Understanding Abnormal Behavior

640 Pages·2008·1.5 MB·English

by  David Sue

Biological Dimension
Genetics, Brain Anatomy,
Biochemical Imbalances, Central
Nervous System Functioning,
Autonomic Nervous System
Reactivity, etc.
Psychological Dimension
Sociocultural Dimension
Race, Gender, Sexual Orientation, MENTAL Personality, Cognition, Emotions,
Learning, Stress-Coping, Self-
Religion, Socioeconomic Status, DISORDER
Esteem, Self-Efficacy, Values,
Ethnicity, Culture, etc.
Developmental History, etc.
Social Dimension
Family, Relationships, Social
Support, Belonging, Love, Marital
Status, Community, etc.
Multipath Model of Mental Disorders
The multipath model describes how four major dimensions—biological,
psychological, social, and sociocultural—contribute to the development of
mental disorders. It operates under several assumptions:
• No one theoretical perspective is adequate to explain the
complexity of the human condition and the development of
mental disorders.
• There are multiple pathways and causes to any single disorder.
It is a statistical rarity to find a disorder due to only one cause.
• Not all dimensions contribute equally to a disorder.
• It is guided by the state of research and scientific findings as to
the relative merits of a proposed cause.
• The multipath model is an integrative and interactive one.
It acknowledges that factors may combine in complex and
reciprocal ways so that people exposed to the same factors may
not develop the same disorder and that different individuals
exposed to different factors may develop a similar mental
disorder.
Understanding
Abnormal
Behavior
David Sue
Western Washington University
Derald Wing Sue
Teachers College, Columbia University
Stanley Sue
University of California—Davis
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David Sue, Derald Wing Sue, Stanley Sue
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1 2 3 4 5 6 7 12 11 10 09 08
brief contents
Features xv
Preface xvi
About the Authors xxiii
1
Abnormal Behavior. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2
Models of Abnormal Behavior. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
3
Assessment and Classification of Abnormal Behavior . . . . .66
4
The Scientific Method in Abnormal Psychology . . . . . . . . . . . .93
5
Anxiety Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117
6
Dissociative Disorders and Somatoform Disorders. . . . . . . .149
7
Stress Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175
8
Personality Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .201
9
Substance-Related Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .232
10
Sexual and Gender Identity Disorders. . . . . . . . . . . . . . . . . . . . .264
11
Mood Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .303
12
Suicide. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .333
13
Schizophrenia: Diagnosis, Etiology, and Treatment. . . . . . .359
14
Cognitive Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .390
15
Disorders of Childhood and Adolescence. . . . . . . . . . . . . . . . . .412
16
Eating Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .443
17
Legal and Ethical Issues in Abnormal Psychology. . . . . . . . .474
Glossary G-1
References R-1
Credits C-1
Name Index I-1
Subject Index I-13
iii
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contents
Features xv
Preface xvi
About the Authors xxiii
1
Abnormal Behavior 2
The Concerns of Abnormal Psychology 3 Reversion to Supernatural Explanations
Describing Abnormal Behavior 3 (the Middle Ages) 17
Explaining Abnormal Behavior 4 The Rise of Humanism (the Renaissance) 19
Predicting Abnormal Behavior 4 The Reform Movement (Eighteenth and
Controlling Abnormal Behavior 5 Nineteenth Centuries) 20
Determining Abnormality 7 Causes: Early Viewpoints 21
Distress 8 The Biological Viewpoint 21
Deviance 8 The Psychological Viewpoint 22
Dysfunction 8 Contemporary Trends in Abnormal Psychology 23
Dangerousness 9 The Drug Revolution in Psychiatry 23
Contextual and Cultural Limitations The Push by Psychologists for Prescription
in Defining Abnormal Behavior 9 Privileges 24
CONTROVERSY: Is Mental Illness a Myth and a The Development of Managed Health Care 24
Political Construction? 12 An Increased Appreciation for Research 25
The Influence of Multicultural Psychology 26
The Frequency and Burden of Mental Disorders 12
CRITICAL THINKING: I Have It, Too: The Medical
Stereotypes About the Mentally Disturbed 14 Student Syndrome 28
Historical Perspectives on Abnormal Behavior 16 Implications 28
Prehistoric and Ancient Beliefs 16 Summary 29
Naturalistic Explanations (Greco-Roman Thought) 16
2
Models of Abnormal Behavior 30
One-Dimensional Models of Mental Disorders 32 Dimension Two: Psychological Factors 44
Using Models to Describe Psychopathology 33 Psychodynamic Models 44
Behavioral Models 47
A Multipath Model of Mental Disorders 34
Cognitive Models 51
Dimension One: Biological Factors 36
Humanistic and Existential Models 53
The Human Brain 37
Multipath Implications of Psychological
Biochemical Theories 38 Explanations 55
Genetic Explanations 40
Dimension Three: Social Factors 56
Biology-Based Treatment Techniques 41
Social Relational Models 56
Multipath Implications of Biological Explanations 43
v
vi
CONTENTS
Family, Couples, and Group Perspectives 56 CONTROVERSY: Problems in Using Racial and Ethnic
Social-Relational Treatment Approaches 57 Group References 60
Criticisms of Social-Relational Models 57 Criticisms of the Multicultural Model 61
CRITICAL THINKING: Applying the Models of
Dimension Four: Sociocultural Factors 58
Psychopathology 62
Gender Factors 58
Implications 64
Socioeconomic Class 59
Race/Ethnicity: Multicultural Models of Summary 65
Psychopathology 59
3
Assessment and Classification of Abnormal Behavior 66
Reliability and Validity 67 The Classification of Abnormal Behavior 83
Diagnostic and Statistical Manual of Mental
The Assessment of Abnormal Behavior 68
Disorders (DSM) 83
Observations 68
DSM-IV-TR Mental Disorders 85
Interviews 69
Evaluation of DSM Classification System 85
Psychological Tests and Inventories 71
Objections to Classification and Labeling 90
CONTROVERSY: Should the Rorschach Be Used in
Making Assessments? 74 Implications 91
Neurological Tests 80 Summary 92
The Ethics of Assessment 81
CRITICAL THINKING: Can We Accurately Assess the Status
of Members of Different Cultural Groups? 82
4
The Scientific Method in Abnormal Psychology 93
The Scientific Method in Clinical Research 96 Genetic Linkage Studies 110
CRITICAL THINKING: Attacks on Scientific Integrity 97 The Endophenotype Concept 110
Characteristics of Clinical Research 97 Other Concepts in Biological Research 111
CONTROVERSY: Repressed Memories: Issues and Epidemiological and Other Forms of Research 112
Questions 99
Ethical Issues in Research 113
Experiments 100
Implications 114
The Experimental Group 101
Summary 115
The Control Group 101
The Placebo Group 102
Additional Concerns in Clinical Research 102
Correlations 103
CRITICAL THINKING: Researcher Allegiance:
A “Wild Card” in Comparative Research 105
Analogue Studies 106
Field Studies 107
Single-Participant Studies 108
The Case Study 108
The Single-Participant Experiment 109
Biological Research Strategies 110
The Human Genome Project 110
vii
CONTENTS
5
Anxiety Disorders 117
Understanding Anxiety Disorders
from a Multipath Perspective 119
Biological Dimension 119
Psychological Dimension 122
Social and Sociocultural Dimensions 123
Phobias 124
Social Phobias 125
Specific Phobias 127
Etiology of Phobias 128
CONTROVERSY: Fear or Disgust? 129
Treatment of Phobias 131
Panic Disorder and Agoraphobia 133
Panic Disorder 133
Agoraphobia 134
Etiology of Panic Disorder and Agoraphobia 134
Treatment of Panic Disorder 136
CRITICAL THINKING: Panic Disorder Treatment:
Should We Focus on Internal Control? 138
Generalized Anxiety Disorder 138
Etiology of Generalized Anxiety Disorder 139
Treatment of Generalized Anxiety Disorder 140 Etiology of Obsessive-Compulsive Disorder 143
Treatment of Obsessive-Compulsive Disorder 146
Obsessive-Compulsive Disorder 141
Implications 147
Obsessions 142
Compulsions 142 Summary 147
6
Dissociative Disorders and Somatoform Disorders 149
Dissociative Disorders 150 CRITICAL THINKING: Factitious Disorder and Factitious
Dissociative Amnesia 150 Order by Proxy 165
Dissociative Fugue 153 Pain Disorder 167
Depersonalization Disorder 153 Hypochondriasis 167
Dissociative Identity Disorder (Multiple-Personality Body Dysmorphic Disorder 168
Disorder) 154 Etiology of Somatoform Disorders 169
CRITICAL THINKING: Culture and Somatoform and Treatment of Somatoform Disorders 172
Dissociative Disorders 156 Implications 173
Etiology of Dissociative Disorders 157
Summary 174
CONTROVERSY: “Suspect” Techniques Used to Treat
Dissociative Identity Disorder 160
Treatment of Dissociative Disorders 161
Somatoform Disorders 162
Somatization Disorder 164
Conversion Disorder 164
viii
CONTENTS
7
Stress Disorders 175
Acute and Posttraumatic Stress Disorders 176 Migraine, Tension, and Cluster Headaches 186
Diagnosis of Acute and Posttraumatic Stress Asthma 188
Disorders 176 Stress and the Immune System 190
Etiology of Acute and Posttraumatic CONTROVERSY: Can Laughter or Humor Influence the
Stress Disorders 177 Course of a Disease? 191
Biological Dimension 178 Etiology of Psychophysiological Disorders 192
Psychological Dimension 179 Biological Dimension 192
Social Dimension 180 Psychological Dimension 194
Sociocultural Dimension 180 Social Dimension 196
Treatment of Acute and Posttraumatic Sociocultural Dimension 196
Stress Disorders 181 Treatment of Psychophysiological Disorders 197
Physical Stress Disorders: Psychophysiological Relaxation Training 197
Disorders 182 Biofeedback 198
CRITICAL THINKING: The Hmong Sudden Death Cognitive-Behavioral Interventions 198
Syndrome 183 Implications 199
Characteristics of Psychophysiological Disorders 183
Summary 200
Coronary Heart Disease 183
Hypertension 184
8
Personality Disorders 201
Diagnosing Personality Disorders 203 Psychological Dimension 224
Social Dimension 225
Disorders Characterized by Odd
Sociocultural Dimension 226
or Eccentric Behaviors 205
Paranoid Personality Disorder 205 Treatment of Antisocial Personality Disorder 227
CRITICAL THINKING: Is There Gender Bias in CONTROVERSY: Impulse Control Disorders 228
Diagnosing Mental Disorders? 207
Implications 230
Schizoid Personality Disorder 208
Summary 231
Schizotypal Personality Disorder 208
Disorders Characterized by Dramatic,
Emotional, or Erratic Behaviors 210
Antisocial Personality Disorder 210
Borderline Personality Disorder 212
Histrionic Personality Disorder 215
Narcissistic Personality Disorder 216
Disorders Characterized by Anxious
or Fearful Behaviors 217
Avoidant Personality Disorder 217
Dependent Personality Disorder 218
Obsessive-Compulsive Personality Disorder 219
Multipath Analysis of One Personality
Disorder: Antisocial Personality Disorder 221
Biological Dimension 221