Abnormal Psychology PDF
Preview Abnormal Psychology
psycholoeigghth edyition THOMAS F. OLTMANNS Washington University in St. Louis ROBERT E. EMERY University of Virginia Boston Columbus Indianapolis New York San Francisco Upper Saddle River Amsterdam Cape Town Dubai London Madrid Milan Munich Paris Montréal Toronto Delhi Mexico City São Paulo Sydney Hong Kong Seoul Singapore Taipei Tokyo To Gail, Josh, Sara, Billy, Presley, Riley, and Kinley—T.F.O. To Kimberly, Maggie, Julia, Bobby, Lucy, and John—R.E.E. Editor-in-Chief: Dickson Musslewhite Procurement Manager: Mary Fischer Senior Acquisitions Editor: Amber Chow Procurement Specialist: Diane Peirano Editorial Assistant: Alex Stavrakas Interior/Cover Designer: DeMarinis Design LLC VP, Director of Marketing: Brandy Dawson Digital Media Editor: Tom Scalzo Senior Marketing Manager: Jeremy Intal Digital Media Project Manager: Pamela Weldin Marketing Assistant: Frank Alarcon Full-Service Project Management: PreMediaGlobal Director, Project Management Services: Printer/Binder: R. R. Donnelley and Sons Lisa Iarkowski Cover Printer: Lehigh-Phoenix Color/Hagerstown Senior Managing Editor: Linda Behrens Cover Image: Terry Vine/Blend Images/Getty Images Project Manager: Shelly Kupperman Text Font: Adobe Garamond Pro 10.5/13 Program Manager: Annemarie Franklin Credits and acknowledgments borrowed from other sources and reproduced, with permission, in this textbook appear on the appropriate page of appearance and on pages 561–563. Copyright © 2015, 2012, 2010 by Pearson Education, Inc. All rights reserved. Printed in the United States of America. This publication is protected by Copyright and permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or likewise. To obtain permission(s) to use material from this work, please submit a written request to Pearson Education, Inc., Permissions Department, One Lake Street, Upper Saddle River, New Jersey 07458 or you may fax your request to 201-236-3290. Library of Congress Cataloging-in-Publication Data Oltmanns, Thomas F. Abnormal psychology \ Thomas F. Oltmanns, Washington University in St. Louis, Robert E. Emery, University of Virginia.—Eighth edition. pages cm ISBN 978-0-205-97074-2 1. Psychology, Pathological. 2. Mental illness. I. Emery, Robert E. II. Title. RC454.O44 2014 616.89—dc23 2013037915 10 9 8 7 6 5 4 3 2 1 Student Edition ISBN-10: 0-205-97074-5 ISBN-13: 978-0-205-97074-2 Books à la Carte ISBN-10: 0-205-97106-7 ISBN-13: 978-0-205-97106-0 brief 1 Examples and Definitions of Abnormal Behavior 1 2 Causes of Abnormal Behavior 24 3 Treatment of Psychological Disorders 52 4 Classification and Assessment of Abnormal Behavior 77 5 Mood Disorders and Suicide 105 6 Anxiety Disorders and Obsessive-Compulsive Disorder 143 7 Acute and Posttraumatic Stress Disorders, Dissociative Disorders, and Somatic Symptom Disorders 174 8 Stress and Physical Health 206 9 Personality Disorders 231 10 Feeding and Eating Disorders 262 11 Substance-Related and Addictive Disorders 284 12 Sexual Dysfunctions, Paraphilic Disorders, and Gender Dysphoria 318 13 Schizophrenia Spectrum and Other Psychotic Disorders 348 14 Neurocognitive Disorders 379 15 Intellectual Disabilities and Autism Spectrum Disorders 404 16 Psychological Disorders of Childhood 435 17 Adjustment Disorders and Life-Cycle Transitions 465 18 Mental Health and the Law 489 iii brief Preface xii About the Authors xix 1 Examples and Definitions Systems Theory 31 of Abnormal Behavior 1 Holism 31 Causality 31 Overview 2 RESEARCH methods: 33 Recognizing the Presence of a Disorder 4 Correlations: Does a Psychology Major Make You Smarter? 33 Developmental Psychopathology 33 Defining Abnormal Behavior 5 Biological Factors 34 Harmful Dysfunction 6 The Neuron and Neurotransmitters 34 Mental Health Versus Absence of Disorder 7 Neurotransmitters and Psychopathology 35 Culture and Diagnostic Practice 7 Mind–Body Dualism 35 THINKING CRITICALLY about DSM-5: Revising an Imperfect Manual 7 Major Brain Structures 36 Cerebral Hemispheres 38 CRITICAL THINKING matters: Is Sexual Addiction a Meaningful Concept? 9 Psychophysiology 38 Behavior Genetics 39 Who Experiences Abnormal Behavior? 10 Frequency in and Impact on Community Populations 11 Psychological Factors 42 Cross-Cultural Comparisons 13 Human Nature 42 The Mental Health Professions 14 CRITICAL THINKING matters: Do Vaccinations Cause Autism? 43 Psychopathology in Historical Context 15 Temperament 44 The Greek Tradition in Medicine 15 Emotions 45 The Creation of the Asylum 16 Learning and Cognition 45 Worcester Lunatic Hospital: A Model Institution 16 The Sense of Self 46 Lessons from the History of Psychopathology 17 Stages of Development 46 Methods for the Scientific Study of Mental Disorders 18 Social Factors 48 The Uses and Limitations of Case Studies 18 Close Relationships 48 RESEARCH methods: Gender and Gender Roles 48 Who Must Provide Scientific Evidence? 19 Prejudice, Poverty, and Society 49 Clinical Research Methods 20 getting HELP 50 getting HELP 21 summary 50 the big picture 51 key terms 51 summary 21 the big picture 22 key terms 23 3 Treatment of Psychological 2 Causes of Abnormal Disorders 52 Behavior 24 Overview 53 Overview 25 Four Views of Frances 54 Brief Historical Perspective 26 Biological Treatments 55 The Biological Paradigm 26 Psychopharmacology 55 The Psychodynamic Paradigm 27 THINKING CRITICALLY about DSM-5: THINKING CRITICALLY about DSM-5: Diagnosis and Treatment 56 Diagnosis and Causes of Mental Disorders 28 Electroconvulsive Therapy 57 The Cognitive-Behavioral Paradigm 29 Psychosurgery 58 The Humanistic Paradigm 30 Psychodynamic Psychotherapies 58 The Problem with Paradigms 30 Freudian Psychoanalysis 58 iv Ego Analysis 60 Validity 86 Psychodynamic Psychotherapy 60 THINKING CRITICALLY about DSM-5: Scientific Progress or Diagnostic Fads? 87 Cognitive-Behavior Therapy 60 Problems and Limitations of the DSM-5 System 88 Systematic Desensitization 61 Other Exposure Therapies 61 Basic Issues in Assessment 90 Aversion Therapy 61 Purposes of Clinical Assessment 90 Contingency Management 61 Assumptions About Consistency of Behavior 91 RESEARCH methods: Evaluating the Usefulness of Assessment Procedures 91 The Experiment: Does Treatment Cause Improvement? 62 CRITICAL THINKING matters: Social Skills Training 63 The Barnum Effect and Assessment Feedback 92 Cognitive Techniques 63 Psychological Assessment Procedures 92 Beck’s Cognitive Therapy 63 Interviews 92 Rational–Emotive Therapy 63 Observational Procedures 94 “Third-Wave” CBT 64 Personality Tests and Self-Report Inventories 96 Humanistic Therapies 64 Projective Personality Tests 99 Client-Centered Therapy 64 Biological Assessment Procedures 100 A Means, Not an End? 64 Brain Imaging Techniques 100 Research on Psychotherapy 65 getting HELP 102 Does Psychotherapy Work? 65 summary 103 the big picture 103 key terms 104 CRITICAL THINKING matters: Are All Therapies Created Equal? 66 The Allegiance Effect 68 Psychotherapy Process Research 69 5 Mood Disorders Ethnic Minorities in Psychotherapy 70 and Suicide 105 Couple, Family, and Group Therapy 72 Overview 106 Couple Therapy 72 Family Therapy 73 Symptoms 109 Group Therapy 73 Emotional Symptoms 109 Prevention 74 Cognitive Symptoms 110 Somatic Symptoms 110 Specific Treatments for Specific Disorders 74 Behavioral Symptoms 111 getting HELP 75 Other Problems Commonly Associated with Depression 111 summary 75 the big picture 76 key terms 76 Diagnosis 111 THINKING CRITICALLY about DSM-5: 4 Classification and Assessment Depression or Grief Following a Major Loss? 112 of Abnormal Behavior 77 Criteria for Major Depressive Episode 113 Criteria for Diagnosis of Manic Episode 114 Overview 78 Course and Outcome 116 Basic Issues in Classification 80 Depressive Disorders 116 Categories Versus Dimensions 80 Bipolar Disorders 116 From Description to Theory 80 Frequency 117 Classifying Abnormal Behavior 81 Incidence and Prevalence 117 The DSM-5 System 81 Risk for Mood Disorders Across the Life Span 117 Labels and Stigma 82 Gender Differences 118 Criteria for Obsessive-Compulsive Disorder 83 Cross-Cultural Differences 118 Culture and Classification 83 Causes 119 Evaluating Classification Systems 85 Social Factors 119 Reliability 85 Psychological Factors 121 RESEARCH methods: Biological Factors 122 Reliability: Agreement Regarding Diagnostic Decisions 85 Integration of Social, Psychological, and Biological Factors 127 CONTENTS v RESEARCH methods: Obsessive-Compulsive and Related Disorders 162 Analogue Studies: Do Rats Get Depressed, and Why? 127 Symptoms of OCD 163 Treatment 128 Diagnosis of OCD and Related Disorders 165 Depressive Disorders 128 Course and Outcome of OCD 167 Cognitive Therapy 128 Frequency of OCD and Related Disorders 168 Bipolar Disorders 130 Causes of OCD 168 CRITICAL THINKING matters: Treatment of OCD 169 Do Antidepressant Drugs Cause Violent Behavior? 131 CRITICAL THINKING matters: Electroconvulsive Therapy 132 Can a Strep Infection Trigger OCD in Children? 169 Seasonal Mood Disorders 132 getting HELP 171 Suicide 132 summary 171 the big picture 172 key terms 172 Classification of Suicide 133 Frequency of Suicide 135 Causes of Suicide 136 Acute and Posttraumatic Stress Common Elements of Suicide 137 7 Disorders, Dissociative Treatment of Suicidal People 138 Disorders, and Somatic getting HELP 139 Symptom Disorders 174 summary 140 the big picture 141 key terms 141 Overview 175 Anxiety Disorders and 6 Acute and Posttraumatic Stress Disorders 175 Obsessive-Compulsive Symptoms of ASD and PTSD 176 Disorder 143 Diagnosis of ASD and PTSD 177 Criteria for Posttraumatic Stress Disorder 178 Overview 144 Criteria for Acute Stress Disorder 179 Symptoms of Anxiety Disorders 145 The Trauma of Sexual Assault 180 Anxiety 145 Frequency of Trauma, PTSD, and ASD 181 Excessive Worry 146 Causes of PTSD and ASD 182 Panic Attacks 147 Prevention and Treatment of ASD and PTSD 184 Phobias 147 Dissociative Disorders 186 Diagnosis of Anxiety Disorders 147 Hysteria and the Unconscious 187 Criteria for Panic Disorder 148 CRITICAL THINKING matters: THINKING CRITICALLY about DSM-5: Recovered Memories? 188 Splitting Up the Anxiety Disorders 149 Symptoms of Dissociative Disorders 189 Course and Outcome 150 Diagnosis of Dissociative Disorders 190 Frequency of Anxiety Disorders 151 Frequency of Dissociative Disorders 192 Prevalence 151 THINKING CRITICALLY about DSM-5: Comorbidity 151 More on Diagnostic Fads 192 Gender Differences 151 Causes of Dissociative Disorders 194 Anxiety Disorders Across the Life Span 151 RESEARCH methods: Cross-Cultural Comparisons 152 Retrospective Reports: Remembering the Past 195 Treatment of Dissociative Disorders 196 Causes of Anxiety Disorders 152 Adaptive and Maladaptive Fears 152 Somatic Symptom Disorders 196 Social Factors 153 Symptoms of Somatic Symptom Disorders 196 Psychological Factors 154 Diagnosis of Somatic Symptom Disorders 197 Biological Factors 156 Criteria for Illness Anxiety Disorder 198 Frequency of Somatic Symptom Disorders 199 Treatment of Anxiety Disorders 158 Causes of Somatic Symptom Disorders 200 Psychological Interventions 158 Treatment of Somatic Symptom Disorders 202 Biological Interventions 160 getting HELP 203 RESEARCH methods: Statistical Significance: When Differences Matter 161 summary 204 the big picture 204 key terms 205 vi CONTENTS CRITICAL THINKING matters: 8 Stress and Physical Can Personality Disorders Be Adaptive? 238 Health 206 Cluster B: Antisocial, Borderline, Histrionic, and Narcissistic Personality Disorders 239 Overview 207 Cluster C: Avoidant, Dependent, and Obsessive-Compulsive Personality Disorders 241 Defining Stress 208 A Dimensional Perspective on Personality Disorders 241 Stress as a Life Event 209 THINKING CRITICALLY about DSM-5: Stress as Appraisal of Life Events 210 Is a Dimensional Model Too Complicated? 243 Symptoms of Stress 210 Frequency 245 Tend and Befriend: The Female Prevalence in Community and Clinical Samples 245 Stress Response? 211 Gender Differences 246 Psychophysiological Responses to Stress 211 Stability of Personality Disorders over Time 246 Coping 213 Culture and Personality 247 Health Behavior 214 RESEARCH methods: CRITICAL THINKING matters: Cross-Cultural Comparisons: The Importance Resilience 214 of Context 248 Illness as a Cause of Stress 217 Schizotypal Personality Disorder (SPD) 249 Diagnosis of Stress and Physical Illness 217 Symptoms 249 THINKING CRITICALLY about DSM-5: Criteria for Schizotypal Personality Disorder 250 Is the Descriptive Approach Too Literal Sometimes? 217 Causes 250 Treatment 250 Psychological Factors and Some Familiar Illnesses 218 Cancer 218 Borderline Personality Disorder (BPD) 251 Criteria for Psychological Factors Affecting Impulse Control Disorders 252 Other Medical Conditions 218 Symptoms 252 Acquired Immune Deficiency Syndrome (AIDS) 219 Criteria for Borderline Personality Disorder 253 Pain Disorder 220 Causes 253 Sleep-Wake Disorders 220 Treatment 254 Cardiovascular Disease 221 Antisocial Personality Disorder (ASPD) 255 Symptoms of CVD 222 Symptoms 256 Diagnosis of CVD 222 Criteria for Antisocial Personality Disorder 256 Frequency of CVD 222 Causes 257 Causes of CVD 222 Treatment 259 RESEARCH methods: getting HELP 259 Longitudinal Studies: Lives over Time 223 summary 260 the big picture 261 key terms 261 Prevention and Treatment of CVD 226 getting HELP 228 summary 229 the big picture 229 key terms 230 10 Feeding and Eating Disorders 262 9 Personality Disorders 231 Overview 263 Eating Disorders in Males 264 Overview 232 Symptoms of Anorexia 265 Symptoms 234 Significantly Low Weight 265 Social Motivation 234 Fear of Gaining Weight 266 Cognitive Perspectives Regarding Self and Others 235 Disturbance in Experiencing Weight or Shape 266 Temperament and Personality Traits 235 Amenorrhea 266 Context and Personality 237 Medical Complications 266 Diagnosis 237 Struggle for Control 266 Cluster A: Paranoid, Schizoid, and Schizotypal Personality Disorders 238 Comorbid Psychological Disorders 266 CONTENTS vii Symptoms of Bulimia 267 DSM-5 296 Binge Eating 268 Course and Outcome 297 Inappropriate Compensatory Behavior 268 Criteria for Alcohol Use Disorder 297 Excessive Emphasis on Weight and Shape 268 Other Disorders Commonly Associated with Addictions 298 Comorbid Psychological Disorders 269 Frequency 298 Medical Complications 269 Prevalence of Alcohol Use Disorder 299 Diagnosis of Feeding and Eating Disorders 269 Prevalence of Drug and Nicotine Use Disorders 300 THINKING CRITICALLY about DSM-5: Risk for Addiction Across the Life Span 301 Is Binge Eating a Mental Disorder? Is Obesity? 269 CRITICAL THINKING matters: Criteria for Anorexia Nervosa 270 Should Tobacco Products Be Illegal? 301 Criteria for Bulimia Nervosa 271 Causes 302 Frequency of Anorexia and Bulimia 271 Social Factors 302 Standards of Beauty 272 Biological Factors 303 CRITICAL THINKING matters: Psychological Factors 306 The Pressure to Be Thin 273 Integrated Systems 307 Age of Onset 273 RESEARCH methods: Causes of Anorexia and Bulimia 274 Studies of People at Risk for Disorders 307 Social Factors 274 Treatment 308 Psychological Factors 275 Detoxification 308 Biological Factors 277 Medications During Remission 308 Integration and Alternative Pathways 277 Self-Help Groups: Alcoholics Anonymous 309 Treatment of Anorexia 278 Cognitive Behavior Therapy 310 Outcome Results and General Conclusions 311 Course and Outcome of Anorexia Nervosa 278 Gambling Disorder 312 Treatment of Bulimia 279 Cognitive Behavior Therapy 279 THINKING CRITICALLY about DSM-5: Is Pathological Gambling an Addiction? 312 Interpersonal Psychotherapy 279 Symptoms 313 Antidepressant Medications 279 Diagnosis 314 RESEARCH methods: Psychotherapy Placebos 280 Frequency 314 Course and Outcome of Bulimia Nervosa 280 getting HELP 315 Prevention of Eating Disorders 280 summary 315 the big picture 316 key terms 317 getting HELP 282 summary 282 the big picture 283 key terms 283 Sexual Dysfunctions, Paraphilic 12 Disorders, and Gender Dysphoria 318 11 Substance-Related Overview 319 and Addictive Disorders 284 Brief Historical Perspective 321 Sexual Dysfunctions 321 Overview 285 Symptoms 321 Symptoms 287 Diagnosis 323 Alcohol 289 RESEARCH methods: Tobacco 290 Hypothetical Constructs: What Is Sexual Arousal? 325 Amphetamine and Cocaine 291 Frequency 327 Opiates 292 Causes 328 Sedatives, Hypnotics, and Anxiolytics 293 Treatment 330 Cannabis 294 CRITICAL THINKING matters: Hallucinogens and Related Drugs 294 Does Medication Cure Sexual Dysfunction? 332 Diagnosis 295 Paraphilic Disorders 332 Brief History of Legal and Illegal Substances 295 Symptoms 333 viii CONTENTS Diagnosis 333 getting HELP 376 THINKING CRITICALLY about DSM-5: summary 377 the big picture 378 key terms 378 Two Sexual Problems That Did Not Become New Mental Disorders 339 14 Neurocognitive Disorders 379 Frequency 340 Causes 340 Treatment 341 Overview 380 Gender Dysphoria 343 Symptoms 383 Symptoms 343 Delirium 383 Frequency 344 Criteria for Delirium 383 Causes 344 Major Neurocognitive Disorder 384 Treatment 345 Memory Changes in Normal Aging 385 getting HELP 345 Diagnosis 388 summary 346 the big picture 346 key terms 347 Brief Historical Perspective 388 Specific Types of Neurocognitive Disorder 389 Criteria for Major Neurocognitive Disorder 389 13 Schizophrenia Spectrum and CRITICAL THINKING matters: Other Psychotic Disorders 348 How Can Clinicians Establish an Early Diagnosis of Alzheimer’s Disease? 390 Overview 349 Frequency of Delirium and Major Symptoms 351 Neurocognitive Disorders 394 Positive Symptoms 352 Prevalence of Dementia 394 Negative Symptoms 353 RESEARCH methods: First-Person Account of Delusional Beliefs 353 Finding Genes That Cause Behavioral Problems 395 Disorganization 354 Prevalence by Subtypes of Neurocognitive Disorder 396 Cross-Cultural Comparisons 396 Diagnosis 355 Causes 396 DSM-5 355 Criteria for Schizophrenia 356 Delirium 396 Subtypes 356 Neurocognitive Disorder 396 CRITICAL THINKING matters: Treatment and Management 399 Why Were the Symptom-Based Subtypes Medication 399 of Schizophrenia Dropped from DSM-5? 357 THINKING CRITICALLY about DSM-5: Related Psychotic Disorders 357 Will Patients and Their Families Understand Course and Outcome 358 “Mild” Neurocognitive Disorder? 400 Frequency 359 Environmental and Behavioral Management 401 Support for Caregivers 401 Gender Differences 359 Cross-Cultural Comparisons 360 getting HELP 402 Causes 360 summary 402 the big picture 403 key terms 403 Biological Factors 360 Social Factors 366 15 Intellectual Disabilities and Psychological Factors 367 Autism Spectrum Disorders 404 RESEARCH methods: Comparison Groups: What Is Normal? 369 Overview 405 Interaction of Biological and Environmental Factors 369 Intellectual Disabilities 405 The Search for Markers of Vulnerability 370 Symptoms of Intellectual Disabilities 407 THINKING CRITICALLY about DSM-5: Criteria for Intellectual Disability (Intellectual Attenuated Psychosis Syndrome Reflects Wishful Developmental Disorder) 407 Rather Than Critical Thinking 370 RESEARCH methods: Treatment 372 Central Tendency and Variability: What Do IQ Scores Mean? 408 Antipsychotic Medication 372 Diagnosis of Intellectual Disabilities 410 Psychosocial Treatment 374 Frequency of Intellectual Disabilities 411 CONTENTS ix
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