dissociative identity disorder (DID) 251
Aetiology of dissociative identity disorder 252
Experimental evidence 257
Treatment of dissociative identity disorder 258
Chapter summary 259
For discussion 260
Further reading 260
10 Sexual disorders 262
Sexual dysfunctions 262
Erectile dysfunction 262
Aetiology of erectile dysfunction 263
Treatment of erectile dysfunction 264
Vaginismus 265
Aetiology of vaginismus 265
Treatment of vaginismus 266
The paraphilias 266
Paedophilia 267

Aetiology of paedophilia 270
Treatment of paedophilia 273
Treatment programmes 274
Transvestic fetishism 277
Aetiology of transvestic fetishism 278
Treatment of transvestic fetishism 280
Gender identity disorder 280
Aetiology of gender identity disorder 281
Treatment of gender identity disorder 283
Chapter summary 286
For discussion 287
Further reading 288