Essentials of Abnormal Psychology 4e Front

FM-1

www.wadsworth.com

wadsworth.com is the World Wide Web site for Wadsworth and is

your direct source to dozens of online resources.

At wadsworth.com you can find out about supplements, demonstration

software, and student resources. You can also send email to many of

our authors and preview new publications and exciting new

technologies.

wadsworth.com

Changing the way the world learns

FM-2

TH EDITION

Essentials of Abnormal Psychology

V. Mark Durand

University of South Florida St. Petersburg

David H. Barlow

Boston University

Australia • Brazil • Canada • Mexico • Singapore

Spain • United Kingdom • United States

FM-3

Essentials of Abnormal Psychology, Fourth Edition

V. Mark Durand, David H. Barlow

Senior Acquisitions Editor, Psychology: Marianne Taflinger

Development Editor: Kristin Makarewycz

Assistant Editor: Dan Moneypenny

Editorial Assistant: Lucy Faridany

Technology Project Manager: Darin Derstine

Marketing Manager: Dory Schaeffer

Marketing Assistant: Nicole Morinon

Marketing Communications Manager: Laurel Anderson

Project Manager, Editorial Production: Jennie Redwitz

Creative Director: Rob Hugel

Art Director: Vernon Boes

Print Buyer: Becky Cross

Permissions Editor: Sarah Harkrader

Production Service: Carol O’Connell, Graphic World

Publishing Services

Text Designer: Roy Neuhaus

Photo Researcher: Myrna Engler

Cover Designer: Cheryl Carrington

Cover Images: Main image: © Arno Rafael Minkkinen,

“Self-portrait, Foster’s Pond,” 1989. Courtesy of the Robert Klein

Gallery. Background image: © Bruce Heinemann/Getty Images.

FM-4

Compositor: Graphic World Inc.

Cover and Text Printer: Quebecor World/Dubuque

logo, and Wadsworth are trademarks used herein under license.

may be reproduced or used in any form or by any means—graphic, electronic, or

mechanical, including photocopying, recording, taping, Web distribution, information

storage and retrieval systems, or in any other manner—without the written permission

of the publisher.

Printed in the United States of America

1 2 3 4 5 6 7 09 08 07 06 05

ExamView

and ExamView Pro

are registered trademarks of FSCreations, Inc.

Windows is a registered trademark of the Microsoft Corporation used herein under

license. Macintosh and Power Macintosh are registered trademarks of Apple

Computer, Inc. Used herein under license.

WebTutor

is a trademark of Thomson Learning, Inc.

Library of Congress Control Number: 2005926732

Student Edition: ISBN 0-534-60575-3

Paper Edition: ISBN 0-495-03128-3

FM-5

Thomson Higher Education

10 Davis Drive

Belmont, CA 94002-3098

USA

For more information about our products, contact us at:

Thomson Learning Academic Resource Center

1-800-423-0563

For permission to use material from this text or product, submit a request online at

http://www.thomsonrights.com.

Any additional questions about permissions can be submitted by e-mail to

thomsonrights@thomson.com.

FM-6

To Wendy, for three decades of love.

V. M. D.

I dedicate this book to my mother, Doris Elinor Barlow-Lanigan,

for her multidimensional influence across my life span.

D. H. B.

FM-7

About the Authors

V. Mark Durand is known worldwide as an authority in the area of autism and

related disabilities and is currently Regional Vice Chancellor for Academic Affairs at

the University of South Florida St. Petersburg. Dr. Durand was previously the

founding Dean of Arts & Sciences. Dr. Durand is a fellow of the American

Psychological Association. He has administered more than $4 million in federal

research and training grants and currently has a 5-year federally funded project

focused on the prevention of severe behavior problems in children with disabilities.

[UNF p.vi goes here]

He taught from 1984 to 2003 at SUNY’s University at Albany. He served in a

variety of leadership positions at the University at Albany, including associate

director for clinical training for the doctoral psychology program from 1987 to 1990,

chair of the psychology department from 1995 to 1998, and interim dean of Arts and

Sciences from 2001 to 2002. He established the Center for Autism and Related

Disabilities at the University at Albany, SUNY. He received his B.A., M.A., and

Ph.D.—all in psychology—from the State University of New York–Stony Brook.

Dr. Durand was awarded the University Award for Excellence in Teaching at

SUNY–Albany in 1991 and in 1989 was named Distinguished Reviewer of the Year

for the Journal of the Association for Persons with Severe Handicaps. He has served

on various editorial boards, reviewed for numerous journals, and written more than

100 scholarly articles and book chapters on the assessment and treatment of problem

behavior. His five books include Severe Behavior Problems: A Functional

Communication Training Approach and, most recently, Sleep Better! A Guide to

Improving Sleep for Children with Special Needs.

Dr. Durand developed a unique treatment for severe behavior problems that is

FM-8

currently mandated by states across the country and is used worldwide. He also

developed an assessment tool that is used internationally and has been translated into

more than 15 languages. In 1993 he was the keynote speaker for the Australian

National Conference on Behaviour Modification; he has also lectured throughout

Norway. He has been consulted by the departments of education in numerous states

and by the U.S. Departments of Justice and Education. His current research program

includes the study of prevention models and treatments for such serious problems as

self-injurious behavior.

In his leisure time he enjoys long-distance running and is in training for his first

marathon race.

FM-9

David H. Barlow is an internationally recognized pioneer and leader in clinical

psychology. A professor at Boston University, Dr. Barlow also directs the Center for

Anxiety and Related Disorders, one of the largest research clinics of its kind in the

world. From 1979 to 1996, he was distinguished professor at the University at

Albany–State University of New York. From 1975 to 1979, he was professor of

psychiatry and psychology at Brown University, where he also founded the clinical

psychology internship program. From 1969 to 1975, he was professor of psychiatry at

the University of Mississippi, where he founded the Medical School psychology

residency program. Dr. Barlow received his B.A. from the University of Notre Dame,

his M.A. from Boston College, and his Ph.D. from the University of Vermont.

[UNF p.vii goes here]

A fellow of every major psychological association, Dr. Barlow has received many

awards in honor of his excellence in scholarship, including the National Institute of

Mental Health Merit Award for long-term contributions to the clinical research effort;

the 2000 Distinguished Scientist Award for applications of psychology from the

American Psychological Association; the Distinguished Scientist Award from the

Society of Clinical Psychology of the American Psychological Association; and a

certificate of appreciation from the APA section on the clinical psychology of women,

for “outstanding commitment to the advancement of women in psychology.” In 2004,

he received the C. Charles Burlingame Award from the Institute of Living and was

awarded an Honorary Doctorate of Humane Letters degree from the Massachusetts

School of Professional Psychology. He also received career contribution awards from

the Massachusetts, California, and Connecticut Psychological Associations and, in

2000, was named Honorary Visiting Professor at the Chinese People’s Liberation

Army General Hospital and Postgraduate Medical School. In addition, the annual

FM-10

Grand Rounds in Clinical Psychology at Brown University was named in his honor,

and he was awarded the first graduate alumni scholar award at the University of

Vermont. During the 1997–1998 academic year he was Fritz Redlich Fellow at the

Center for Advanced Study in the Behavioral Sciences in Menlo Park, California.

Dr. Barlow has served on the editorial boards of 19 different journals, published

more than 500 scholarly articles, and written 25 books, including Anxiety and Its

Disorders, 2nd edition, Guilford Press; Clinical Handbook of Psychological

Disorders: A Step-by-Step Treatment Manual, 3rd edition, Guilford Press; Single-

Case Experimental Designs: Strategies for Studying Behavior Change, 2nd edition,

Allyn & Bacon (with Michael Herson); The Scientist-Practitioner: Research and

Accountability in the Age of Managed Care, 2nd edition, Allyn & Bacon (with Steve

Hayes and Rosemery Nelson); and Mastery of Your Anxiety and Panic, Oxford

University Press (with Michelle Craske).

From 1990 to 1994, Dr. Barlow was one of three psychologists on the task force

that was responsible for reviewing the work of more than 1,000 mental health

professionals who participated in the creation of the new DSM-IV. He also chaired

the APA Task Force on Psychological Intervention Guidelines, which created a

template for clinical practice guidelines. His current research program focuses on the

nature and treatment of anxiety and related emotional disorders.

At leisure he plays golf, skis, and retreats to his home in Nantucket, where he

loves to write, walk on the beach, and visit with his island friends.

FM-11

Brief Contents

Abnormal Behavior in Historical Context 1

An Integrative Approach to Psychopathology 33

Clinical Assessment, Diagnosis, and Research Methods 73

Anxiety Disorders 123

Somatoform and Dissociative Disorders 172

Mood Disorders and Suicide 208

Physical Disorders and Health Psychology 262

Eating and Sleep Disorders 298

Sexual and Gender Identity Disorders 344

Substance-Related and Impulse-Control Disorders 386

Personality Disorders 430

Schizophrenia and Other Psychotic Disorders 470

Developmental and Cognitive Disorders 506

Mental Health Services: Legal and Ethical Issues 562

FM-12

FM-13

Contents

Preface

xix

Culture Index xxvii

Gender Index xxviii

[UNF p.xi goes here] 1

Abnormal Behavior in Historical Context 1

Understanding Psychopathology 2

Judy:

The Girl Who Fainted at the Sight of Blood 2

What Is a Psychological Disorder? 2

The Science of Psychopathology 5

Historical Conceptions of Abnormal Behavior 8

The Supernatural Tradition 8

Demons and Witches 8

Stress and Melancholy 9

Charles

VI:

The Mad King 9

Treatments for Possession 10

The Moon and the Stars 11

Comments

The Biological Tradition 11

Hippocrates and Galen 11

The 19th Century 13

The Development of Biological Treatments 14

Consequences of the Biological Tradition 14

FM-14

The Psychological Tradition 15

Moral Therapy 15

Asylum Reform and the Decline of Moral Therapy 16

Psychoanalytic Theory 17

Humanistic

Theory

The Behavioral Model 24

The Present: The Scientific Method and an Integrative Approach 28

Summary 29

Key Terms 30

Answers to Concept Checks 30

Chapter Quiz 32

[UNF p.xi goes here] 2

An Integrative Approach to Psychopathology 33

One-Dimensional or Multidimensional Models 34

What Caused Judy’s Phobia? 34

Outcome and Comments 36

Genetic Contributions to Psychopathology 37

The Nature of Genes 38

New Developments in the Study of Genes and Behavior 38

The Interaction of Genetic and Environmental Effects 39

Nongenomic “Inheritance” of Behavior 42

Neuroscience and Its Contributions to Psychopathology 43

The Central Nervous System 44

FM-15

The Structure of the Brain 45

The Peripheral Nervous System 48

Neurotransmitters

Implications

for

Psychopathology 54

Psychosocial Influences on Brain Structure and Function 54

Interactions of Psychosocial Factors with Brain Structure and Function 56

Comments

Behavioral and Cognitive Science 57

Conditioning and Cognitive Processes 57

Learned Helplessness and Learned Optimism 58

Social Learning 59

Prepared Learning 59

Cognitive Science and the Unconscious 60

Emotions 61

The Physiology and Purpose of Fear 61

Emotional Phenomena 62

The Components of Emotion 62

Anger and Your Heart 63

Emotions and Psychopathology 64

Cultural, Social, and Interpersonal Factors 64

Voodoo, the Evil Eye, and Other Fears 65

Gender

Social Effects on Health and Behavior 66

FM-16

Global Incidence of Psychological Disorders 67

Life-Span Development 67

The Principle of Equifinality 68

Conclusions 69

Summary 70

Key Terms 71

Answers to Concept Checks 71

Chapter Quiz 72

[UNF p.xii goes here] 3

Clinical Assessment, Diagnosis, and Research Methods 73

Assessing Psychological Disorders 74

Frank:

Young, Serious, and Anxious 74

Key Concepts in Assessment 75

The Clinical Interview 76

Physical Examination 79

Behavioral Assessment 79

Psychological Testing 81

Neuropsychological Testing 85

Neuroimaging: Pictures of the Brain 86

Psychophysiological Assessment 88

Diagnosing Psychological Disorders 89

Classification Issues 90

DSM-IV

FM-17

Current Trends 95

Conducting Research in Psychopathology 97

Basic Components of a Research Study 97

Statistical versus Clinical Significance 99

The “Average” Client 100

Types of Research Methods 101

Studying Individual Cases 101

Research by Correlation 102

Research by Experiment 104

Single-Case

Experimental Designs 106

Genetics and Research Across Time and Cultures 110

Studying Genetics 110

Studying Behavior over Time 112

Studying Behavior Across Cultures 115

The Power of a Program of Research 116

Replication

117

Research Ethics 117

Summary 119

Key Terms 120

Answers to Concept Checks 121

Chapter Quiz 122

[UNF p.xii goes here] 4

Anxiety Disorders 123

FM-18

The Complexity of Anxiety Disorders 124

Anxiety, Fear, and Panic: Some Definitions 124

Gretchen:

Attacked by Panic 125

Causes of Anxiety Disorders 126

Comorbidity of Anxiety Disorders 129

Generalized Anxiety Disorder 130

Clinical Description 130

Irene: Ruled by Worry 130

Statistics

131

Causes

132

Treatment

133

Panic Disorder with and without Agoraphobia 135

Mrs. M.: Self-Imprisoned 135

Clinical Description 136

Statistics

137

Causes

140

Treatment

141

Specific Phobia 144

Clinical Description 144

Statistics

147

Causes

148

Treatment

150

FM-19

Social Phobia 151

Billy: Too Shy 151

Clinical Description 151

Star Player? 151

Statistics

152

Causes

152

Treatment

154

Posttraumatic Stress Disorder 155

Clinical Description 155

The Joneses: One Victim, Many Traumas 155

Statistics

157

Causes

158

Treatment

160

Obsessive-Compulsive Disorder 162

Clinical Description 162

Richard: Enslaved by Ritual 162

Statistics

163

Causes

164

Treatment

165

Summary 166

Key Terms 167

Answers to Concept Checks 167

Chapter Quiz 169

FM-20

[UNF p.xiii goes here] 5

Somatoform and Dissociative Disorders 172

Somatoform Disorders 173

Hypochondriasis

173

Gail: Invisibly Ill 174

Somatization Disorder 177

Linda: Full-Time Patient 177

Conversion

Disorder

180

Eloise: Unlearning Walking 181

Celia: Seeing Through Blindness 183

Pain Disorder 185

The Medical Student: Temporary Pain 186

The Woman with Cancer: Managing Pain 186

Body Dysmorphic Disorder 186

Jim: Ashamed to Be Seen 186

Dissociative Disorders 191

Depersonalization Disorder 192

Bonnie: Dancing Away from Herself 192

Dissociative Amnesia 193

The Woman Who Lost Her Memory 193

Dissociative Fugue 194

The Misbehaving Sheriff 194

FM-21

Dissociative Trance Disorder 195

Dissociative Identity Disorder 195

Jonah: Bewildering Blackouts 195

The Hillside Strangler 197

Sybil: A Childhood Drama 198

Summary 203

Key Terms 204

Answers to Concept Checks 204

Chapter Quiz 205

[UNF p.xiv goes here] 6

Mood Disorders and Suicide 208

Understanding and Defining Mood Disorders 209

Katie: Weathering Depression 209

An Overview of Depression and Mania 210

The Structure of Mood Disorders 211

Depressive

Disorders

212

Jack: A Life Kept Down 213

Bipolar Disorders 216

Jane: Funny, Smart, and Desperate 216

Billy: The World’s Best at Everything 217

Prevalence of Mood Disorders 221

In Children and Adolescents 222

FM-22

In the Elderly 224

Across Cultures 225

Among the Creative 226

The Overlap of Anxiety and Depression 226

Causes of Mood Disorders 228

Biological Dimensions 228

Brain Wave Activity 231

Psychological Dimensions 231

Katie: No Easy Transitions 233

Social and Cultural Dimensions 236

An Integrative Theory 238

Treatment of Mood Disorders 240

Medications

240

Electroconvulsive Therapy and Transcranial Magnetic Stimulation 243

Psychological Treatments 244

Beck and Irene: A Dialogue 244

Combined Treatments 247

Preventing

Relapse

247

Psychological Treatments for Bipolar Disorder 248

Katie: The Triumph of the Self 249

Suicide 250

Statistics

250

Causes

252

FM-23

Risk Factors 253

Is Suicide Contagious? 254

Treatment

255

Summary 256

Key Terms 257

Answers to Concept Checks 258

Chapter Quiz 259

[UNF p.xi goes here] 7

Physical Disorders and Health Psychology 262

Psychological and Social Factors That Influence Health 263

Health and Health-Related Behavior 264

The Nature of Stress 265

The Physiology of Stress 265

Contributions to the Stress Response 266

Stress, Anxiety, Depression, and Excitement 267

Stress and the Immune Response 268

Psychosocial Effects on Physical Disorders 271

AIDS

271

Cancer

272

Cardiovascular Problems 274

John: The Human Volcano 274

Hypertension

275

Coronary Heart Disease 276

FM-24

Chronic Pain 279

Chronic Fatigue Syndrome 282

Psychosocial Treatment of Physical Disorders 284

Biofeedback

285

Relaxation and Meditation 286

A Comprehensive Stress- and Pain-Reduction Program 286

Sally: Improving Her Perception 287

Drugs and Stress-Reduction Programs 288

Denial as a Means of Coping 288

Modifying Behaviors to Promote Health 289

Summary 293

Key Terms 294

Answers to Concept Checks 294

Chapter Quiz 295

[UNF p.xv goes here] 8

Eating and Sleep Disorders 298

Major Types of Eating Disorders 299

Bulimia Nervosa 300

Phoebe: Apparently Perfect 300

Anorexia Nervosa 303

Julie: The Thinner the Better 303

Binge-Eating Disorder 305

Statistics

306

FM-25

Causes of Eating Disorders 309

Social Dimensions 309

Phoebe: Dancing to Destruction 312

Biological Dimensions 313

Psychological Dimensions 314

An Integrative Model 314

Treatment of Eating Disorders 316

Drug Treatments 316

Psychological Treatments 316

Phoebe: Taking Control 317

Preventing Eating Disorders 319

Obesity 321

Statistics

321

Disordered Eating Patterns in Cases of Obesity 322

Causes

322

Treatment

323

Sleep Disorders: The Major Dyssomnias 325

An Overview of Sleep Disorders 325

Primary Insomnia 327

Sonja: School on Her Mind 328

Primary Hypersomnia 331

Ann: Sleeping in Public 331

Narcolepsy

332

FM-26

Breathing-Related Sleep Disorders 332

Circadian Rhythm Sleep Disorders 333

Treatment of Sleep Disorders 334

Medical Treatments 334

Environmental Treatments 335

Psychological Treatments 336

Preventing Sleep Disorders 337

Parasomnias and Their Treatment 337

Summary 339

Key Terms 340

Answers to Concept Checks 340

Chapter Quiz 341

[UNF p.xv goes here] 9

Sexual and Gender Identity Disorders 344

What Is Normal Sexuality? 345

Gender Differences 346

Cultural Differences 348

The Development of Sexual Orientation 348

Gender Identity Disorder 350

Joe: Trapped in the Wrong Body 350

Defining Gender Identity Disorder 350

Causes

351

FM-27

John/Joan 352

Treatment

353

Overview of Sexual Dysfunctions 354

Sexual Desire Disorders 356

Mr. and Mrs. C.: Getting Started 356

Lisa: The Terror of Sex 357

Sexual Arousal Disorders 357

Bill:

Long Marriage, New Problem 358

Orgasm Disorders 359

Greta and Will: Loving Disunion 359

Gary: Running Scared 360

Sexual Pain Disorders 361

Jill:

Sex and Spasms 361

Assessing Sexual Behavior 362

Causes and Treatment of Sexual Dysfunction 363

Causes of Sexual Dysfunction 363

Treatment of Sexual Dysfunction 368

Carl:

Never Too Late 368

Paraphilia: Clinical Descriptions 372

Fetishism

372

Voyeurism and Exhibitionism 372

Robert:

Outside the Curtains 373

Transvestic

Fetishism

373

FM-28

Mr. M.: Strong Man in a Dress 373

Sexual Sadism and Sexual Masochism 374

Pedophilia and Incest 374

Tony: More and Less a Father 375

Paraphilia in Women 376

Causes of Paraphilia 376

Robert: Revenge on Repression 376

Tony: Trained Too Young 376

Assessing and Treating Paraphilia 378

Psychological Treatment 378

Tony: Imagining the Worst 378

Drug Treatments 380

Summary

380

Summary 381

Key Terms 382

Answers to Concept Checks 382

Chapter Quiz 383

[UNF p.xvi goes here] 10

Substance-Related and Impulse-Control Disorders 386

Perspectives on Substance-Related Disorders 387

Danny: Multiple Dependencies 387

Levels of Involvement 388

Diagnostic

Issues

393

FM-29

Depressants 394

Alcohol Use Disorders 394

Sedative, Hypnotic, or Anxiolytic Substance Use Disorders 398

Stimulants 400

Amphetamine Use Disorders 400

Cocaine Use Disorders 401

Nicotine Use Disorders 403

Caffeine Use Disorders 404

Opioids 404

Hallucinogens 405

Marijuana

406

LSD and Other Hallucinogens 407

Other Drugs of Abuse 408

Causes of Substance-Related Disorders 409

Biological Dimensions 410

Psychological Dimensions 411

Cognitive Factors 412

Social Dimensions 413

Cultural Dimensions 413

An Integrative Model 414

Treatment of Substance-Related Disorders 416

Biological Treatments 416

FM-30

Psychosocial Treatments 418

Prevention

421

Impulse-Control Disorders 422

Intermittent Explosive Disorder 422

Kleptomania

422

Pyromania

423

Pathological Gambling 423

Trichotillomania

424

Summary 424

Key Terms 425

Answers to Concept Checks 425

Chapter Quiz 427

[UNF p.xvii goes here] 11

Personality Disorders 430

An Overview of Personality Disorders 431

Aspects of Personality Disorders 431

Categorical and Dimensional Models 432

Personality Disorder Clusters 433

Statistics and Development 433

Gender Differences 434

Comorbidity

436

Personality Disorders Under Study 436

Cluster A Personality Disorders 437

FM-31

Paranoid Personality Disorder 437

Jake:

Research Victim 437

Schizoid Personality Disorder 439

Mr. Z.: All on His Own 440

Schizotypal Personality Disorder 441

Mr. S.: Man with a Mission 441

Cluster B Personality Disorders 443

Antisocial Personality Disorder 444

Ryan: The Thrill Seeker 444

Borderline Personality Disorder 452

Claire: A Stranger Among Us 452

Histrionic Personality Disorder 455

Pat: Always Onstage 455

Narcissistic

Personality Disorder 457

Willie: It’s All About Me 457

Cluster C Personality Disorders 459

Avoidant Personality Disorder 459

Jane: Not Worth Noticing 459

Dependent Personality Disorder 461

Karen: Whatever You Say 461

Obsessive-Compulsive Personality Disorder 462

Daniel: Getting It Exactly Right 462

Summary 464

FM-32

Key Terms 465

Answers to Concept Checks 465

Chapter Quiz 467

[UNF p.xvii goes here] 12

Schizophrenia and Other Psychotic Disorders 470

Perspectives on Schizophrenia 471

Early Figures in Diagnosing Schizophrenia 471

Identifying Symptoms 472

Arthur: Saving the Children 472

Clinical Description, Symptoms, and Subtypes 474

Positive Symptoms 474

David: Missing Uncle Bill 475

Negative Symptoms 477

Disorganized Symptoms 478

Schizophrenia

Subtypes

479

Other Psychotic Disorders 480

Prevalence and Causes of Schizophrenia 483

Statistics

483

Development

483

Cultural Factors 484

Genetic

Influences

485

Neurobiological

Influences

488

Psychological and Social Influences 492

FM-33

Treatment of Schizophrenia 494

Biological Interventions 495

Psychosocial Interventions 497

Treatment Across Cultures 500

Prevention

500

Summary 501

Key Terms 502

Answers to Concept Checks 502

Chapter Quiz 503

[UNF p.xviii goes here] 13

Developmental and Cognitive Disorders 506

Common Developmental Disorders 507

Attention

Deficit/Hyperactivity Disorder 508

Danny: The Boy Who Couldn’t Sit Still 508

Learning Disorders 512

Alice: Taking a Reading Disorder to College 513

Pervasive Developmental Disorders 517

Autistic Disorder 518

Amy: In Her Own World 518

Asperger’s

Disorder

522

Treatment of Pervasive Developmental Disorders 523

Mental Retardation 525

FM-34

James: Up to the Challenge 526

Clinical Description 527

Statistics

529

Causes

529

Treatment of Mental Retardation 532

Prevention of Developmental Disorders 534

Cognitive Disorders 535

Delirium

536

Mr. J.: Sudden Distress 536

Dementia

538

Diana: Humiliation and Fear 538

Amnestic Disorder 552

S.T.: Remembering Fragments 552

Summary 553

Key Terms 555

Answers to Concept Checks 555

Chapter Quiz 557

[UNF p.xviii goes here] 14

Mental Health Services: Legal and Ethical Issues 562

Arthur:

A Family’s Dilemma 563

Civil Commitment 563

Criteria for Civil Commitment 564

Changes Affecting Civil Commitment 566

FM-35

Joyce Brown: Homeless but Not Helpless 568

An Overview of Civil Commitment 569

Criminal Commitment 569

The Insanity Defense 570

Reactions to the Insanity Defense 571

Therapeutic

Jurisprudence

573

Competence to Stand Trial 574

Duty to Warn 574

Mental Health Professionals as Expert Witnesses 574

Patients’ Rights and Clinical Practice Guidelines 576

The Right to Treatment 576

The Right to Refuse Treatment 576

Research Participants’ Rights 577

Greg Aller: Concerned About Rights 577

Evidence-Based Practice and Clinical Practice Guidelines 578

Conclusions 580

Summary 581

Key Terms 582

Answers to Concept Checks 582

Chapter Quiz 583

Answers to Chapter Quizzes 584

Glossary G-1

References R-1

FM-36

Credits C-1

Name Index I-1

Subject Index I-22

FM-37

Preface

Until several years ago, the science of psychopathology had been compartmentalized,

with psychopathologists examining the separate effects of psychological, biological,

and social influences. This approach is still reflected in popular media accounts that

describe, for example, a newly discovered gene, a biological dysfunction (chemical

imbalance), or early childhood experiences as a “cause” of a psychological disorder.

This way of thinking still dominates discussions of causality and treatment in some

psychology textbooks: “The psychoanalytic views of this disorder are . . . ,” “the

biological views are . . . ,” and, often in a separate chapter, “psychoanalytic treatment

approaches for this disorder are . . . ,” “cognitive behavioral treatment approaches are

. . . ,” or “biological treatment approaches are. . . .”

In the first edition of this text we tried to do something very different. We thought

the field had advanced to the point that it was ready for an integrative approach in

which the intricate interactions of biological, psychological, and social factors are

explicated in as clear and convincing a manner as possible. Recent explosive

advances in knowledge confirm this approach as the only viable way of understanding

psychopathology. To take just one example, Chapter 2 now contains a description of a

study demonstrating that stressful life events can lead to depression, but not everyone

shows this response. Rather, stress is more likely to cause depression in individuals

who already carry a particular gene that influences serotonin at the brain synapses.

These results confirm the integrative approach in this book: Psychological disorders

cannot be explained by genetic or environmental factors alone, but rather by their

interaction. We now understand that psychological and social factors directly affect

neurotransmitter function and even genetic expression. Similarly, we cannot study

behavioral, cognitive, or emotional processes without appreciating the contribution of

FM-38

biological and social factors to psychological and psychopathological expression.

Instead of compartmentalizing psychopathology, we use a more accessible approach

that accurately reflects the current state of our clinical science.

Integrative Approach

As noted above, the first edition of our text pioneered a new generation of abnormal

psychology textbooks that offer an integrative and multidimensional perspective. (We

acknowledge such one-dimensional approaches as biological, psychosocial, and

supernatural as historic trends.) We include substantial current evidence of the

reciprocal influences of biology and behavior and of psychological and social

influences on biology. Our examples hold students’ attention; for example, we discuss

genetic contributions to divorce, the effects of early social and behavioral experience

on later brain function and structure, new information on the relation of social

networks to the common cold, and new data on psychosocial treatments for cancer.

We emphasize the fact that in the phenomenon of implicit memory and blind sight,

which may have parallels in dissociative experiences, psychological science verifies

the existence of the unconscious (although it does not much resemble the seething

caldron of conflicts envisioned by Freud). We present new evidence confirming the

effects of psychological treatments on neurotransmitter flow and brain function. We

acknowledge the often neglected area of emotion theory for its rich contributions to

psychopathology, for example, the effects of anger on cardiovascular disease. We

weave scientific findings from the study of emotions together with behavioral,

biological, cognitive, and social discoveries to create an integrated tapestry of

psychopathology.

Life-Span Developmental Influences

FM-39

No modern view of abnormal psychology can ignore the importance of life-span

developmental factors to the manifestation and treatment of psychopathology.

Accordingly, we consider the importance of development throughout the text; we

discuss childhood and geriatric anxiety, for example, in the context of the anxiety

disorders chapter. This organization, which is for the most part consistent with DSM-

IV, helps students appreciate the need to study each disorder from childhood through

adulthood. We note findings on developmental considerations in separate sections of

each disorder chapter and, as appropriate, discuss how specific developmental factors

affect causation and treatment.

Scientist-Practitioner Approach

We go to some lengths to explain why the scientist-practitioner approach to

psychopathology is both practical and ideal. Like most of our colleagues, we view this

as something more than simple awareness of how scientific findings apply to

psychopathology. We show how every clinician contributes to general scientific

knowledge through astute and systematic clinical observations, functional analyses of

individual case studies, and systematic observations of series of cases in clinical

settings. For example, we explain how information on dissociative phenomena

provided by early psychoanalytic theorists remains relevant today. We also describe

the formal methods used by scientist-practitioners, showing how abstract research

designs are actually implemented in research programs.

Clinical Cases of Real People

We have enriched the book with authentic clinical histories to illustrate scientific

findings on the causes and treatment of psychopathology. We have both run active

clinics for years, so 95% of the cases are from our own files, and they provide a

FM-40

fascinating frame of reference for the findings we describe. Most chapters begin with

a case description, and most discussions of the latest theory and research are related to

these very human cases.

Disorders in Detail

We cover the major psychological disorders in 10 chapters, focusing on three broad

categories: clinical description, causal factors, and treatment and outcomes. We pay

considerable attention to case studies and DSM-IV criteria, and we include statistical

data, such as prevalence and incidence rates, sex ratio, age of onset, and the general

course or pattern for the disorder as a whole. Throughout, we explore how biological,

psychological, and social dimensions may interact to cause a particular disorder.

Finally, by covering treatment and outcomes within the context of specific disorders,

we provide a realistic sense of clinical practice.

Treatment

One of the best-received innovations in the first three editions is that we discuss

treatment in the same chapter as the disorders themselves instead of in a separate

chapter, an approach that is supported by the development of specific psychosocial

and pharmacological treatment procedures for specific disorders. We have retained

this integrative format and have improved on it, and we include treatment procedures

in the key terms and glossary.

Legal and Ethical Issues

In our closing chapter we integrate many of the approaches and themes that have been

discussed throughout the text. We include case studies of people who have been

involved directly with many legal and ethical issues and with the delivery of mental

FM-41

health services. We also provide a historical context for current perspectives so

students will understand the effects of social and cultural influences on legal and

ethical issues.

Diversity

Issues of culture and gender are integral to the study of psychopathology. Throughout

the text we describe current thinking about which aspects of the disorders are

culturally specific and which are universal, and about the strong and sometimes

puzzling effects of gender roles. For instance, we discuss the current information on

topics such as the gender imbalance in depression, how panic disorders are expressed

differently in various Asian cultures, the ethnic differences in eating disorders, and the

diagnosis of ADHD outside the United States. Clearly, our field will grow in depth

and detail as these subjects and others become standard research topics. For example,

why do some disorders overwhelmingly affect females and others appear

predominantly in males? And why does this apportionment sometimes change from

one culture to another? In answering questions like these, we adhere closely to

science, emphasizing that gender and culture are each one dimension among several

that may influence psychopathology.

The Culture Index and Gender Index on pages xxvii and xxviii will help you

locate specific areas of the text where issues of culture and gender are discussed.

New to This Edition

A Thorough Update

This exciting field moves at a rapid pace, and we take particular pride in how our

book reflects the most recent developments. This fourth edition of Essentials of

FM-42

Abnormal Psychology has been thoroughly updated, incorporating hundreds of new

research studies on psychological disorders and their treatment. In Chapter 8, “Eating

and Sleep Disorders,” a major new section on obesity has been added. With public

health agencies characterizing obesity as a fast-growing epidemic, this important

coverage highlights the prevalence, causes, and treatment of obesity from a

psychopathological perspective. Chapter 10 has been retitled “Substance-Related and

Impulse-Control Disorders” to reflect the addition of a new section at the end of the

chapter on impulse-control disorders. The disorders covered in this new section are

intermittent explosive disorder, kleptomania, pyromania, pathological gambling, and

trichotillomania.

The chapters on anxiety disorders (Chapter 4), mood disorders (Chapter 6),

schizophrenia (Chapter 12), and developmental disorders (Chapter 13) have been the

most heavily revised to reflect new research, but all chapters have been significantly

updated and freshened. Some highlights of the changes to this edition include:

•

In Chapter 2, a landmark new study by Caspi et al. (2003) on the interaction of

genes and the environment is described in detail, with an accompanying new

graph (Figure 2.3) depicting findings on how genetic and environmental

influences interact to produce major depression in adults. This important work

reinforces our emphasis on the integrative model of psychopathology.

•

In Chapter 3, a new table, an “Outline for a Possible Future Multiaxial System”

(Table 3.2), has been included to show potential new directions in the future

DSM-V.

• The research ethics section of Chapter 3 now includes a discussion of the

Declaration of Helsinki, which has important implications for using placebo

controls in research protocols.

FM-43

•

In the coverage of the causes of anxiety disorders in Chapter 4, a broadened

explanation of the “triple vulnerability theory” includes a new graphic (Figure 4.2)

highlighting these three vulnerabilities.

•

New research by Devon Hinton and associates on the manifestation of panic

disorder among Khmer refugees in the United States is now described in some

detail in Chapter 4, highlighting an intriguing cultural variation.

•

In Chapter 5, we cite new research on recent reports of preliminary successes with

drug treatments for hypochondriasis.

•

Important new research on the co-occurrence of certain types of depression in

twins (by McGuffin et al., 2003) is presented in Chapter 6, with an accompanying

graphic (Figure 6.2).

•

In the section on psychological treatments for bipolar disorders in Chapter 6, new

research studies indicating the success of family-focused treatment are cited and

described, and a new graphic based on the findings of D. J. Miklowitz et al.

(2003) is added, depicting the effectiveness of family-focused treatment.

•

Also in Chapter 6, new studies are cited detailing the effectiveness of transcranial

magnetic stimulation (TMS) in treating severe or psychotic depression, suggesting

that TMS is equally effective as (and a potentially good alternative to) ECT.

•

Chapter 7 now includes new information on the epidemiology, psychological risk

factors, and psychological treatments for chronic fatigue syndrome.

•

In Chapter 8, a new case study has been included in the section on primary

insomnia: “Sonja: School on Her Mind.” Sonja’s case illustrates how anxiety

about work can exacerbate an existing sleep disorder.

•

In Chapter 9, interesting new research by Bancroft, Loftus, and Long (2003) is

cited, indicating that while a significant precentage of heterosexual women in

FM-44

long-term relationships report some criteria for sexual dysfunction, many of them

did not feel distress over the condition.

• A new feature box in Chapter 11 focuses on the question “Can Borderline

Personality Disorder Arise Without Trauma?” This box describes some of the

controversy surrounding the assumption that people with borderline personality

disorder who do not report early abuse are either not remembering it or are

deliberately not reporting these events.

•

In Chapter 12 significant new research on smooth-pursuit eye movement research

and abnormal eye tracking as a marker for schizophrenia by Thaker and Avila

(2003) is now described, with a new graphic (Figure 12.5).

•

Also in Chapter 12, the entire section on neurobiological influences of

schizophrenia has been rewritten to reflect the dramatic change in our

understanding of the roles played by brain chemicals in schizophrenia.

•

In Chapter 13, a new feature box has been added on “Is ADHD Different in

Girls?” This box explores the controversy surrounding gender differences in

ADHD. In addition, numerous new research findings regarding the causes and

treatment of ADHD are now incorporated into this chapter.

•

A new subsection has been added to Chapter 14 on therapeutic jurisprudence,

which describes the use of “problem-solving courts,” a major trend in how the

judicial system relates to persons with psychological disorders.

DSM-IV, DSM-IV-TR, and DSM-V

Much has been said about the mix of political and scientific considerations that

resulted in DSM-IV, and naturally we have our own opinions. (David H. Barlow had

the interesting experience of sitting on the task force.) Psychologists are often

FM-45

concerned about turf issues in what has become, for better or worse, the nosological

standard in our field, and with good reason: In previous DSM editions, scientific

findings sometimes gave way to personal opinions. However, this time most

professional biases were left at the door while the task force almost endlessly debated

the data. This process produced enough new information to fill every

psychopathology journal for a year with integrative reviews, reanalysis of existing

databases, and new data from field trials. From a scholarly point of view, the process

was both stimulating and exhausting. In this book are highlights of various debates

that created the nomenclature and recent updates. For example, we summarize and

update the data and discussion of premenstrual dysphoric disorder and mixed anxiety

depression, two disorders that did not make it into the final criteria. Students can thus

see the process of making diagnoses, as well as the mix of data and inference that are

part of it.

In 2000, the American Psychiatric Association published a revision of the text

accompanying the DSM-IV diagnostic criteria that updates the scientific literature

with few changes to the criteria themselves. Several senior clinical investigators from

one of our research centers (DHB) participated in the text revision, and much of this

information has found its way into this fourth edition. For example, the text revision

(DSM-IV-TR) discusses the intense continuing debate on categorical and dimensional

approaches to classification. We describe some of the compromises the task force

made to accommodate data, such as why it does not yet seem possible to

dimensionalize personality disorders, although almost everyone agrees that when we

can we will prefer to do so.

Now the planning process has begun for DSM-V, and a senior scientist from one

of our centers is a member of the Planning Committee. The first phase of this massive

FM-46

project involved a joint effort by the National Institute of Mental Health and the

American Psychiatric Association focused on delineating needed research efforts to

provide crucial information for the DSM-V process. Research planning workgroups

were formed in areas such as neuroscience, problems/gaps in the current system,

cross-cultural issues, and developmental issues, with the charge of producing “white

papers” outlining the required research agenda. The white papers, along with an

article summarizing important recommendations, were published in 2002. The

Planning Committee has now organized a series of conferences to further these

efforts. Eleven conferences are planned through 2007, chaired by members of the

American and international research communities on topics such as: externalizing

disorders of childhood, personality disorders, and stress-induced and fear circuitry

disorders. In 2007, the DSM-V task force will convene with the goal of producing

DSM-V by 2011–2012. It is already clear that DSM-V will incorporate a more

dimensional approach to classification, and one preliminary recommendation along

these lines is presented in Chapter 3.

Prevention

Looking ahead into the future of abnormal psychology as a field, the prospect of

helping the most people who display psychological disorders may lie in our ability to

prevent these difficulties. Although this has long been a goal of many, we are now at

the precipice of what appears to be the beginning of a new age in prevention research.

Numerous scientists from all over the globe are developing the methodologies and

techniques that may at long last provide us with the means to interrupt the debilitating

toll of emotional distress caused by the disorders chronicled in this book. We

therefore highlight these cutting-edge prevention efforts—such as preventing eating

FM-47

disorders, suicide, and health problems like HIV and injuries—in appropriate chapters

as a means of celebrating these important events as well as to spur on the field to

continue this important work.

Retained Features

Visual Summaries

At the end of each disorder chapter is a colorful two-page visual overview that

succinctly summarizes the causes, development, symptoms, and treatment of each

disorder covered in the chapter. These visual summaries have been completely

revamped in the fourth edition to include more life-like images and an improved

layout that will engage students even more effectively. Our integrative approach is

instantly evident in these diagrams, which show the interaction of biological,

psychological, and social factors in the etiology and treatment of disorders. The visual

summaries will help instructors wrap up discussions, and students will appreciate

them as study aids.

Outstanding Pedagogy

•

Chapter Quizzes are included at the end of every chapter, providing students with

a valuable opportunity to measure their mastery of key chapter material. Answers

to these quizzes appear at the end of the text.

•

Concept Checks appear regularly at the end of nearly every major section in each

chapter, offering a mini-test of the material just covered.

•

Study aids built into each chapter and retained from the previous edition include

Learning Objectives, a bulleted list placed at the beginning of every major section;

boldfacing of Key Terms and a Running Glossary that appears at the bottom of the

FM-48

pages; and Disorder Criteria Summary tables that provide a digested version of

many of the disorders listed in the DSM-IV-TR.

•

Also retained from the previous edition are end-of-chapter study aids: a detailed,

bulleted Chapter Summary, organized by major section; a list of Key Terms, now

with page references included; answers to the Concept Check questions;

InfoTrac

College Edition search terms for researching articles related to key

topics in the chapter; a list of relevant video clips pertaining to the chapter’s topics

on the Abnormal Psychology Live CD-ROM that is included with every new

edition of the text; and a prompt to the student to find additional study help on the

book companion website.

•

NEW to this edition, the end-of-chapter material now includes a prompt to special

Video Concept Reviews on the Abnormal PsychologyNow product, where one or

two particularly difficult concepts in the chapter are explained by author Mark

Durand.

Learning Aids for the Student

Abnormal Psychology Live Student CD-ROM

Every new copy of the fourth edition is packaged with a free CD-ROM, Abnormal

Psychology Live, which includes video clips of actual clients discussing their

disorders. Each video clip has specific questions written about it, and students can

write their responses on screen as well as print them out. New clips have been added,

and questions are posed to students to help them better understand the nature of

disorders. In the fourth edition, we offer 10 new videos:

Virtual Reality Therapy (Chapter 4)

FM-49

Snake Phobia Treatment (Chapter 4)

Studying the Effects of Emotions on Physical Health (Chapter 7)

Breast Cancer Support and Education (Chapter 7)

Research on Exercise and Weight Control (Chapter 7)

Nicotine Dependence (Chapter 10)

Edward: ADHD in a Gifted Student (Chapter 13)

Rebecca: A First-Grader with Autistic Disorder (Chapter 13)

Lauren: A Kindergartener with Down Syndrome (Chapter 13)

Computer Simulations and Senile Dementia (Chapter 13)

New copies of the fourth edition can be packaged with Abnormal PsychologyNow

(http://now.ilrn.com/durand_barlow_4e) at no additional cost. This online,

diagnostic study tool identifies each student’s unique needs with a Pre-Test that

generates a personalized Study Plan for each chapter, helping students focus on

concepts they’re having the most difficulty mastering. Students then take a Post-Test

to measure their understanding of the material. An instructor Gradebook is available

to track and monitor student progress.

Within Abnormal PsychologyNow, Mark Durand provides a brief Video Concept

Review for each chapter. In these onscreen videos, he briefly reviews difficult

concepts that may need additional explanation so students can “hear them again”

before the test.

Student Study Guide

The fourth edition Study Guide by David Santogrossi of Purdue University

encourages collaborative learning and active reading, listening, and study skills. It

FM-50

contains chapter summaries, key words, sample questions, activities, and Internet

resources for every chapter of the text. (ISBN 0-495-03129-1)

InfoTrac® College Edition

Instructors in the United States and Canada can order InfoTrac College Edition, an

online library offering instant access (through a password) to the latest research and

new articles on subjects related to abnormal psychology. At the end of every chapter

of this text, InfoTrac College Edition search terms are suggested.

Companion Website

The book-specific website (at http://psychology.wadsworth.com/durand_

barlow4e/) offers students practice quizzes and links to related sites for each chapter

of the text, as well as flash cards, glossaries, research activities, and more.

WebTutor™ Advantage

An online instructional tool, WebTutor is available for sale, and includes flash cards

(with audio), practice quizzes, online tutorials, links to related websites, video clips,

and more. Available in either WebCT

or Blackboard

formats.

WebCT 0-495-03131-3; Blackboard 0-495-03132-1

Teaching Aids for the Instructor

Videos

•

Abnormal Psychology: Inside Out, Volume I 0-534-20359-0

•

Abnormal Psychology: Inside/Out, Volume II 0-534- 36480-2

•

Abnormal Psychology: Inside/Out, Volume III 0-534- 50759-X

FM-51

•

Abnormal Psychology: Inside/Out, Volume IV 0-534- 63369-2

•

Deficits of the Mind and the Brain for Abnormal Psychology 0-534-20356-6

Classroom Presentation Materials

•

Multimedia Manager Instructor’s Resource CD, a Microsoft

PowerPoint

Link

Tool: This CD-ROM includes lecture outlines built around this fourth edition,

most of the figures from the text, relevant video clips, and a direct link to the

Durand/Barlow website. Also included are Microsoft Word files for the print

Instructor’s Manual and Test Bank. 0-495-03135-6

•

Transparency Acetates: A selection of more than 100 full-color figures that reflect

art from the text and other sources. The labels have been upsized to allow easy

reading in large lecture halls. 0-495-03176-3

Additional Resources

•

Test Bank by Marilyn Blumenthal and Michael Goodstone of SUNY–Farmingdale

contains 100–125 items per chapter in multiple-choice, true/false, and essay

formats that sorted into factual, conceptual, and applied questions. The items are

all page-referenced to the main text, and each chapter contains at least 10 items

that are located on the book companion website. 0-495-03134-8

•

ExamView

: All test items from the printed test bank are available in electronic

format. 0-495-03180-1

•

Instructor’s Manual by John Forsyth of SUNY–Albany contains learning

objectives, chapter outlines, chapter summaries, key terms, classroom activities,

demonstrations, lecture topics, supplemental reading material, book reviews,

video resources, and Internet resources. 0-495-03133-X

•

InfoTrac College Edition: Instructors can order this fully searchable online

FM-52

university library that offers complete articles from more than 600 scholarly and

popular publications, including such periodicals as the American Journal of

Psychology. InfoTrac College Edition access is available on a password-protected

website that is updated daily.

•

WebTutor Advantage: A course-management tool offering the ability to post

syllabi, track student progress, view preloaded media resources, and set up

threaded discussions, WebTutor offers communication tools (a whiteboard,

asynchronous discussion, real-time chat) as well. Available in both WebCT and

Blackboard formats.

•

JoinIn

™

on Turning Point

: This classroom response system software allows

instructors to assess students’ progress with instant in-class quizzes and polls.

Instructors can pose book-specific questions and display students’ answers

seamlessly within the Microsoft

PowerPoint

slides of their own lecture, in

conjunction with the “clicker” hardware. 0-495-03181-X

Titles of Interest

•

Looking into Abnormal Psychology: Contemporary Readings by Scott O.

Lilienfeld is a fascinating 234-page reader comprised of 40 articles from popular

magazines and journals. Each article explores ongoing controversies regarding

mental illness and its treatment. 0-534-35416-5

•

Casebook in Abnormal Psychology by Timothy A. Brown and David H. Barlow is

a comprehensive casebook that reflects the integrative approach, which considers

the multiple influences of genetics, biology, and familial and environmental

factors within a unified model of causality, as well as maintenance and treatment

of the disorder. The casebook reflects treatment methods that are the most

FM-53

effective interventions developed for a particular disorder. It also presents two

undiagnosed cases in order to give students an appreciation for the complexity of

disorders. The cases are strictly teaching/learning exercises similar to what many

instructors use on their examinations.

0-534-363 16-4

Acknowledgments

This book in all of its editions would not have begun and certainly would not have

been finished without the inspiration and coordination of Marianne Taflinger, our

senior editor at Wadsworth for the life of this book. She convinced us that we could

truly accomplish something new and different and continues to put her own heart and

soul into the process. We are particularly delighted to be working once again with Jim

Standberg, our development editor, who in many ways should be considered a third

author on this book. His experience, his way with a phrase, and his guiding hand have

made the book immeasurably better, and we hope to be working with you, Jim, for

many more editions to come.

It is always amazing that so many people, some of whom we never have the

privilege to meet, contribute so much of themselves to the success of this book. In

editorial, we are grateful to Kristin Makarewycz, Dan Moneypenny, and Lucy

Faridany for their attention to the many details of this book and ancillary products.

We thank Darin Derstine for his technological savvy. We are indebted to Jennie

Redwitz for her active involvement in all aspects of production, and to Vernon Boes

and Roy Neuhaus for their creative work on the book’s design. In marketing, we

appreciate the support of Dory Schaeffer, Laurel Anderson, and Nicole Morinon. We

also thank Carol O’Connell at Graphic World for her outstanding management of the

FM-54

book’s production, and Myrna Engler for her commitment to finding the best photos

possible.

This book would not have been finished without the considerable efforts of some

of our closest associates working directly with us. At USF St. Petersburg, Pat White

Butcher and students Robin Lane, Cary Jordan, Christina Jensen, Monica Unger, and

Sarah Pigott kept us on track. David Brodosi was the local technical expert who

worked magic on the Video Concept Reviews that accompany this book. In Boston,

Erica Moss and Morline Gordon-Grier continued to exercise their uncanny ability to

find missing references and counter the effects of numerous gremlins who keep trying

to put the wrong year, or the wrong middle initial, in the wrong place.

Numerous colleagues and students provided superb feedback on the previous

editions, and to them we express our deepest gratitude. Although not all comments

were favorable, all were important. Readers who take the time to communicate their

thoughts offer the greatest reward to writers or scholars.

Finally, you share with us the task of communicating knowledge and discoveries

in the exciting field of psychopathology, a challenge that none of us takes lightly. In

the spirit of collegiality, we would greatly appreciate your comments on the content

and style of this book and recommendations for improving it further.

Reviewers

We thank the reviewers of the fourth edition of Essentials of Abnormal Psychology:

Holly Hazlett-Stevens, University of Nevada–Reno

Shaine Henert, Chicago State University

Mark Lukin, University of Nebraska–Lincoln

Gregory Page, University of Pittsburgh–Bradford

FM-55

Deborah Roundtree, University of Michigan–Dearborn

Lisa Terre, University of Missouri–Kansas City

Doug Uselding, Marian College

We also thank the reviewers of previous editions:

Kerm O. Almos, Capital University

Frank Andrasik, University of West Florida

Robin Apple, Stanford University Medical Center

Jim Backlund, Kirtland Community College

Joe S. Bean, Shorter College

Dorothy Bianco, Rhode Island College

Cheryl Bluestone, Queensborough Community College

Susan Blumenson, City University of New York, John Jay College of Criminal Justice

Robert Bornstein, Gettysburg College

Edwin Boudreaux, Louisiana State University

Mary Bower Russa, Grand Valley State University

James Calhoun, University of Georgia

Montie Campbell, Oklahoma Baptist University

Antonio Cepeda-Benito, Texas A&M University

Sheree Dukes Conrad, University of Massachusetts at Boston

Eric J. Cooley, Western Oregon State University

Laurie Rotando Corey, Westchester Community College

Lenore DeFonson, Indiana–Purdue University–Fort Wayne

Andrew L. Dickson, University of Southern Mississippi

Joan B. Doolittle, Anne Arundel Community College

Juris Draguns, Pennsylvania State University

FM-56

Mitchell Earlywine, University of Southern California

Raymond Eastman, Stephen F. Austin State University

Elizabeth Epstein, Rutgers University

Donald Evans, Drake University

Ronald Evans, Washburn University

Anthony Fazio, University of Wisconsin, Milwaukee

Mark A. Fine, University of Missouri at Columbia

Diane Finley, Towson State University

Sheila Fling, Southwest Texas State University

Karen E. Ford, Mesa State College

John R. Foust, Parkland College

Allen Frances, Duke University

Andrew Getzfeld, New Jersey City University

David Gleaves, Texas A&M University

Frank Goodkin, Castleton State College

Irving Gottesman, University of Virginia

Peter Gram, Pensacola Junior College

Marjorie Hardy, Muhlenberg College

Brian Hayden, Brown University

Stephen Hinshaw, University of California, Berkeley

Steven Huprich, Baylor University

William Iacono, University of Minnesota

Heidi M. Inderbitzen-Nolan, University of Nebraska–Lincoln

Ken Ishida, California State University–Bakersfield

Thomas Jackson, University of Arkansas

FM-57

Boaz Kahana, Cleveland State University

Stephen R. Kahoe, El Paso Community College

Ricki E. Kantrowitz, Westfield State College

Susan Kashubeck, Texas Tech University

Arthur Kaye, Virginia Commonwealth University

Christopher Kearney, University of Nevada–Las Vegas

Ernest Keen, Bucknell University

Elizabeth Klonoff

Ann Kring, Vanderbilt University

Julie Kuehnel, California Lutheran

Marvin Kumler, Bowling Green State University

Thomas Kwapil, University of North Carolina, Greensboro

Michael Lambert, Brigham Young University

Kristi Lane, Winona State University

Travis Langley, Henderson State University

Cynthia Ann Lease, Virginia Polytechnic Institute and State University

Richard Leavy, Ohio Wesleyan University

Scott Lilienfeld, Emory University

Karsten Look, Columbus State Community College

Michael Lyons, Boston University

Jerald Marshall, Valencia Community College

Charles Mate-Kole, Central Connecticut State University

Janet Matthews, Loyola University

Dena Matzenbacher, McNeese State University

Edward McEntee, Community College of Rhode Island

FM-58

Dean McKay, Fordham University

Mary McNaughton-Cassill, University of Texas at San Antonio

Thomas Miller, Murray State University

Scott Monroe, University of Oregon

Laura A. Negel, University of Tennessee

Bridget Nelson, Hocking Technical College

Sumie Okazaki, University of Wisconsin, Madison

John W. Otey, South Arkansas University

Victoria Pederson, Southwestern Community College

Diane J. Pfahler, California State University, San Bernardino

Ralph G. Pifer, Sauk Valley College

P. B. Poorman, University of Wisconsin

Gene Ritter, Santa Fe Community College

Carole Rothman, City University of New York–Herbert H. Lehman College

David A. Santogrossi, Purdue University

Charles Seidel, Mansfield University

John Shepherd, New Mexico Junior College

Richard Siegel, University of Massachusetts–Lowell

David Skinner, Valencia Community College

Jerome Small, Youngstown State University

Brian Stagner, Texas A&M University

Irene Staik, University of Montevallo

Tome Stuber, Itasca Community College

Chris Tate, Middle Tennessee State University

Lisa Terre, University of Missouri–Kansas City

FM-59

Susan Troy, Northeast Iowa Community College

Michael Vasey, Ohio State University

John Velasquez, University of the Incarnate Word

Larry Ventis, College of William and Mary

Richard Viken, Indiana University

Philip Watkins, Eastern Washington University

Marcia Wehr, Santa Fe Community College

Kim Weikel, Shippensburg University of Pennsylvania

Michael Wierzbicki, Marquette University

John Wincze, Brown University

Bradley Woldt, South Dakota State University

Guy Wylie, Western Nebraska Community College

Ellen Zaleski, Fordham University

Raymond Zurawski, St. Norbert College

V. Mark Durand

St. Petersburg, Florida

David H. Barlow

Nantucket Island

FM-60

Culture Index

African Americans

alcohol use, 103, 397

body dysmorphic disorder, 188

dementia,

548

depression,

222,

225

dissociative

disorders,

195

eating disorders, 307

fetal alcohol syndrome, 396

hypertension vulnerability, 275, 276

panic disorder, 139–140

psychopathy,

450

schizophrenia,

484–485

sleep disorders, 328

suicide,

250

Alcohol use disorders

and

culture,

397

fetal alcohol syndrome differences in vulnerability, 396

Asian Americans

alcohol

use,

397

coronary heart disease vulnerability, 278

dementia,

548

eating disorders, 307

panic disorder, 139

phobias, 148, 152

FM-61

sleep disorders in adolescence, 328

Body dysmorphic disorder, 186–191

Conversion disorder, 184, 185

Coronary heart disease, 277, 278

Cultural bias

cognitive disorders, 543

ethnic minorities and violence, 564–565

intelligence

testing,

MMPI,

schizophrenia diagnosis, 484, 494

Thematic Apperception Test (TAT), 83

Dementia, 548

Depression, 222, 225–226, 236–238, 237

Diagnostic guidelines, 93–94

Dissociative trance disorder, 195

Eating disorders

and culture, 299, 300, 307–308

and socioeconomic status, 300, 306, 307

Gender identity disorder, 350–354

Hispanic Americans

alcohol

use,

397

depression,

222,

225

eating disorders, 307

panic disorder, 94, 138

phobias,

148

FM-62

schizophrenia,

500

sleep disorders in adolescence, 328

suicide,

250

Native Americans

Alzheimer’s disease, 543

depression,

225

dissociative

disorder,

195

eating disorders, 307, 308, 322

fetal alcohol syndrome, 396

gender identity disorder, 351

smoking,

403

suicide,

250

Obesity, 300, 322, 323

Obsessive-compulsive disorder, 164

Panic disorder, 138–139

Personality disorders, 433

Phobias, 148, 152

Posttraumatic stress disorder, 159

Research, 115–116

Schizophrenia, 484–485, 494

Sexual dysfunctions, 365–367

Sexuality, 348, 367

Sleep disorders, 328, 330

Smoking, 292, 403

Socioeconomic status

FM-63

and conduct disorders, 445, 447

and eating disorders, 300, 306, 307

and mental retardation, 532, 534

Somatization disorder, 179

Somatoform disorders, 175–176

Substance-related disorders, 413–414

Suicide, 252, 254

Gender Index

Agoraphobia, 138

Body dysmorphic disorder, 188, 189

Conversion disorder, 184

Dementia, 540

Developmental disorders, 515

Eating disorders, 299, 300

Gender bias

MMPI,

personality disorders, 13, 434–435, 457, 462

Gender identity disorder, 345, 350-354

causes,

351

incidence,

351

treatment,

353-354

Generalized anxiety disorder, 132

Hypocondriasis, 175

Impulse-control disorders, 422–424

Insomnia, 231

FM-64

Mood disorders, 222, 229, 236–238

Obsessive-compulsive disorder, 164

Pain, 282

Paraphilias, 376, 377

Personality disorders, 434–436, 457

Phobias, 147, 150

Schizophrenia, 483

Sexual dysfunction, 354–357

orgasm disorders, 359–361

sexual arousal disorders, 357–359

sexual desire disorders, 356–357

sexual pain disorders, 361–362

Sexuality, 345–349

sexual behavior and attitudes, 346–348

sexual response cycles, 355

Sleep disorders, 328

Social phobia, 152

Somatization disorder, 179

Substance-related disorders, 402

Suicide, 251–252

Type A behavior and coronary heart disease, 277–278