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Transcript of Whi33389 Fm i Xxiii
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ABNORMAL PSYCHOLOGY
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ABNORMAL PSYCHOLOGYClinical Perspectives on Psychological Disorders
SEVENTH EDITION DSM-5 UPDATE
SUSAN KRAUSS WHITBOURNE
University of Massachusetts Amherst
RICHARD P HALGIN
University of Massachusetts Amherst
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ABNORMAL PSYCHOLOGY CLINICAL PERSPECIVES ON PSYCHOLOGICAL DISORDERS DSM9830855 UPDAE
SEVENH EDIION
Published by McGraw-Hill Education 2 Penn Plaza New York NY 10121 Copyright copy 2014 by McGraw-Hill
Education All rights reserved Printed in the United States o America Previous editions copy 2013 2010 and 2007
No part o this publication may be reproduced or distributed in any orm or by any means or stored in a database or
retrieval system without the prior written consent o McGraw-Hill Education including but not limited to in any
network or other electronic storage or transmission or broadcast or distance learning
Some ancillaries including electronic and print components may not be available to customers outside the
United States
Tis book is printed on acid-ree paper
1 2 3 4 5 6 7 8 9 0 DOWDOW 1 0 9 8 7 6 5 4 3
ISBN 978ndash1ndash259ndash13338ndash1
MHID 1ndash259ndash13338ndash9
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All credits appearing on page or at the end o the book are considered to be an extension o the copyright page
Library of Congress Cataloging-in-Publication Data
Cataloging-in-Publication Data has been requested rom the Library o Congress
Te Internet addresses listed in the text were accurate at the time o publication Te inclusion o a website does not
indicate an endorsement by the authors or McGraw-Hill Education and McGraw-Hill Education does not guarantee
the accuracy o the inormation presented at these sites
wwwmhhecom
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To our families with love and appreciation
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vi Chapter 15 Ethical and Legal Issues
Susan Krauss Whitbourne and Richard Halgin are Proessors o Psychologyat the University o Massachusetts Amherst Both teach large undergraduate classes inaddition to teaching and supervising doctoral students in developmental and clinicalpsychology Teir clinical experience has covered both inpatient and outpatient settingsProessors Whitbourne and Halgin are Fellows o the American PsychologicalAssociation Tey co-edited A Case Book in Abnormal Psychology From the Files ofExperts (Oxord University Press) containing case studies written by leading internationalauthorities in the field o psychopathology
Proessor Whitbourne received her PhD rom Columbia University and has dual
specializations in lie-span developmental psychology and clinical psychology Shetaught at the State University o New York at Geneseo and the University o RochesterAt the University o Massachusetts she received the Universityrsquos Distinguished eachingAward the Outstanding Advising Award and the College o Arts and SciencesOutstanding eacher Award In 2001 she received the Psi Chi Eastern Region FacultyAdvisor Award and in 2002 the Florence Denmark Psi Chi National Advisor Award In2003 she received both the APA Division 20 and Gerontological Society o AmericaMentoring Awards She served as the Departmental Honors Coordinator rom 1990ndash2010 and currently is the Psi Chi Faculty Advisor and the Director o the Offi ce oNational Scholarship Advisement in the Commonwealth Honors College Te author osixteen books and over 160 journal articles and book chapters Proessor Whitbourne isregarded as an expert on personality development in mid- and late lie She is on theAPA Membership Board was Chair o APArsquos Policy and Planning Board and was amember o the APA Committee or the Structure and Function o Council She is APACouncil Representative to Division 20 (Adult Development and Aging) having alsoserved as Division 20 President She is a Fellow o APArsquos Divisions 20 1 (GeneralPsychology) 2 (eaching o Psychology) 12 (Clinical Psychology) and 35 (Society orthe Psychology o Women) A Fellow o the Gerontological Society o America sheserves on the Executive Board o the Behavioral and Social Sciences Section In 2007
she was the Psi Chi Eastern Region Vice President and in 2009 was the Program Chairo the 2009 National Leadership Conerence Proessor Whitbourne served as an itemwriter or the Educational esting Service was a member o APArsquos High SchoolCurriculum National Standards Advisory Panel wrote the APA High School CurriculumGuidelines or Lie-Span Developmental Psychology and serves as an item writer or theExamination or Proessional Practice o Psychology and as Chair o the Council oProessional Geropsychology raining Programs Her 2010 book ldquoTe Search orFulfillmentrdquo was nominated or an APA William James Award In 2011 she wasrecognized with a Presidential Citation rom APA In addition to her academic writingshe edits a blog on Psychology Today entitled ldquoFulfillment at Any Agerdquo
Proessor Halgin received his PhD rom Fordham University and completed aellowship in the Department o Psychiatry at New York Hospital-Cornell MedicalCenter prior to joining the aculty o the University o Massachusetts in 1977 He is aBoard-Certified Clinical Psychologist with over our decades o clinical supervisory andconsulting experience At the University o Massachusetts he received the Distinguishedeaching Award the Alumni Associationrsquos Distinguished Faculty Award and wasnominated or the Carnegie Foundationrsquos US Proessor o the Year Award His teachingwas recognized by the Danorth Foundation and the Society or the eaching oPsychology Proessor Halgin is the author o sixty journal articles and book chaptersin the fields o psychotherapy clinical supervision and proessional issues in psychology
He is also the editor o Taking Sides Controversial Issues in Abnormal Psychology SixthEdition (McGraw-Hill) Proessor Halgin served as Chair o the Committee o Examinersor the Psychology Graduate Record Examination as an Associate Member o the EthicsCommittee o the American Psychological Association and currently serves on theMassachusetts Board o Registration o Psychologists
ABOUT THE AUTHORS
vi
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vii
Preface xvi
1 Overview to Understanding Abnormal Behavior 2
2 Diagnosis and Treatment 24
3 Assessment 46
4
Theoretical Perspectives 70 5 Neurodevelopmental Disorders 100
6 Schizophrenia Spectrum and Other Psychotic Disorders 136
7 Depressive and Bipolar Disorders 162
8 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders 184 9 Dissociative and Somatic Symptom Disorders 214
10 Feeding and Eating Disorders Elimination DisordersSleep-Wake Disorders and Disruptive Impulse-Controland Conduct Disorders 236
11 Paraphilic Disorders Sexual Dysfunctions and Gender Dysphoria 258
12 Substance-Related and Addictive Disorders 286
13 Neurocognitive Disorders 320
14 Personality Disorders 348
15 Ethical and Legal Issues 378
Glossary G-1
References R-1
Credits C-1
Name Index I-1
Subject Index I-9
BRIEF CONTENTS
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viii
Preface xvi
CHAPTER 1
Overview to Understanding AbnormalBehavior 2
Case Report Rebecca Hasbrouck 3
11 What Is Abnormal
Behavior 4
12 The Social Impact of Psychological Disorders 5
13 Defining Abnormality 6
14 What Causes Abnormal Behavior 7
Biological Causes 7
Psychological Causes 7
Sociocultural Causes 7
The Biopsychosocial Perspective 8
15 Prominent Themes in Abnormal Psychology
throughout History 9
Spiritual Approach 9
Humanitarian Approach 10
Scientific Approach 12
16 Research Methods in Abnormal Psychology 14
17 Experimental Design 14
Whatrsquos New in the DSM-5 Definition of a
Mental Disorder 15
18 Correlational Design 15
You Be the Judge Being Sane in Insane
Places 16
19 Types of Research Studies 17
Survey 17
REAL STORIES Vincent van Gogh
Psychosis 18
Laboratory Studies 19
The Case Study Method 20
Single Case Experimental Design 20
Investigations in Behavioral Genetics 20
Bringing It All Together Clinical
Perspectives 22
Return to the Case Rebecca Hasbrouck 22
SUMMARY 23
KEY TERMS 23
CHAPTER 2
Diagnosis and Treatment 24
Case Report PeterDickinson 25
21 Psychological Disorder
Experiences of Client and Clinician 26
The Client 26
The Clinician 27
22 The Diagnostic Process 27
Whatrsquos New in the DSM-5 Changes in
the DSM-5 Structure 28
The Diagnostic and Statistical Manual
(DSM-5) 28
Additional Information 28
Culture-Bound Syndromes 30
23 Steps in the Diagnostic Process 34
Diagnostic Procedures 34
Case Formulation 35
Cultural Formulation 35
24 Planning the Treatment 36
Goals of Treatment 36
You Be the Judge Psychologists as
Prescribers 37
Treatment Site 38
Psychiatric Hospitals 38
Specialized Inpatient Treatment Centers 38
Outpatient Treatment 39
Halfway Houses and Day Treatment Programs 39
Other Treatment Sites 39
Modality of Treatment 40
Determining the Best Approach to
Treatment 41
25The Course of Treatment 41
The Clinicianrsquos Role in Treatment 41
The Clientrsquos Role in Treatment 41
CONTENTS
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ix
REAL STORIES Daniel Johnston Bipolar
Disorder 42
26 The Outcome of Treatment 43
Return to the Case Peter Dickinson 44
SUMMARY 44
KEY TERMS 45
CHAPTER 3
Assessment 46
Case Report Ben Robsha m 47
31 Characteristics of Psychological
Assessments 48
32 Clinical Interview 49
33 Mental Status Examination 52
34 Intelligence Testing 52
Stanford-Binet Intelligence Test 53
Wechsler Intelligence Scales 53
35 Personality Testing 56
Self-Report Tests 56
Projective Testing 60
36 Behavioral Assessment 61
37 Multicultural Assessment 61
38 Neuropsychological Assessment 62
Whatrsquos New in the DSM-5 Section 3
Assessment Measures 63
You Be the Judge Psychologists in the
Legal System 64
39 Neuroimaging 65
REAL STORIES Ludwig van Beethoven
Bipolar Disorder 66
310 Putting It All Together 68
Return to the Case Ben Robsham 68
SUMMARY 69
KEY TERMS 69
CHAPTER 4
TheoreticalPerspectives 70
Case Report Meera
Krishnan 71
41 Theoretical Perspectives in Abnormal Psychology 72
42 Biological Perspective 72
Theories 72
Treatment 77
43 Trait Theory 80
Whatrsquos New in the DSM-5 Theoretical
Approaches 81
44 Psychodynamic Perspective 81
Freudrsquos Theory 81
Post-Freudian Psychodynamic Views 83
Treatment 86
45 Behavioral Perspective 86
Theories 86
You Be the Judge Evidence-Based
Practice 87
Treatment 88
46 Cognitive Perspective 89
Theories 89
Treatment 90
47 Humanistic Perspective 91
Theories 91
Treatment 93
48 Sociocultural Perspective 94
Theories 94
Treatment 94
REAL STORIES Sylvia Plath Major
Depressive Disorder 96
49 Biopsychosocial Perspectives on Theories and
Treatments An Integrative Approach 97
Return to the Case Meera Krishnan 98
SUMMARY 98
KEY TERMS 99
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x
CHAPTER 5
NeurodevelopmentalDisorders 100
Case Report Jason Newman 101
51 Intellectual Disability (Intellectual Developmental
Disorder) 103
Causes of Intellectual Disability 104
Whatrsquos New in the DSM-5
Neurodevelopmental Disorders 107
Treatment of Intellectual Disability 109
52 Autism Spectrum Disorder 110
Theories and Treatment of Autism
Spectrum Disorder 112
Rett Syndrome 115
High-Functioning Autism Spectrum Disorder
Formerly Called Aspergerrsquos Disorder 115
REAL STORIES Daniel Tammet Autism
Spectrum Disorder 116
53 Learning and Communication Disorders 118
Specific Learning Disorders 118
Communication Disorders 121
54 Attention-DeficitHyperactivity Disorder
(ADHD) 122
Characteristics of ADHD 122
ADHD in Adults 125
Theories and Treatment of ADHD 126
You Be the Judge Prescribing Psychiatric
Medications to Children 128
55 Motor Disorders 130
Developmental Coordination Disorder 130
Tic Disorders 131
Stereotypic Movement Disorder 132
56 Neurodevelopmental Disorders The Biopsychosocial
Perspective 132
Return to the Case Jason Newman 133
SUMMARY 133
KEY TERMS 134
CHAPTER 6
Schizophrenia Spectrumand Other PsychoticDisorders 136
Case Report David
Marshall 137
61 Schizophrenia 139
Whatrsquos New in the DSM-5 Schizophrenia
Subtypes and Dimensional Ratings 143
Course of Schizophrenia 143
You Be the Judge Schizophrenia
Diagnosis 145
62 Brief Psychotic Disorder 146
63 Schizophreniform Disorder 14764 Schizoaffective Disorder 147
65 Delusional Disorders 148
66 Theories and Treatment of Schizophrenia 150
Biological Perspectives 150
Theories 150
REAL STORIES Elyn Saks Schizophrenia 152
Treatments 153
Psychological Perspectives 154
Theories 154
Treatments 156
Sociocultural Perspectives 156
Theories 156
Treatments 158
67 Schizophrenia The Biopsychosocial
Perspective 159
Return to the Case David Marshall 160
SUMMARY 160
KEY TERMS 161
CHAPTER 7
Depressive and
Bipolar Disorders 162Case Report Janice Butterf ield 163
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xi
71 Depressive Disorders 164
Major Depressive Disorder 164
Persistent Depressive Disorder (Dysthymia) 166
Disruptive Mood Dysregulation Disorder 166
Premenstrual Dysphoric Disorder 167
72 Disorders Involving Alternations in Mood 167
Bipolar Disorder 167
REAL STORIES Carrie Fisher Bipolar
Disorder 168
Cyclothymic Disorder 170
73 Theories and Treatment of
Depressive and Bipolar Disorder 171
Biological Perspectives 171
Whatrsquos New in the DSM-5 Depressive
and Bipolar Disorders 174
Psychological Perspectives 176
Psychodynamic Approaches 176
Behavioral and Cognitive -Behavioral Approaches 176
Interpersonal Approaches 178
Sociocultural Perspectives 179
You Be the Judge Do-Not-Resuscitate
Orders for Suicidal Patients 180
74 Suicide 180
75 Depressive and Bipolar Disorders The Biopsychosocial
Perspective 182
Return to the Case Janice Butterfield 182
SUMMARY 183
KEY TERMS 183
CHAPTER 8
Anxiety Obsessive-Compulsive andTrauma- and Stressor-Related Disorders 184
Case Report Barba ra Wilder 185
81 Anxiety Disorders 186
Separation Anxiety Disorder 187
Theories and Treatment of Separation Anxiety Disorder 187
Selective Mutism 188
Specific Phobias 189
Theories and Treatment of Specific Phobias 190
Social Anxiety Disorder 192
Theories and Treatment of Social Anxiety Disorder 192
Panic Disorder and Agoraphobia 193
Panic Disorder 193
Agoraphobiar 194
Theories and Treatment of Panic Disorder and Agoraphobia 194
Generalized Anxiety Disorder 195
REAL STORIES Paula Deen Panic Disorder
with Agoraphobia 196
Theories and Treatment of Generalized Anxiety Disorder 197
82 Obsessive-Compulsive and Related Disorders 198
Whatrsquos New in the DSM-5 Definition and
Categorization of Anxiety Disorders 199
Theories and Treatment of Obsessive-Compulsive
Disorder 199
You Be the Judge Psychiatric
Neurosurgery 201
Body Dysmorphic Disorder 201
Hoarding Disorder 203
Trichotillomania (Hair-Pulling Disorder) 204
Excoriation (Skin-Picking) Disorder 206
83 Trauma- and Stressor-Related Disorders 206
Reactive Attachment Disorder and Disinhibited
Social Engagement Disorder 207
Acute Stress Disorder and Post-Traumatic Stress
Disorder 207
Theories and Treatment of Post-Traumatic Stress Disorder 208
84 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders The Biopsychosocial
Perspective 210
Return to the Case Barbara Wilder 210
SUMMARY 211
KEY TERMS 212
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xii
CHAPTER 9
Dissociative andSomatic SymptomDisorders 214
Case Report Rose
Marston 215
91 Dissociative Disorders 216
Major Forms of Dissociative Disorders 216
Theories and Treatment of Dissociative
Disorders 217
REAL STORIES Herschel Walker
Dissociative Identity Disorder 218
You Be the Judge Dissociative Identity
Disorder 220
92 Somatic Symptom and Related Disorders 222
Somatic Symptom Disorder 222
Illness Anxiety Disorder 223
Conversion Disorder (Functional Neurological
Symptom Disorder) 223
Conditions Related to Somatic Symptom
Disorders 224
Theories and Treatment of Somatic Symptom andRelated Disorders 225
Whatrsquos New in the DSM-5 Somatic
Symptom and Related Disorders 227
93 Psychological Factors Affecting
Medical Condition 227
Relevant Concepts for Understanding
Psychological Factors Affecting Medical
Condition 228
Stress and Coping 228
Emotional Expression 231
Personality Style 232
Applications to Behavioral Medicine 232
94 Dissociative and Somatic Symptom Disorders
The Biopsychosocial Perspective 233
Return to the Case Rose Marston 234
SUMMARY 234
KEY TERMS 235
CHAPTER 10
Feeding and EatingDisorders EliminationDisorders Sleep-WakeDisorders andDisruptive Impulse-
Control and ConductDisorders 236
Case Report Rosa
Nomirez 237
101 Eating Disorders 238
Characteristics of Anorexia Nervosa 239
REAL STORIES Portia de Rossi Anorexia
Nervosa 240Characteristics of Bulimia Nervosa 242
Binge-Eating Disorder 243
Theories and Treatment of Eating Disorders 243
Whatrsquos New in the DSM-5 Reclassifying
Eating Elimination Sleep-Wake and Disruptive
Impulse-Control and Conduct Disorders 245
AvoidantRestrictive Food Intake Disorder 245
Eating Disorders Associated with Childhood 246
102 Elimination Disorders 246
103 Sleep-Wake Disorders 247
104 Disruptive Impulse-Control and Conduct Disorders 249
Oppositional Defiant Disorder 249
Intermitten t Explosive Disorder 250
Conduct Disorder 252
Impulse-Control Disorders 252
Pyromania 252
You Be the Judge Legal Implications of
Impulse-Control Disorders 253
Kleptomania 254
105 Eating Elimination Sleep-Wake and Impulse-Control
Disorder The Biopsychosocial Perspective 255
Return to the Case Rosa Nomirez 255
SUMMARY 256
KEY TERMS 257
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xiii
CHAPTER 11
Paraphilic DisordersSexual Dysfunctionsand Gender Dysphoria 258
Case Report Shaun Boyden 259
111 What Patterns of Sexual Behavior Represent
Psychological Disorders 260
112 Paraphilic Disorders 262
Pedophilic Disorder 263
Exhibitionistic Disorder 264
Voyeuristic Disorder 264
Fetishistic Disorder 265
Frotteuristic Disorder 266
Sexual Masochism and Sexual Sadism
Disorders 266
Transvestic Disorder 267
Theories and Treatment of Paraphilic
Disorders 267
Biological Perspectives 268
Whatrsquos New in the DSM-5 The
Reorganization of Sexual Disorders 269
Psychological Perspectives 269
113 Sexual Dysfunctions 270
Arousal Disorders 271
Disorders Involving Orgasm 274
You Be the Judge Treatment for Sex
Offenders 275
Disorders Involving Pain 276
Theories and Treatment of SexualDysfunctions 276
Biological Perspectives 276
Psychological Perspectives 277
REAL STORIES Sue William Silverman Sex
Addiction 278
114 Gender Dysphoria 280
Theories and Treatment of Gender
Dysphoria 282
115 Paraphilic Disorders Sexual Dysfunctions and Gender
Dysphoria The Biopsychosocial Perspective 282
Return to the Case Shaun Boyden 284
SUMMARY 284
KEY TERMS 285
CHAPTER 12
Substance-Relatedand Addictive Disorders 286
Case Report Carl Wadsworth 287
121 Key Features of Substance
Disorders 289
Whatrsquos New in the DSM-5 Combining Abuse and
Dependence 290
122 Disorders Associated with Specific
Substances 290
Alcohol 292
Theories and Treatment of Alcohol
Use Disorders 295
Biological Perspectives 295
Psychological Perspectives 297
Sociocultural Perspective 298
Stimulants 299
Amphetamines 299
Cocaine 300
Cannabis 301
Hallucinogens 303
Opioids 306
You Be the Judge Prescribing
Prescription Drugs 307
Sedatives Hypnotics and Anxiolytics 308
Caffeine 309
REAL STORIES Robert Downey Jr
Substance Use Disorder 310
Tobacco 311
Inhalants 311
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xiv
Theories and Treatment of Substance Use
Disorders 311
Biologica l Perspectives 312
Psychological Perspectives 312
123 Non-Substance-Related Disorders 313
Gambling Disorder 313
124 Substance Disorders The Biopsychosocial
Perspective 316
Return to the Case
Carl Wadsworth 316
SUMMARY 317
KEY TERMS 318
CHAPTER 13
NeurocognitiveDisorders 320
Case Report Irene Heller 321
131 Characteristics of Neurocognitive Disorders 322
132 Delirium 324
133 Neurocognitive Disorder due to Alzheimerrsquos
Disease 327
Prevalence of Alzheimerrsquos Disease 328
Whatrsquos New in the DSM-5
Recategorization of Neurocognitive
Disorders 329
Stages of Alzheimerrsquos Disease 329
Diagnosis of Alzheimerrsquos Disease 330
Theories and Treatment of Alzheimerrsquos
Disease 333
Theories 333
You Be the Judge Early Diagnosis of
Alzheimerrsquos Disease 334
Treatment 336
REAL STORIES Ronald Reagan
Alzheimerrsquos Disease 338
134 Neurocognitive Disorders due to Neurological Disor-
ders Other than Alzheimerrsquos Disease 340
135 Neurocognitive Disorder due to TraumaticBrain Injury 343
136 Neurocognitive Disorders due to Substances
Medications and HIV Infection 344
137 Neurocognitive Disorders due to Another General
Medical Condition 344
138 Neurocognitive Disorders The Biopsychosocial
Perspective 345
Return to the Case Irene Heller 346
SUMMARY 346
KEY TERMS 347
CHAPTER 14
Personality Disorders 348
Case Report Harold Morrill 349
141 The Nature of Personality
Disorders 350
Whatrsquos New in the DSM-5
Dimensionalizing the Personality
Disorders 351
Personality Disorders in DSM-5 351
Alternative Personality Disorder Diagnostic System
in Section 3 of the DSM-5 352
142 Cluster A Personality Disorders 355
Paranoid Personality Disorder 355
Schizoid Personality Disorder 356Schizotypal Personality Disorder 357
143 Cluster B Personality Disorders 357
Antisocial Personality Disorder 357
Characteristics of Antisocial Personality
Disorder 358
Theories of Antisocial Personality
Disorder 360
You Be the Judge Antisocial PersonalityDisorder and Moral Culpability 361
Biological Perspectives 361
REAL STORIES Ted Bundy Antisocial
Personality Disorder 362
Psychological Perspectives 363
Treatment of Antisocial Personality
Disorder 364
Borderline Personality Disorder 364Characteristics of Borderline Personality
Disorder (BPD) 365
Theories and Treatment of BPD 366
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xv
Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
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You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
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xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
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xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
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ABNORMAL PSYCHOLOGYClinical Perspectives on Psychological Disorders
SEVENTH EDITION DSM-5 UPDATE
SUSAN KRAUSS WHITBOURNE
University of Massachusetts Amherst
RICHARD P HALGIN
University of Massachusetts Amherst
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ABNORMAL PSYCHOLOGY CLINICAL PERSPECIVES ON PSYCHOLOGICAL DISORDERS DSM9830855 UPDAE
SEVENH EDIION
Published by McGraw-Hill Education 2 Penn Plaza New York NY 10121 Copyright copy 2014 by McGraw-Hill
Education All rights reserved Printed in the United States o America Previous editions copy 2013 2010 and 2007
No part o this publication may be reproduced or distributed in any orm or by any means or stored in a database or
retrieval system without the prior written consent o McGraw-Hill Education including but not limited to in any
network or other electronic storage or transmission or broadcast or distance learning
Some ancillaries including electronic and print components may not be available to customers outside the
United States
Tis book is printed on acid-ree paper
1 2 3 4 5 6 7 8 9 0 DOWDOW 1 0 9 8 7 6 5 4 3
ISBN 978ndash1ndash259ndash13338ndash1
MHID 1ndash259ndash13338ndash9
Senior Vice President Products amp Markets Kurt L Strand
Vice President General Manager Products amp Markets Michael Ryan
Vice President Content Production amp echnology Services Kimberly Meriwether David
Managing Director William Glass
Director Krista BettinoSenior Director o Development Dawn Groundwater
Senior Development Editor Judith Kromm
Editorial Coordinator Chantelle Walker
Senior Digital Development Editor Sarah Colwell
Marketing Managers AJ LaferreraAnn Helgerson
Director Content Production Terri Schiesl
Content Project Manager (Print) Peggy J Selle
Content Project Manager (Media) Katie Klochan
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Design Srdjan Savanovic
Cover Image copy JGIJamie GrillBlend ImagesCorbisLead Content Licensing Specialist Keri Johnson
Compositor Aptarareg Inc
ypeace 1012 Times LT
Printer R R Donnelley Willard
All credits appearing on page or at the end o the book are considered to be an extension o the copyright page
Library of Congress Cataloging-in-Publication Data
Cataloging-in-Publication Data has been requested rom the Library o Congress
Te Internet addresses listed in the text were accurate at the time o publication Te inclusion o a website does not
indicate an endorsement by the authors or McGraw-Hill Education and McGraw-Hill Education does not guarantee
the accuracy o the inormation presented at these sites
wwwmhhecom
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To our families with love and appreciation
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vi Chapter 15 Ethical and Legal Issues
Susan Krauss Whitbourne and Richard Halgin are Proessors o Psychologyat the University o Massachusetts Amherst Both teach large undergraduate classes inaddition to teaching and supervising doctoral students in developmental and clinicalpsychology Teir clinical experience has covered both inpatient and outpatient settingsProessors Whitbourne and Halgin are Fellows o the American PsychologicalAssociation Tey co-edited A Case Book in Abnormal Psychology From the Files ofExperts (Oxord University Press) containing case studies written by leading internationalauthorities in the field o psychopathology
Proessor Whitbourne received her PhD rom Columbia University and has dual
specializations in lie-span developmental psychology and clinical psychology Shetaught at the State University o New York at Geneseo and the University o RochesterAt the University o Massachusetts she received the Universityrsquos Distinguished eachingAward the Outstanding Advising Award and the College o Arts and SciencesOutstanding eacher Award In 2001 she received the Psi Chi Eastern Region FacultyAdvisor Award and in 2002 the Florence Denmark Psi Chi National Advisor Award In2003 she received both the APA Division 20 and Gerontological Society o AmericaMentoring Awards She served as the Departmental Honors Coordinator rom 1990ndash2010 and currently is the Psi Chi Faculty Advisor and the Director o the Offi ce oNational Scholarship Advisement in the Commonwealth Honors College Te author osixteen books and over 160 journal articles and book chapters Proessor Whitbourne isregarded as an expert on personality development in mid- and late lie She is on theAPA Membership Board was Chair o APArsquos Policy and Planning Board and was amember o the APA Committee or the Structure and Function o Council She is APACouncil Representative to Division 20 (Adult Development and Aging) having alsoserved as Division 20 President She is a Fellow o APArsquos Divisions 20 1 (GeneralPsychology) 2 (eaching o Psychology) 12 (Clinical Psychology) and 35 (Society orthe Psychology o Women) A Fellow o the Gerontological Society o America sheserves on the Executive Board o the Behavioral and Social Sciences Section In 2007
she was the Psi Chi Eastern Region Vice President and in 2009 was the Program Chairo the 2009 National Leadership Conerence Proessor Whitbourne served as an itemwriter or the Educational esting Service was a member o APArsquos High SchoolCurriculum National Standards Advisory Panel wrote the APA High School CurriculumGuidelines or Lie-Span Developmental Psychology and serves as an item writer or theExamination or Proessional Practice o Psychology and as Chair o the Council oProessional Geropsychology raining Programs Her 2010 book ldquoTe Search orFulfillmentrdquo was nominated or an APA William James Award In 2011 she wasrecognized with a Presidential Citation rom APA In addition to her academic writingshe edits a blog on Psychology Today entitled ldquoFulfillment at Any Agerdquo
Proessor Halgin received his PhD rom Fordham University and completed aellowship in the Department o Psychiatry at New York Hospital-Cornell MedicalCenter prior to joining the aculty o the University o Massachusetts in 1977 He is aBoard-Certified Clinical Psychologist with over our decades o clinical supervisory andconsulting experience At the University o Massachusetts he received the Distinguishedeaching Award the Alumni Associationrsquos Distinguished Faculty Award and wasnominated or the Carnegie Foundationrsquos US Proessor o the Year Award His teachingwas recognized by the Danorth Foundation and the Society or the eaching oPsychology Proessor Halgin is the author o sixty journal articles and book chaptersin the fields o psychotherapy clinical supervision and proessional issues in psychology
He is also the editor o Taking Sides Controversial Issues in Abnormal Psychology SixthEdition (McGraw-Hill) Proessor Halgin served as Chair o the Committee o Examinersor the Psychology Graduate Record Examination as an Associate Member o the EthicsCommittee o the American Psychological Association and currently serves on theMassachusetts Board o Registration o Psychologists
ABOUT THE AUTHORS
vi
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vii
Preface xvi
1 Overview to Understanding Abnormal Behavior 2
2 Diagnosis and Treatment 24
3 Assessment 46
4
Theoretical Perspectives 70 5 Neurodevelopmental Disorders 100
6 Schizophrenia Spectrum and Other Psychotic Disorders 136
7 Depressive and Bipolar Disorders 162
8 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders 184 9 Dissociative and Somatic Symptom Disorders 214
10 Feeding and Eating Disorders Elimination DisordersSleep-Wake Disorders and Disruptive Impulse-Controland Conduct Disorders 236
11 Paraphilic Disorders Sexual Dysfunctions and Gender Dysphoria 258
12 Substance-Related and Addictive Disorders 286
13 Neurocognitive Disorders 320
14 Personality Disorders 348
15 Ethical and Legal Issues 378
Glossary G-1
References R-1
Credits C-1
Name Index I-1
Subject Index I-9
BRIEF CONTENTS
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viii
Preface xvi
CHAPTER 1
Overview to Understanding AbnormalBehavior 2
Case Report Rebecca Hasbrouck 3
11 What Is Abnormal
Behavior 4
12 The Social Impact of Psychological Disorders 5
13 Defining Abnormality 6
14 What Causes Abnormal Behavior 7
Biological Causes 7
Psychological Causes 7
Sociocultural Causes 7
The Biopsychosocial Perspective 8
15 Prominent Themes in Abnormal Psychology
throughout History 9
Spiritual Approach 9
Humanitarian Approach 10
Scientific Approach 12
16 Research Methods in Abnormal Psychology 14
17 Experimental Design 14
Whatrsquos New in the DSM-5 Definition of a
Mental Disorder 15
18 Correlational Design 15
You Be the Judge Being Sane in Insane
Places 16
19 Types of Research Studies 17
Survey 17
REAL STORIES Vincent van Gogh
Psychosis 18
Laboratory Studies 19
The Case Study Method 20
Single Case Experimental Design 20
Investigations in Behavioral Genetics 20
Bringing It All Together Clinical
Perspectives 22
Return to the Case Rebecca Hasbrouck 22
SUMMARY 23
KEY TERMS 23
CHAPTER 2
Diagnosis and Treatment 24
Case Report PeterDickinson 25
21 Psychological Disorder
Experiences of Client and Clinician 26
The Client 26
The Clinician 27
22 The Diagnostic Process 27
Whatrsquos New in the DSM-5 Changes in
the DSM-5 Structure 28
The Diagnostic and Statistical Manual
(DSM-5) 28
Additional Information 28
Culture-Bound Syndromes 30
23 Steps in the Diagnostic Process 34
Diagnostic Procedures 34
Case Formulation 35
Cultural Formulation 35
24 Planning the Treatment 36
Goals of Treatment 36
You Be the Judge Psychologists as
Prescribers 37
Treatment Site 38
Psychiatric Hospitals 38
Specialized Inpatient Treatment Centers 38
Outpatient Treatment 39
Halfway Houses and Day Treatment Programs 39
Other Treatment Sites 39
Modality of Treatment 40
Determining the Best Approach to
Treatment 41
25The Course of Treatment 41
The Clinicianrsquos Role in Treatment 41
The Clientrsquos Role in Treatment 41
CONTENTS
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ix
REAL STORIES Daniel Johnston Bipolar
Disorder 42
26 The Outcome of Treatment 43
Return to the Case Peter Dickinson 44
SUMMARY 44
KEY TERMS 45
CHAPTER 3
Assessment 46
Case Report Ben Robsha m 47
31 Characteristics of Psychological
Assessments 48
32 Clinical Interview 49
33 Mental Status Examination 52
34 Intelligence Testing 52
Stanford-Binet Intelligence Test 53
Wechsler Intelligence Scales 53
35 Personality Testing 56
Self-Report Tests 56
Projective Testing 60
36 Behavioral Assessment 61
37 Multicultural Assessment 61
38 Neuropsychological Assessment 62
Whatrsquos New in the DSM-5 Section 3
Assessment Measures 63
You Be the Judge Psychologists in the
Legal System 64
39 Neuroimaging 65
REAL STORIES Ludwig van Beethoven
Bipolar Disorder 66
310 Putting It All Together 68
Return to the Case Ben Robsham 68
SUMMARY 69
KEY TERMS 69
CHAPTER 4
TheoreticalPerspectives 70
Case Report Meera
Krishnan 71
41 Theoretical Perspectives in Abnormal Psychology 72
42 Biological Perspective 72
Theories 72
Treatment 77
43 Trait Theory 80
Whatrsquos New in the DSM-5 Theoretical
Approaches 81
44 Psychodynamic Perspective 81
Freudrsquos Theory 81
Post-Freudian Psychodynamic Views 83
Treatment 86
45 Behavioral Perspective 86
Theories 86
You Be the Judge Evidence-Based
Practice 87
Treatment 88
46 Cognitive Perspective 89
Theories 89
Treatment 90
47 Humanistic Perspective 91
Theories 91
Treatment 93
48 Sociocultural Perspective 94
Theories 94
Treatment 94
REAL STORIES Sylvia Plath Major
Depressive Disorder 96
49 Biopsychosocial Perspectives on Theories and
Treatments An Integrative Approach 97
Return to the Case Meera Krishnan 98
SUMMARY 98
KEY TERMS 99
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x
CHAPTER 5
NeurodevelopmentalDisorders 100
Case Report Jason Newman 101
51 Intellectual Disability (Intellectual Developmental
Disorder) 103
Causes of Intellectual Disability 104
Whatrsquos New in the DSM-5
Neurodevelopmental Disorders 107
Treatment of Intellectual Disability 109
52 Autism Spectrum Disorder 110
Theories and Treatment of Autism
Spectrum Disorder 112
Rett Syndrome 115
High-Functioning Autism Spectrum Disorder
Formerly Called Aspergerrsquos Disorder 115
REAL STORIES Daniel Tammet Autism
Spectrum Disorder 116
53 Learning and Communication Disorders 118
Specific Learning Disorders 118
Communication Disorders 121
54 Attention-DeficitHyperactivity Disorder
(ADHD) 122
Characteristics of ADHD 122
ADHD in Adults 125
Theories and Treatment of ADHD 126
You Be the Judge Prescribing Psychiatric
Medications to Children 128
55 Motor Disorders 130
Developmental Coordination Disorder 130
Tic Disorders 131
Stereotypic Movement Disorder 132
56 Neurodevelopmental Disorders The Biopsychosocial
Perspective 132
Return to the Case Jason Newman 133
SUMMARY 133
KEY TERMS 134
CHAPTER 6
Schizophrenia Spectrumand Other PsychoticDisorders 136
Case Report David
Marshall 137
61 Schizophrenia 139
Whatrsquos New in the DSM-5 Schizophrenia
Subtypes and Dimensional Ratings 143
Course of Schizophrenia 143
You Be the Judge Schizophrenia
Diagnosis 145
62 Brief Psychotic Disorder 146
63 Schizophreniform Disorder 14764 Schizoaffective Disorder 147
65 Delusional Disorders 148
66 Theories and Treatment of Schizophrenia 150
Biological Perspectives 150
Theories 150
REAL STORIES Elyn Saks Schizophrenia 152
Treatments 153
Psychological Perspectives 154
Theories 154
Treatments 156
Sociocultural Perspectives 156
Theories 156
Treatments 158
67 Schizophrenia The Biopsychosocial
Perspective 159
Return to the Case David Marshall 160
SUMMARY 160
KEY TERMS 161
CHAPTER 7
Depressive and
Bipolar Disorders 162Case Report Janice Butterf ield 163
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71 Depressive Disorders 164
Major Depressive Disorder 164
Persistent Depressive Disorder (Dysthymia) 166
Disruptive Mood Dysregulation Disorder 166
Premenstrual Dysphoric Disorder 167
72 Disorders Involving Alternations in Mood 167
Bipolar Disorder 167
REAL STORIES Carrie Fisher Bipolar
Disorder 168
Cyclothymic Disorder 170
73 Theories and Treatment of
Depressive and Bipolar Disorder 171
Biological Perspectives 171
Whatrsquos New in the DSM-5 Depressive
and Bipolar Disorders 174
Psychological Perspectives 176
Psychodynamic Approaches 176
Behavioral and Cognitive -Behavioral Approaches 176
Interpersonal Approaches 178
Sociocultural Perspectives 179
You Be the Judge Do-Not-Resuscitate
Orders for Suicidal Patients 180
74 Suicide 180
75 Depressive and Bipolar Disorders The Biopsychosocial
Perspective 182
Return to the Case Janice Butterfield 182
SUMMARY 183
KEY TERMS 183
CHAPTER 8
Anxiety Obsessive-Compulsive andTrauma- and Stressor-Related Disorders 184
Case Report Barba ra Wilder 185
81 Anxiety Disorders 186
Separation Anxiety Disorder 187
Theories and Treatment of Separation Anxiety Disorder 187
Selective Mutism 188
Specific Phobias 189
Theories and Treatment of Specific Phobias 190
Social Anxiety Disorder 192
Theories and Treatment of Social Anxiety Disorder 192
Panic Disorder and Agoraphobia 193
Panic Disorder 193
Agoraphobiar 194
Theories and Treatment of Panic Disorder and Agoraphobia 194
Generalized Anxiety Disorder 195
REAL STORIES Paula Deen Panic Disorder
with Agoraphobia 196
Theories and Treatment of Generalized Anxiety Disorder 197
82 Obsessive-Compulsive and Related Disorders 198
Whatrsquos New in the DSM-5 Definition and
Categorization of Anxiety Disorders 199
Theories and Treatment of Obsessive-Compulsive
Disorder 199
You Be the Judge Psychiatric
Neurosurgery 201
Body Dysmorphic Disorder 201
Hoarding Disorder 203
Trichotillomania (Hair-Pulling Disorder) 204
Excoriation (Skin-Picking) Disorder 206
83 Trauma- and Stressor-Related Disorders 206
Reactive Attachment Disorder and Disinhibited
Social Engagement Disorder 207
Acute Stress Disorder and Post-Traumatic Stress
Disorder 207
Theories and Treatment of Post-Traumatic Stress Disorder 208
84 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders The Biopsychosocial
Perspective 210
Return to the Case Barbara Wilder 210
SUMMARY 211
KEY TERMS 212
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CHAPTER 9
Dissociative andSomatic SymptomDisorders 214
Case Report Rose
Marston 215
91 Dissociative Disorders 216
Major Forms of Dissociative Disorders 216
Theories and Treatment of Dissociative
Disorders 217
REAL STORIES Herschel Walker
Dissociative Identity Disorder 218
You Be the Judge Dissociative Identity
Disorder 220
92 Somatic Symptom and Related Disorders 222
Somatic Symptom Disorder 222
Illness Anxiety Disorder 223
Conversion Disorder (Functional Neurological
Symptom Disorder) 223
Conditions Related to Somatic Symptom
Disorders 224
Theories and Treatment of Somatic Symptom andRelated Disorders 225
Whatrsquos New in the DSM-5 Somatic
Symptom and Related Disorders 227
93 Psychological Factors Affecting
Medical Condition 227
Relevant Concepts for Understanding
Psychological Factors Affecting Medical
Condition 228
Stress and Coping 228
Emotional Expression 231
Personality Style 232
Applications to Behavioral Medicine 232
94 Dissociative and Somatic Symptom Disorders
The Biopsychosocial Perspective 233
Return to the Case Rose Marston 234
SUMMARY 234
KEY TERMS 235
CHAPTER 10
Feeding and EatingDisorders EliminationDisorders Sleep-WakeDisorders andDisruptive Impulse-
Control and ConductDisorders 236
Case Report Rosa
Nomirez 237
101 Eating Disorders 238
Characteristics of Anorexia Nervosa 239
REAL STORIES Portia de Rossi Anorexia
Nervosa 240Characteristics of Bulimia Nervosa 242
Binge-Eating Disorder 243
Theories and Treatment of Eating Disorders 243
Whatrsquos New in the DSM-5 Reclassifying
Eating Elimination Sleep-Wake and Disruptive
Impulse-Control and Conduct Disorders 245
AvoidantRestrictive Food Intake Disorder 245
Eating Disorders Associated with Childhood 246
102 Elimination Disorders 246
103 Sleep-Wake Disorders 247
104 Disruptive Impulse-Control and Conduct Disorders 249
Oppositional Defiant Disorder 249
Intermitten t Explosive Disorder 250
Conduct Disorder 252
Impulse-Control Disorders 252
Pyromania 252
You Be the Judge Legal Implications of
Impulse-Control Disorders 253
Kleptomania 254
105 Eating Elimination Sleep-Wake and Impulse-Control
Disorder The Biopsychosocial Perspective 255
Return to the Case Rosa Nomirez 255
SUMMARY 256
KEY TERMS 257
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xiii
CHAPTER 11
Paraphilic DisordersSexual Dysfunctionsand Gender Dysphoria 258
Case Report Shaun Boyden 259
111 What Patterns of Sexual Behavior Represent
Psychological Disorders 260
112 Paraphilic Disorders 262
Pedophilic Disorder 263
Exhibitionistic Disorder 264
Voyeuristic Disorder 264
Fetishistic Disorder 265
Frotteuristic Disorder 266
Sexual Masochism and Sexual Sadism
Disorders 266
Transvestic Disorder 267
Theories and Treatment of Paraphilic
Disorders 267
Biological Perspectives 268
Whatrsquos New in the DSM-5 The
Reorganization of Sexual Disorders 269
Psychological Perspectives 269
113 Sexual Dysfunctions 270
Arousal Disorders 271
Disorders Involving Orgasm 274
You Be the Judge Treatment for Sex
Offenders 275
Disorders Involving Pain 276
Theories and Treatment of SexualDysfunctions 276
Biological Perspectives 276
Psychological Perspectives 277
REAL STORIES Sue William Silverman Sex
Addiction 278
114 Gender Dysphoria 280
Theories and Treatment of Gender
Dysphoria 282
115 Paraphilic Disorders Sexual Dysfunctions and Gender
Dysphoria The Biopsychosocial Perspective 282
Return to the Case Shaun Boyden 284
SUMMARY 284
KEY TERMS 285
CHAPTER 12
Substance-Relatedand Addictive Disorders 286
Case Report Carl Wadsworth 287
121 Key Features of Substance
Disorders 289
Whatrsquos New in the DSM-5 Combining Abuse and
Dependence 290
122 Disorders Associated with Specific
Substances 290
Alcohol 292
Theories and Treatment of Alcohol
Use Disorders 295
Biological Perspectives 295
Psychological Perspectives 297
Sociocultural Perspective 298
Stimulants 299
Amphetamines 299
Cocaine 300
Cannabis 301
Hallucinogens 303
Opioids 306
You Be the Judge Prescribing
Prescription Drugs 307
Sedatives Hypnotics and Anxiolytics 308
Caffeine 309
REAL STORIES Robert Downey Jr
Substance Use Disorder 310
Tobacco 311
Inhalants 311
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xiv
Theories and Treatment of Substance Use
Disorders 311
Biologica l Perspectives 312
Psychological Perspectives 312
123 Non-Substance-Related Disorders 313
Gambling Disorder 313
124 Substance Disorders The Biopsychosocial
Perspective 316
Return to the Case
Carl Wadsworth 316
SUMMARY 317
KEY TERMS 318
CHAPTER 13
NeurocognitiveDisorders 320
Case Report Irene Heller 321
131 Characteristics of Neurocognitive Disorders 322
132 Delirium 324
133 Neurocognitive Disorder due to Alzheimerrsquos
Disease 327
Prevalence of Alzheimerrsquos Disease 328
Whatrsquos New in the DSM-5
Recategorization of Neurocognitive
Disorders 329
Stages of Alzheimerrsquos Disease 329
Diagnosis of Alzheimerrsquos Disease 330
Theories and Treatment of Alzheimerrsquos
Disease 333
Theories 333
You Be the Judge Early Diagnosis of
Alzheimerrsquos Disease 334
Treatment 336
REAL STORIES Ronald Reagan
Alzheimerrsquos Disease 338
134 Neurocognitive Disorders due to Neurological Disor-
ders Other than Alzheimerrsquos Disease 340
135 Neurocognitive Disorder due to TraumaticBrain Injury 343
136 Neurocognitive Disorders due to Substances
Medications and HIV Infection 344
137 Neurocognitive Disorders due to Another General
Medical Condition 344
138 Neurocognitive Disorders The Biopsychosocial
Perspective 345
Return to the Case Irene Heller 346
SUMMARY 346
KEY TERMS 347
CHAPTER 14
Personality Disorders 348
Case Report Harold Morrill 349
141 The Nature of Personality
Disorders 350
Whatrsquos New in the DSM-5
Dimensionalizing the Personality
Disorders 351
Personality Disorders in DSM-5 351
Alternative Personality Disorder Diagnostic System
in Section 3 of the DSM-5 352
142 Cluster A Personality Disorders 355
Paranoid Personality Disorder 355
Schizoid Personality Disorder 356Schizotypal Personality Disorder 357
143 Cluster B Personality Disorders 357
Antisocial Personality Disorder 357
Characteristics of Antisocial Personality
Disorder 358
Theories of Antisocial Personality
Disorder 360
You Be the Judge Antisocial PersonalityDisorder and Moral Culpability 361
Biological Perspectives 361
REAL STORIES Ted Bundy Antisocial
Personality Disorder 362
Psychological Perspectives 363
Treatment of Antisocial Personality
Disorder 364
Borderline Personality Disorder 364Characteristics of Borderline Personality
Disorder (BPD) 365
Theories and Treatment of BPD 366
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xv
Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
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You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
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xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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xx
CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
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A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
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ABNORMAL PSYCHOLOGYClinical Perspectives on Psychological Disorders
SEVENTH EDITION DSM-5 UPDATE
SUSAN KRAUSS WHITBOURNE
University of Massachusetts Amherst
RICHARD P HALGIN
University of Massachusetts Amherst
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ABNORMAL PSYCHOLOGY CLINICAL PERSPECIVES ON PSYCHOLOGICAL DISORDERS DSM9830855 UPDAE
SEVENH EDIION
Published by McGraw-Hill Education 2 Penn Plaza New York NY 10121 Copyright copy 2014 by McGraw-Hill
Education All rights reserved Printed in the United States o America Previous editions copy 2013 2010 and 2007
No part o this publication may be reproduced or distributed in any orm or by any means or stored in a database or
retrieval system without the prior written consent o McGraw-Hill Education including but not limited to in any
network or other electronic storage or transmission or broadcast or distance learning
Some ancillaries including electronic and print components may not be available to customers outside the
United States
Tis book is printed on acid-ree paper
1 2 3 4 5 6 7 8 9 0 DOWDOW 1 0 9 8 7 6 5 4 3
ISBN 978ndash1ndash259ndash13338ndash1
MHID 1ndash259ndash13338ndash9
Senior Vice President Products amp Markets Kurt L Strand
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Director Krista BettinoSenior Director o Development Dawn Groundwater
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Marketing Managers AJ LaferreraAnn Helgerson
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ypeace 1012 Times LT
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All credits appearing on page or at the end o the book are considered to be an extension o the copyright page
Library of Congress Cataloging-in-Publication Data
Cataloging-in-Publication Data has been requested rom the Library o Congress
Te Internet addresses listed in the text were accurate at the time o publication Te inclusion o a website does not
indicate an endorsement by the authors or McGraw-Hill Education and McGraw-Hill Education does not guarantee
the accuracy o the inormation presented at these sites
wwwmhhecom
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To our families with love and appreciation
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vi Chapter 15 Ethical and Legal Issues
Susan Krauss Whitbourne and Richard Halgin are Proessors o Psychologyat the University o Massachusetts Amherst Both teach large undergraduate classes inaddition to teaching and supervising doctoral students in developmental and clinicalpsychology Teir clinical experience has covered both inpatient and outpatient settingsProessors Whitbourne and Halgin are Fellows o the American PsychologicalAssociation Tey co-edited A Case Book in Abnormal Psychology From the Files ofExperts (Oxord University Press) containing case studies written by leading internationalauthorities in the field o psychopathology
Proessor Whitbourne received her PhD rom Columbia University and has dual
specializations in lie-span developmental psychology and clinical psychology Shetaught at the State University o New York at Geneseo and the University o RochesterAt the University o Massachusetts she received the Universityrsquos Distinguished eachingAward the Outstanding Advising Award and the College o Arts and SciencesOutstanding eacher Award In 2001 she received the Psi Chi Eastern Region FacultyAdvisor Award and in 2002 the Florence Denmark Psi Chi National Advisor Award In2003 she received both the APA Division 20 and Gerontological Society o AmericaMentoring Awards She served as the Departmental Honors Coordinator rom 1990ndash2010 and currently is the Psi Chi Faculty Advisor and the Director o the Offi ce oNational Scholarship Advisement in the Commonwealth Honors College Te author osixteen books and over 160 journal articles and book chapters Proessor Whitbourne isregarded as an expert on personality development in mid- and late lie She is on theAPA Membership Board was Chair o APArsquos Policy and Planning Board and was amember o the APA Committee or the Structure and Function o Council She is APACouncil Representative to Division 20 (Adult Development and Aging) having alsoserved as Division 20 President She is a Fellow o APArsquos Divisions 20 1 (GeneralPsychology) 2 (eaching o Psychology) 12 (Clinical Psychology) and 35 (Society orthe Psychology o Women) A Fellow o the Gerontological Society o America sheserves on the Executive Board o the Behavioral and Social Sciences Section In 2007
she was the Psi Chi Eastern Region Vice President and in 2009 was the Program Chairo the 2009 National Leadership Conerence Proessor Whitbourne served as an itemwriter or the Educational esting Service was a member o APArsquos High SchoolCurriculum National Standards Advisory Panel wrote the APA High School CurriculumGuidelines or Lie-Span Developmental Psychology and serves as an item writer or theExamination or Proessional Practice o Psychology and as Chair o the Council oProessional Geropsychology raining Programs Her 2010 book ldquoTe Search orFulfillmentrdquo was nominated or an APA William James Award In 2011 she wasrecognized with a Presidential Citation rom APA In addition to her academic writingshe edits a blog on Psychology Today entitled ldquoFulfillment at Any Agerdquo
Proessor Halgin received his PhD rom Fordham University and completed aellowship in the Department o Psychiatry at New York Hospital-Cornell MedicalCenter prior to joining the aculty o the University o Massachusetts in 1977 He is aBoard-Certified Clinical Psychologist with over our decades o clinical supervisory andconsulting experience At the University o Massachusetts he received the Distinguishedeaching Award the Alumni Associationrsquos Distinguished Faculty Award and wasnominated or the Carnegie Foundationrsquos US Proessor o the Year Award His teachingwas recognized by the Danorth Foundation and the Society or the eaching oPsychology Proessor Halgin is the author o sixty journal articles and book chaptersin the fields o psychotherapy clinical supervision and proessional issues in psychology
He is also the editor o Taking Sides Controversial Issues in Abnormal Psychology SixthEdition (McGraw-Hill) Proessor Halgin served as Chair o the Committee o Examinersor the Psychology Graduate Record Examination as an Associate Member o the EthicsCommittee o the American Psychological Association and currently serves on theMassachusetts Board o Registration o Psychologists
ABOUT THE AUTHORS
vi
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vii
Preface xvi
1 Overview to Understanding Abnormal Behavior 2
2 Diagnosis and Treatment 24
3 Assessment 46
4
Theoretical Perspectives 70 5 Neurodevelopmental Disorders 100
6 Schizophrenia Spectrum and Other Psychotic Disorders 136
7 Depressive and Bipolar Disorders 162
8 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders 184 9 Dissociative and Somatic Symptom Disorders 214
10 Feeding and Eating Disorders Elimination DisordersSleep-Wake Disorders and Disruptive Impulse-Controland Conduct Disorders 236
11 Paraphilic Disorders Sexual Dysfunctions and Gender Dysphoria 258
12 Substance-Related and Addictive Disorders 286
13 Neurocognitive Disorders 320
14 Personality Disorders 348
15 Ethical and Legal Issues 378
Glossary G-1
References R-1
Credits C-1
Name Index I-1
Subject Index I-9
BRIEF CONTENTS
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viii
Preface xvi
CHAPTER 1
Overview to Understanding AbnormalBehavior 2
Case Report Rebecca Hasbrouck 3
11 What Is Abnormal
Behavior 4
12 The Social Impact of Psychological Disorders 5
13 Defining Abnormality 6
14 What Causes Abnormal Behavior 7
Biological Causes 7
Psychological Causes 7
Sociocultural Causes 7
The Biopsychosocial Perspective 8
15 Prominent Themes in Abnormal Psychology
throughout History 9
Spiritual Approach 9
Humanitarian Approach 10
Scientific Approach 12
16 Research Methods in Abnormal Psychology 14
17 Experimental Design 14
Whatrsquos New in the DSM-5 Definition of a
Mental Disorder 15
18 Correlational Design 15
You Be the Judge Being Sane in Insane
Places 16
19 Types of Research Studies 17
Survey 17
REAL STORIES Vincent van Gogh
Psychosis 18
Laboratory Studies 19
The Case Study Method 20
Single Case Experimental Design 20
Investigations in Behavioral Genetics 20
Bringing It All Together Clinical
Perspectives 22
Return to the Case Rebecca Hasbrouck 22
SUMMARY 23
KEY TERMS 23
CHAPTER 2
Diagnosis and Treatment 24
Case Report PeterDickinson 25
21 Psychological Disorder
Experiences of Client and Clinician 26
The Client 26
The Clinician 27
22 The Diagnostic Process 27
Whatrsquos New in the DSM-5 Changes in
the DSM-5 Structure 28
The Diagnostic and Statistical Manual
(DSM-5) 28
Additional Information 28
Culture-Bound Syndromes 30
23 Steps in the Diagnostic Process 34
Diagnostic Procedures 34
Case Formulation 35
Cultural Formulation 35
24 Planning the Treatment 36
Goals of Treatment 36
You Be the Judge Psychologists as
Prescribers 37
Treatment Site 38
Psychiatric Hospitals 38
Specialized Inpatient Treatment Centers 38
Outpatient Treatment 39
Halfway Houses and Day Treatment Programs 39
Other Treatment Sites 39
Modality of Treatment 40
Determining the Best Approach to
Treatment 41
25The Course of Treatment 41
The Clinicianrsquos Role in Treatment 41
The Clientrsquos Role in Treatment 41
CONTENTS
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ix
REAL STORIES Daniel Johnston Bipolar
Disorder 42
26 The Outcome of Treatment 43
Return to the Case Peter Dickinson 44
SUMMARY 44
KEY TERMS 45
CHAPTER 3
Assessment 46
Case Report Ben Robsha m 47
31 Characteristics of Psychological
Assessments 48
32 Clinical Interview 49
33 Mental Status Examination 52
34 Intelligence Testing 52
Stanford-Binet Intelligence Test 53
Wechsler Intelligence Scales 53
35 Personality Testing 56
Self-Report Tests 56
Projective Testing 60
36 Behavioral Assessment 61
37 Multicultural Assessment 61
38 Neuropsychological Assessment 62
Whatrsquos New in the DSM-5 Section 3
Assessment Measures 63
You Be the Judge Psychologists in the
Legal System 64
39 Neuroimaging 65
REAL STORIES Ludwig van Beethoven
Bipolar Disorder 66
310 Putting It All Together 68
Return to the Case Ben Robsham 68
SUMMARY 69
KEY TERMS 69
CHAPTER 4
TheoreticalPerspectives 70
Case Report Meera
Krishnan 71
41 Theoretical Perspectives in Abnormal Psychology 72
42 Biological Perspective 72
Theories 72
Treatment 77
43 Trait Theory 80
Whatrsquos New in the DSM-5 Theoretical
Approaches 81
44 Psychodynamic Perspective 81
Freudrsquos Theory 81
Post-Freudian Psychodynamic Views 83
Treatment 86
45 Behavioral Perspective 86
Theories 86
You Be the Judge Evidence-Based
Practice 87
Treatment 88
46 Cognitive Perspective 89
Theories 89
Treatment 90
47 Humanistic Perspective 91
Theories 91
Treatment 93
48 Sociocultural Perspective 94
Theories 94
Treatment 94
REAL STORIES Sylvia Plath Major
Depressive Disorder 96
49 Biopsychosocial Perspectives on Theories and
Treatments An Integrative Approach 97
Return to the Case Meera Krishnan 98
SUMMARY 98
KEY TERMS 99
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CHAPTER 5
NeurodevelopmentalDisorders 100
Case Report Jason Newman 101
51 Intellectual Disability (Intellectual Developmental
Disorder) 103
Causes of Intellectual Disability 104
Whatrsquos New in the DSM-5
Neurodevelopmental Disorders 107
Treatment of Intellectual Disability 109
52 Autism Spectrum Disorder 110
Theories and Treatment of Autism
Spectrum Disorder 112
Rett Syndrome 115
High-Functioning Autism Spectrum Disorder
Formerly Called Aspergerrsquos Disorder 115
REAL STORIES Daniel Tammet Autism
Spectrum Disorder 116
53 Learning and Communication Disorders 118
Specific Learning Disorders 118
Communication Disorders 121
54 Attention-DeficitHyperactivity Disorder
(ADHD) 122
Characteristics of ADHD 122
ADHD in Adults 125
Theories and Treatment of ADHD 126
You Be the Judge Prescribing Psychiatric
Medications to Children 128
55 Motor Disorders 130
Developmental Coordination Disorder 130
Tic Disorders 131
Stereotypic Movement Disorder 132
56 Neurodevelopmental Disorders The Biopsychosocial
Perspective 132
Return to the Case Jason Newman 133
SUMMARY 133
KEY TERMS 134
CHAPTER 6
Schizophrenia Spectrumand Other PsychoticDisorders 136
Case Report David
Marshall 137
61 Schizophrenia 139
Whatrsquos New in the DSM-5 Schizophrenia
Subtypes and Dimensional Ratings 143
Course of Schizophrenia 143
You Be the Judge Schizophrenia
Diagnosis 145
62 Brief Psychotic Disorder 146
63 Schizophreniform Disorder 14764 Schizoaffective Disorder 147
65 Delusional Disorders 148
66 Theories and Treatment of Schizophrenia 150
Biological Perspectives 150
Theories 150
REAL STORIES Elyn Saks Schizophrenia 152
Treatments 153
Psychological Perspectives 154
Theories 154
Treatments 156
Sociocultural Perspectives 156
Theories 156
Treatments 158
67 Schizophrenia The Biopsychosocial
Perspective 159
Return to the Case David Marshall 160
SUMMARY 160
KEY TERMS 161
CHAPTER 7
Depressive and
Bipolar Disorders 162Case Report Janice Butterf ield 163
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xi
71 Depressive Disorders 164
Major Depressive Disorder 164
Persistent Depressive Disorder (Dysthymia) 166
Disruptive Mood Dysregulation Disorder 166
Premenstrual Dysphoric Disorder 167
72 Disorders Involving Alternations in Mood 167
Bipolar Disorder 167
REAL STORIES Carrie Fisher Bipolar
Disorder 168
Cyclothymic Disorder 170
73 Theories and Treatment of
Depressive and Bipolar Disorder 171
Biological Perspectives 171
Whatrsquos New in the DSM-5 Depressive
and Bipolar Disorders 174
Psychological Perspectives 176
Psychodynamic Approaches 176
Behavioral and Cognitive -Behavioral Approaches 176
Interpersonal Approaches 178
Sociocultural Perspectives 179
You Be the Judge Do-Not-Resuscitate
Orders for Suicidal Patients 180
74 Suicide 180
75 Depressive and Bipolar Disorders The Biopsychosocial
Perspective 182
Return to the Case Janice Butterfield 182
SUMMARY 183
KEY TERMS 183
CHAPTER 8
Anxiety Obsessive-Compulsive andTrauma- and Stressor-Related Disorders 184
Case Report Barba ra Wilder 185
81 Anxiety Disorders 186
Separation Anxiety Disorder 187
Theories and Treatment of Separation Anxiety Disorder 187
Selective Mutism 188
Specific Phobias 189
Theories and Treatment of Specific Phobias 190
Social Anxiety Disorder 192
Theories and Treatment of Social Anxiety Disorder 192
Panic Disorder and Agoraphobia 193
Panic Disorder 193
Agoraphobiar 194
Theories and Treatment of Panic Disorder and Agoraphobia 194
Generalized Anxiety Disorder 195
REAL STORIES Paula Deen Panic Disorder
with Agoraphobia 196
Theories and Treatment of Generalized Anxiety Disorder 197
82 Obsessive-Compulsive and Related Disorders 198
Whatrsquos New in the DSM-5 Definition and
Categorization of Anxiety Disorders 199
Theories and Treatment of Obsessive-Compulsive
Disorder 199
You Be the Judge Psychiatric
Neurosurgery 201
Body Dysmorphic Disorder 201
Hoarding Disorder 203
Trichotillomania (Hair-Pulling Disorder) 204
Excoriation (Skin-Picking) Disorder 206
83 Trauma- and Stressor-Related Disorders 206
Reactive Attachment Disorder and Disinhibited
Social Engagement Disorder 207
Acute Stress Disorder and Post-Traumatic Stress
Disorder 207
Theories and Treatment of Post-Traumatic Stress Disorder 208
84 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders The Biopsychosocial
Perspective 210
Return to the Case Barbara Wilder 210
SUMMARY 211
KEY TERMS 212
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xii
CHAPTER 9
Dissociative andSomatic SymptomDisorders 214
Case Report Rose
Marston 215
91 Dissociative Disorders 216
Major Forms of Dissociative Disorders 216
Theories and Treatment of Dissociative
Disorders 217
REAL STORIES Herschel Walker
Dissociative Identity Disorder 218
You Be the Judge Dissociative Identity
Disorder 220
92 Somatic Symptom and Related Disorders 222
Somatic Symptom Disorder 222
Illness Anxiety Disorder 223
Conversion Disorder (Functional Neurological
Symptom Disorder) 223
Conditions Related to Somatic Symptom
Disorders 224
Theories and Treatment of Somatic Symptom andRelated Disorders 225
Whatrsquos New in the DSM-5 Somatic
Symptom and Related Disorders 227
93 Psychological Factors Affecting
Medical Condition 227
Relevant Concepts for Understanding
Psychological Factors Affecting Medical
Condition 228
Stress and Coping 228
Emotional Expression 231
Personality Style 232
Applications to Behavioral Medicine 232
94 Dissociative and Somatic Symptom Disorders
The Biopsychosocial Perspective 233
Return to the Case Rose Marston 234
SUMMARY 234
KEY TERMS 235
CHAPTER 10
Feeding and EatingDisorders EliminationDisorders Sleep-WakeDisorders andDisruptive Impulse-
Control and ConductDisorders 236
Case Report Rosa
Nomirez 237
101 Eating Disorders 238
Characteristics of Anorexia Nervosa 239
REAL STORIES Portia de Rossi Anorexia
Nervosa 240Characteristics of Bulimia Nervosa 242
Binge-Eating Disorder 243
Theories and Treatment of Eating Disorders 243
Whatrsquos New in the DSM-5 Reclassifying
Eating Elimination Sleep-Wake and Disruptive
Impulse-Control and Conduct Disorders 245
AvoidantRestrictive Food Intake Disorder 245
Eating Disorders Associated with Childhood 246
102 Elimination Disorders 246
103 Sleep-Wake Disorders 247
104 Disruptive Impulse-Control and Conduct Disorders 249
Oppositional Defiant Disorder 249
Intermitten t Explosive Disorder 250
Conduct Disorder 252
Impulse-Control Disorders 252
Pyromania 252
You Be the Judge Legal Implications of
Impulse-Control Disorders 253
Kleptomania 254
105 Eating Elimination Sleep-Wake and Impulse-Control
Disorder The Biopsychosocial Perspective 255
Return to the Case Rosa Nomirez 255
SUMMARY 256
KEY TERMS 257
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xiii
CHAPTER 11
Paraphilic DisordersSexual Dysfunctionsand Gender Dysphoria 258
Case Report Shaun Boyden 259
111 What Patterns of Sexual Behavior Represent
Psychological Disorders 260
112 Paraphilic Disorders 262
Pedophilic Disorder 263
Exhibitionistic Disorder 264
Voyeuristic Disorder 264
Fetishistic Disorder 265
Frotteuristic Disorder 266
Sexual Masochism and Sexual Sadism
Disorders 266
Transvestic Disorder 267
Theories and Treatment of Paraphilic
Disorders 267
Biological Perspectives 268
Whatrsquos New in the DSM-5 The
Reorganization of Sexual Disorders 269
Psychological Perspectives 269
113 Sexual Dysfunctions 270
Arousal Disorders 271
Disorders Involving Orgasm 274
You Be the Judge Treatment for Sex
Offenders 275
Disorders Involving Pain 276
Theories and Treatment of SexualDysfunctions 276
Biological Perspectives 276
Psychological Perspectives 277
REAL STORIES Sue William Silverman Sex
Addiction 278
114 Gender Dysphoria 280
Theories and Treatment of Gender
Dysphoria 282
115 Paraphilic Disorders Sexual Dysfunctions and Gender
Dysphoria The Biopsychosocial Perspective 282
Return to the Case Shaun Boyden 284
SUMMARY 284
KEY TERMS 285
CHAPTER 12
Substance-Relatedand Addictive Disorders 286
Case Report Carl Wadsworth 287
121 Key Features of Substance
Disorders 289
Whatrsquos New in the DSM-5 Combining Abuse and
Dependence 290
122 Disorders Associated with Specific
Substances 290
Alcohol 292
Theories and Treatment of Alcohol
Use Disorders 295
Biological Perspectives 295
Psychological Perspectives 297
Sociocultural Perspective 298
Stimulants 299
Amphetamines 299
Cocaine 300
Cannabis 301
Hallucinogens 303
Opioids 306
You Be the Judge Prescribing
Prescription Drugs 307
Sedatives Hypnotics and Anxiolytics 308
Caffeine 309
REAL STORIES Robert Downey Jr
Substance Use Disorder 310
Tobacco 311
Inhalants 311
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Theories and Treatment of Substance Use
Disorders 311
Biologica l Perspectives 312
Psychological Perspectives 312
123 Non-Substance-Related Disorders 313
Gambling Disorder 313
124 Substance Disorders The Biopsychosocial
Perspective 316
Return to the Case
Carl Wadsworth 316
SUMMARY 317
KEY TERMS 318
CHAPTER 13
NeurocognitiveDisorders 320
Case Report Irene Heller 321
131 Characteristics of Neurocognitive Disorders 322
132 Delirium 324
133 Neurocognitive Disorder due to Alzheimerrsquos
Disease 327
Prevalence of Alzheimerrsquos Disease 328
Whatrsquos New in the DSM-5
Recategorization of Neurocognitive
Disorders 329
Stages of Alzheimerrsquos Disease 329
Diagnosis of Alzheimerrsquos Disease 330
Theories and Treatment of Alzheimerrsquos
Disease 333
Theories 333
You Be the Judge Early Diagnosis of
Alzheimerrsquos Disease 334
Treatment 336
REAL STORIES Ronald Reagan
Alzheimerrsquos Disease 338
134 Neurocognitive Disorders due to Neurological Disor-
ders Other than Alzheimerrsquos Disease 340
135 Neurocognitive Disorder due to TraumaticBrain Injury 343
136 Neurocognitive Disorders due to Substances
Medications and HIV Infection 344
137 Neurocognitive Disorders due to Another General
Medical Condition 344
138 Neurocognitive Disorders The Biopsychosocial
Perspective 345
Return to the Case Irene Heller 346
SUMMARY 346
KEY TERMS 347
CHAPTER 14
Personality Disorders 348
Case Report Harold Morrill 349
141 The Nature of Personality
Disorders 350
Whatrsquos New in the DSM-5
Dimensionalizing the Personality
Disorders 351
Personality Disorders in DSM-5 351
Alternative Personality Disorder Diagnostic System
in Section 3 of the DSM-5 352
142 Cluster A Personality Disorders 355
Paranoid Personality Disorder 355
Schizoid Personality Disorder 356Schizotypal Personality Disorder 357
143 Cluster B Personality Disorders 357
Antisocial Personality Disorder 357
Characteristics of Antisocial Personality
Disorder 358
Theories of Antisocial Personality
Disorder 360
You Be the Judge Antisocial PersonalityDisorder and Moral Culpability 361
Biological Perspectives 361
REAL STORIES Ted Bundy Antisocial
Personality Disorder 362
Psychological Perspectives 363
Treatment of Antisocial Personality
Disorder 364
Borderline Personality Disorder 364Characteristics of Borderline Personality
Disorder (BPD) 365
Theories and Treatment of BPD 366
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xv
Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
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You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
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xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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xx
CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
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xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
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ABNORMAL PSYCHOLOGY CLINICAL PERSPECIVES ON PSYCHOLOGICAL DISORDERS DSM9830855 UPDAE
SEVENH EDIION
Published by McGraw-Hill Education 2 Penn Plaza New York NY 10121 Copyright copy 2014 by McGraw-Hill
Education All rights reserved Printed in the United States o America Previous editions copy 2013 2010 and 2007
No part o this publication may be reproduced or distributed in any orm or by any means or stored in a database or
retrieval system without the prior written consent o McGraw-Hill Education including but not limited to in any
network or other electronic storage or transmission or broadcast or distance learning
Some ancillaries including electronic and print components may not be available to customers outside the
United States
Tis book is printed on acid-ree paper
1 2 3 4 5 6 7 8 9 0 DOWDOW 1 0 9 8 7 6 5 4 3
ISBN 978ndash1ndash259ndash13338ndash1
MHID 1ndash259ndash13338ndash9
Senior Vice President Products amp Markets Kurt L Strand
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Director Content Production Terri Schiesl
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All credits appearing on page or at the end o the book are considered to be an extension o the copyright page
Library of Congress Cataloging-in-Publication Data
Cataloging-in-Publication Data has been requested rom the Library o Congress
Te Internet addresses listed in the text were accurate at the time o publication Te inclusion o a website does not
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the accuracy o the inormation presented at these sites
wwwmhhecom
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To our families with love and appreciation
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vi Chapter 15 Ethical and Legal Issues
Susan Krauss Whitbourne and Richard Halgin are Proessors o Psychologyat the University o Massachusetts Amherst Both teach large undergraduate classes inaddition to teaching and supervising doctoral students in developmental and clinicalpsychology Teir clinical experience has covered both inpatient and outpatient settingsProessors Whitbourne and Halgin are Fellows o the American PsychologicalAssociation Tey co-edited A Case Book in Abnormal Psychology From the Files ofExperts (Oxord University Press) containing case studies written by leading internationalauthorities in the field o psychopathology
Proessor Whitbourne received her PhD rom Columbia University and has dual
specializations in lie-span developmental psychology and clinical psychology Shetaught at the State University o New York at Geneseo and the University o RochesterAt the University o Massachusetts she received the Universityrsquos Distinguished eachingAward the Outstanding Advising Award and the College o Arts and SciencesOutstanding eacher Award In 2001 she received the Psi Chi Eastern Region FacultyAdvisor Award and in 2002 the Florence Denmark Psi Chi National Advisor Award In2003 she received both the APA Division 20 and Gerontological Society o AmericaMentoring Awards She served as the Departmental Honors Coordinator rom 1990ndash2010 and currently is the Psi Chi Faculty Advisor and the Director o the Offi ce oNational Scholarship Advisement in the Commonwealth Honors College Te author osixteen books and over 160 journal articles and book chapters Proessor Whitbourne isregarded as an expert on personality development in mid- and late lie She is on theAPA Membership Board was Chair o APArsquos Policy and Planning Board and was amember o the APA Committee or the Structure and Function o Council She is APACouncil Representative to Division 20 (Adult Development and Aging) having alsoserved as Division 20 President She is a Fellow o APArsquos Divisions 20 1 (GeneralPsychology) 2 (eaching o Psychology) 12 (Clinical Psychology) and 35 (Society orthe Psychology o Women) A Fellow o the Gerontological Society o America sheserves on the Executive Board o the Behavioral and Social Sciences Section In 2007
she was the Psi Chi Eastern Region Vice President and in 2009 was the Program Chairo the 2009 National Leadership Conerence Proessor Whitbourne served as an itemwriter or the Educational esting Service was a member o APArsquos High SchoolCurriculum National Standards Advisory Panel wrote the APA High School CurriculumGuidelines or Lie-Span Developmental Psychology and serves as an item writer or theExamination or Proessional Practice o Psychology and as Chair o the Council oProessional Geropsychology raining Programs Her 2010 book ldquoTe Search orFulfillmentrdquo was nominated or an APA William James Award In 2011 she wasrecognized with a Presidential Citation rom APA In addition to her academic writingshe edits a blog on Psychology Today entitled ldquoFulfillment at Any Agerdquo
Proessor Halgin received his PhD rom Fordham University and completed aellowship in the Department o Psychiatry at New York Hospital-Cornell MedicalCenter prior to joining the aculty o the University o Massachusetts in 1977 He is aBoard-Certified Clinical Psychologist with over our decades o clinical supervisory andconsulting experience At the University o Massachusetts he received the Distinguishedeaching Award the Alumni Associationrsquos Distinguished Faculty Award and wasnominated or the Carnegie Foundationrsquos US Proessor o the Year Award His teachingwas recognized by the Danorth Foundation and the Society or the eaching oPsychology Proessor Halgin is the author o sixty journal articles and book chaptersin the fields o psychotherapy clinical supervision and proessional issues in psychology
He is also the editor o Taking Sides Controversial Issues in Abnormal Psychology SixthEdition (McGraw-Hill) Proessor Halgin served as Chair o the Committee o Examinersor the Psychology Graduate Record Examination as an Associate Member o the EthicsCommittee o the American Psychological Association and currently serves on theMassachusetts Board o Registration o Psychologists
ABOUT THE AUTHORS
vi
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vii
Preface xvi
1 Overview to Understanding Abnormal Behavior 2
2 Diagnosis and Treatment 24
3 Assessment 46
4
Theoretical Perspectives 70 5 Neurodevelopmental Disorders 100
6 Schizophrenia Spectrum and Other Psychotic Disorders 136
7 Depressive and Bipolar Disorders 162
8 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders 184 9 Dissociative and Somatic Symptom Disorders 214
10 Feeding and Eating Disorders Elimination DisordersSleep-Wake Disorders and Disruptive Impulse-Controland Conduct Disorders 236
11 Paraphilic Disorders Sexual Dysfunctions and Gender Dysphoria 258
12 Substance-Related and Addictive Disorders 286
13 Neurocognitive Disorders 320
14 Personality Disorders 348
15 Ethical and Legal Issues 378
Glossary G-1
References R-1
Credits C-1
Name Index I-1
Subject Index I-9
BRIEF CONTENTS
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viii
Preface xvi
CHAPTER 1
Overview to Understanding AbnormalBehavior 2
Case Report Rebecca Hasbrouck 3
11 What Is Abnormal
Behavior 4
12 The Social Impact of Psychological Disorders 5
13 Defining Abnormality 6
14 What Causes Abnormal Behavior 7
Biological Causes 7
Psychological Causes 7
Sociocultural Causes 7
The Biopsychosocial Perspective 8
15 Prominent Themes in Abnormal Psychology
throughout History 9
Spiritual Approach 9
Humanitarian Approach 10
Scientific Approach 12
16 Research Methods in Abnormal Psychology 14
17 Experimental Design 14
Whatrsquos New in the DSM-5 Definition of a
Mental Disorder 15
18 Correlational Design 15
You Be the Judge Being Sane in Insane
Places 16
19 Types of Research Studies 17
Survey 17
REAL STORIES Vincent van Gogh
Psychosis 18
Laboratory Studies 19
The Case Study Method 20
Single Case Experimental Design 20
Investigations in Behavioral Genetics 20
Bringing It All Together Clinical
Perspectives 22
Return to the Case Rebecca Hasbrouck 22
SUMMARY 23
KEY TERMS 23
CHAPTER 2
Diagnosis and Treatment 24
Case Report PeterDickinson 25
21 Psychological Disorder
Experiences of Client and Clinician 26
The Client 26
The Clinician 27
22 The Diagnostic Process 27
Whatrsquos New in the DSM-5 Changes in
the DSM-5 Structure 28
The Diagnostic and Statistical Manual
(DSM-5) 28
Additional Information 28
Culture-Bound Syndromes 30
23 Steps in the Diagnostic Process 34
Diagnostic Procedures 34
Case Formulation 35
Cultural Formulation 35
24 Planning the Treatment 36
Goals of Treatment 36
You Be the Judge Psychologists as
Prescribers 37
Treatment Site 38
Psychiatric Hospitals 38
Specialized Inpatient Treatment Centers 38
Outpatient Treatment 39
Halfway Houses and Day Treatment Programs 39
Other Treatment Sites 39
Modality of Treatment 40
Determining the Best Approach to
Treatment 41
25The Course of Treatment 41
The Clinicianrsquos Role in Treatment 41
The Clientrsquos Role in Treatment 41
CONTENTS
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REAL STORIES Daniel Johnston Bipolar
Disorder 42
26 The Outcome of Treatment 43
Return to the Case Peter Dickinson 44
SUMMARY 44
KEY TERMS 45
CHAPTER 3
Assessment 46
Case Report Ben Robsha m 47
31 Characteristics of Psychological
Assessments 48
32 Clinical Interview 49
33 Mental Status Examination 52
34 Intelligence Testing 52
Stanford-Binet Intelligence Test 53
Wechsler Intelligence Scales 53
35 Personality Testing 56
Self-Report Tests 56
Projective Testing 60
36 Behavioral Assessment 61
37 Multicultural Assessment 61
38 Neuropsychological Assessment 62
Whatrsquos New in the DSM-5 Section 3
Assessment Measures 63
You Be the Judge Psychologists in the
Legal System 64
39 Neuroimaging 65
REAL STORIES Ludwig van Beethoven
Bipolar Disorder 66
310 Putting It All Together 68
Return to the Case Ben Robsham 68
SUMMARY 69
KEY TERMS 69
CHAPTER 4
TheoreticalPerspectives 70
Case Report Meera
Krishnan 71
41 Theoretical Perspectives in Abnormal Psychology 72
42 Biological Perspective 72
Theories 72
Treatment 77
43 Trait Theory 80
Whatrsquos New in the DSM-5 Theoretical
Approaches 81
44 Psychodynamic Perspective 81
Freudrsquos Theory 81
Post-Freudian Psychodynamic Views 83
Treatment 86
45 Behavioral Perspective 86
Theories 86
You Be the Judge Evidence-Based
Practice 87
Treatment 88
46 Cognitive Perspective 89
Theories 89
Treatment 90
47 Humanistic Perspective 91
Theories 91
Treatment 93
48 Sociocultural Perspective 94
Theories 94
Treatment 94
REAL STORIES Sylvia Plath Major
Depressive Disorder 96
49 Biopsychosocial Perspectives on Theories and
Treatments An Integrative Approach 97
Return to the Case Meera Krishnan 98
SUMMARY 98
KEY TERMS 99
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CHAPTER 5
NeurodevelopmentalDisorders 100
Case Report Jason Newman 101
51 Intellectual Disability (Intellectual Developmental
Disorder) 103
Causes of Intellectual Disability 104
Whatrsquos New in the DSM-5
Neurodevelopmental Disorders 107
Treatment of Intellectual Disability 109
52 Autism Spectrum Disorder 110
Theories and Treatment of Autism
Spectrum Disorder 112
Rett Syndrome 115
High-Functioning Autism Spectrum Disorder
Formerly Called Aspergerrsquos Disorder 115
REAL STORIES Daniel Tammet Autism
Spectrum Disorder 116
53 Learning and Communication Disorders 118
Specific Learning Disorders 118
Communication Disorders 121
54 Attention-DeficitHyperactivity Disorder
(ADHD) 122
Characteristics of ADHD 122
ADHD in Adults 125
Theories and Treatment of ADHD 126
You Be the Judge Prescribing Psychiatric
Medications to Children 128
55 Motor Disorders 130
Developmental Coordination Disorder 130
Tic Disorders 131
Stereotypic Movement Disorder 132
56 Neurodevelopmental Disorders The Biopsychosocial
Perspective 132
Return to the Case Jason Newman 133
SUMMARY 133
KEY TERMS 134
CHAPTER 6
Schizophrenia Spectrumand Other PsychoticDisorders 136
Case Report David
Marshall 137
61 Schizophrenia 139
Whatrsquos New in the DSM-5 Schizophrenia
Subtypes and Dimensional Ratings 143
Course of Schizophrenia 143
You Be the Judge Schizophrenia
Diagnosis 145
62 Brief Psychotic Disorder 146
63 Schizophreniform Disorder 14764 Schizoaffective Disorder 147
65 Delusional Disorders 148
66 Theories and Treatment of Schizophrenia 150
Biological Perspectives 150
Theories 150
REAL STORIES Elyn Saks Schizophrenia 152
Treatments 153
Psychological Perspectives 154
Theories 154
Treatments 156
Sociocultural Perspectives 156
Theories 156
Treatments 158
67 Schizophrenia The Biopsychosocial
Perspective 159
Return to the Case David Marshall 160
SUMMARY 160
KEY TERMS 161
CHAPTER 7
Depressive and
Bipolar Disorders 162Case Report Janice Butterf ield 163
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xi
71 Depressive Disorders 164
Major Depressive Disorder 164
Persistent Depressive Disorder (Dysthymia) 166
Disruptive Mood Dysregulation Disorder 166
Premenstrual Dysphoric Disorder 167
72 Disorders Involving Alternations in Mood 167
Bipolar Disorder 167
REAL STORIES Carrie Fisher Bipolar
Disorder 168
Cyclothymic Disorder 170
73 Theories and Treatment of
Depressive and Bipolar Disorder 171
Biological Perspectives 171
Whatrsquos New in the DSM-5 Depressive
and Bipolar Disorders 174
Psychological Perspectives 176
Psychodynamic Approaches 176
Behavioral and Cognitive -Behavioral Approaches 176
Interpersonal Approaches 178
Sociocultural Perspectives 179
You Be the Judge Do-Not-Resuscitate
Orders for Suicidal Patients 180
74 Suicide 180
75 Depressive and Bipolar Disorders The Biopsychosocial
Perspective 182
Return to the Case Janice Butterfield 182
SUMMARY 183
KEY TERMS 183
CHAPTER 8
Anxiety Obsessive-Compulsive andTrauma- and Stressor-Related Disorders 184
Case Report Barba ra Wilder 185
81 Anxiety Disorders 186
Separation Anxiety Disorder 187
Theories and Treatment of Separation Anxiety Disorder 187
Selective Mutism 188
Specific Phobias 189
Theories and Treatment of Specific Phobias 190
Social Anxiety Disorder 192
Theories and Treatment of Social Anxiety Disorder 192
Panic Disorder and Agoraphobia 193
Panic Disorder 193
Agoraphobiar 194
Theories and Treatment of Panic Disorder and Agoraphobia 194
Generalized Anxiety Disorder 195
REAL STORIES Paula Deen Panic Disorder
with Agoraphobia 196
Theories and Treatment of Generalized Anxiety Disorder 197
82 Obsessive-Compulsive and Related Disorders 198
Whatrsquos New in the DSM-5 Definition and
Categorization of Anxiety Disorders 199
Theories and Treatment of Obsessive-Compulsive
Disorder 199
You Be the Judge Psychiatric
Neurosurgery 201
Body Dysmorphic Disorder 201
Hoarding Disorder 203
Trichotillomania (Hair-Pulling Disorder) 204
Excoriation (Skin-Picking) Disorder 206
83 Trauma- and Stressor-Related Disorders 206
Reactive Attachment Disorder and Disinhibited
Social Engagement Disorder 207
Acute Stress Disorder and Post-Traumatic Stress
Disorder 207
Theories and Treatment of Post-Traumatic Stress Disorder 208
84 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders The Biopsychosocial
Perspective 210
Return to the Case Barbara Wilder 210
SUMMARY 211
KEY TERMS 212
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CHAPTER 9
Dissociative andSomatic SymptomDisorders 214
Case Report Rose
Marston 215
91 Dissociative Disorders 216
Major Forms of Dissociative Disorders 216
Theories and Treatment of Dissociative
Disorders 217
REAL STORIES Herschel Walker
Dissociative Identity Disorder 218
You Be the Judge Dissociative Identity
Disorder 220
92 Somatic Symptom and Related Disorders 222
Somatic Symptom Disorder 222
Illness Anxiety Disorder 223
Conversion Disorder (Functional Neurological
Symptom Disorder) 223
Conditions Related to Somatic Symptom
Disorders 224
Theories and Treatment of Somatic Symptom andRelated Disorders 225
Whatrsquos New in the DSM-5 Somatic
Symptom and Related Disorders 227
93 Psychological Factors Affecting
Medical Condition 227
Relevant Concepts for Understanding
Psychological Factors Affecting Medical
Condition 228
Stress and Coping 228
Emotional Expression 231
Personality Style 232
Applications to Behavioral Medicine 232
94 Dissociative and Somatic Symptom Disorders
The Biopsychosocial Perspective 233
Return to the Case Rose Marston 234
SUMMARY 234
KEY TERMS 235
CHAPTER 10
Feeding and EatingDisorders EliminationDisorders Sleep-WakeDisorders andDisruptive Impulse-
Control and ConductDisorders 236
Case Report Rosa
Nomirez 237
101 Eating Disorders 238
Characteristics of Anorexia Nervosa 239
REAL STORIES Portia de Rossi Anorexia
Nervosa 240Characteristics of Bulimia Nervosa 242
Binge-Eating Disorder 243
Theories and Treatment of Eating Disorders 243
Whatrsquos New in the DSM-5 Reclassifying
Eating Elimination Sleep-Wake and Disruptive
Impulse-Control and Conduct Disorders 245
AvoidantRestrictive Food Intake Disorder 245
Eating Disorders Associated with Childhood 246
102 Elimination Disorders 246
103 Sleep-Wake Disorders 247
104 Disruptive Impulse-Control and Conduct Disorders 249
Oppositional Defiant Disorder 249
Intermitten t Explosive Disorder 250
Conduct Disorder 252
Impulse-Control Disorders 252
Pyromania 252
You Be the Judge Legal Implications of
Impulse-Control Disorders 253
Kleptomania 254
105 Eating Elimination Sleep-Wake and Impulse-Control
Disorder The Biopsychosocial Perspective 255
Return to the Case Rosa Nomirez 255
SUMMARY 256
KEY TERMS 257
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xiii
CHAPTER 11
Paraphilic DisordersSexual Dysfunctionsand Gender Dysphoria 258
Case Report Shaun Boyden 259
111 What Patterns of Sexual Behavior Represent
Psychological Disorders 260
112 Paraphilic Disorders 262
Pedophilic Disorder 263
Exhibitionistic Disorder 264
Voyeuristic Disorder 264
Fetishistic Disorder 265
Frotteuristic Disorder 266
Sexual Masochism and Sexual Sadism
Disorders 266
Transvestic Disorder 267
Theories and Treatment of Paraphilic
Disorders 267
Biological Perspectives 268
Whatrsquos New in the DSM-5 The
Reorganization of Sexual Disorders 269
Psychological Perspectives 269
113 Sexual Dysfunctions 270
Arousal Disorders 271
Disorders Involving Orgasm 274
You Be the Judge Treatment for Sex
Offenders 275
Disorders Involving Pain 276
Theories and Treatment of SexualDysfunctions 276
Biological Perspectives 276
Psychological Perspectives 277
REAL STORIES Sue William Silverman Sex
Addiction 278
114 Gender Dysphoria 280
Theories and Treatment of Gender
Dysphoria 282
115 Paraphilic Disorders Sexual Dysfunctions and Gender
Dysphoria The Biopsychosocial Perspective 282
Return to the Case Shaun Boyden 284
SUMMARY 284
KEY TERMS 285
CHAPTER 12
Substance-Relatedand Addictive Disorders 286
Case Report Carl Wadsworth 287
121 Key Features of Substance
Disorders 289
Whatrsquos New in the DSM-5 Combining Abuse and
Dependence 290
122 Disorders Associated with Specific
Substances 290
Alcohol 292
Theories and Treatment of Alcohol
Use Disorders 295
Biological Perspectives 295
Psychological Perspectives 297
Sociocultural Perspective 298
Stimulants 299
Amphetamines 299
Cocaine 300
Cannabis 301
Hallucinogens 303
Opioids 306
You Be the Judge Prescribing
Prescription Drugs 307
Sedatives Hypnotics and Anxiolytics 308
Caffeine 309
REAL STORIES Robert Downey Jr
Substance Use Disorder 310
Tobacco 311
Inhalants 311
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xiv
Theories and Treatment of Substance Use
Disorders 311
Biologica l Perspectives 312
Psychological Perspectives 312
123 Non-Substance-Related Disorders 313
Gambling Disorder 313
124 Substance Disorders The Biopsychosocial
Perspective 316
Return to the Case
Carl Wadsworth 316
SUMMARY 317
KEY TERMS 318
CHAPTER 13
NeurocognitiveDisorders 320
Case Report Irene Heller 321
131 Characteristics of Neurocognitive Disorders 322
132 Delirium 324
133 Neurocognitive Disorder due to Alzheimerrsquos
Disease 327
Prevalence of Alzheimerrsquos Disease 328
Whatrsquos New in the DSM-5
Recategorization of Neurocognitive
Disorders 329
Stages of Alzheimerrsquos Disease 329
Diagnosis of Alzheimerrsquos Disease 330
Theories and Treatment of Alzheimerrsquos
Disease 333
Theories 333
You Be the Judge Early Diagnosis of
Alzheimerrsquos Disease 334
Treatment 336
REAL STORIES Ronald Reagan
Alzheimerrsquos Disease 338
134 Neurocognitive Disorders due to Neurological Disor-
ders Other than Alzheimerrsquos Disease 340
135 Neurocognitive Disorder due to TraumaticBrain Injury 343
136 Neurocognitive Disorders due to Substances
Medications and HIV Infection 344
137 Neurocognitive Disorders due to Another General
Medical Condition 344
138 Neurocognitive Disorders The Biopsychosocial
Perspective 345
Return to the Case Irene Heller 346
SUMMARY 346
KEY TERMS 347
CHAPTER 14
Personality Disorders 348
Case Report Harold Morrill 349
141 The Nature of Personality
Disorders 350
Whatrsquos New in the DSM-5
Dimensionalizing the Personality
Disorders 351
Personality Disorders in DSM-5 351
Alternative Personality Disorder Diagnostic System
in Section 3 of the DSM-5 352
142 Cluster A Personality Disorders 355
Paranoid Personality Disorder 355
Schizoid Personality Disorder 356Schizotypal Personality Disorder 357
143 Cluster B Personality Disorders 357
Antisocial Personality Disorder 357
Characteristics of Antisocial Personality
Disorder 358
Theories of Antisocial Personality
Disorder 360
You Be the Judge Antisocial PersonalityDisorder and Moral Culpability 361
Biological Perspectives 361
REAL STORIES Ted Bundy Antisocial
Personality Disorder 362
Psychological Perspectives 363
Treatment of Antisocial Personality
Disorder 364
Borderline Personality Disorder 364Characteristics of Borderline Personality
Disorder (BPD) 365
Theories and Treatment of BPD 366
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xv
Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
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You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
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xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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xx
CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
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Craf your teaching resources to
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helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
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Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
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A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
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To our families with love and appreciation
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vi Chapter 15 Ethical and Legal Issues
Susan Krauss Whitbourne and Richard Halgin are Proessors o Psychologyat the University o Massachusetts Amherst Both teach large undergraduate classes inaddition to teaching and supervising doctoral students in developmental and clinicalpsychology Teir clinical experience has covered both inpatient and outpatient settingsProessors Whitbourne and Halgin are Fellows o the American PsychologicalAssociation Tey co-edited A Case Book in Abnormal Psychology From the Files ofExperts (Oxord University Press) containing case studies written by leading internationalauthorities in the field o psychopathology
Proessor Whitbourne received her PhD rom Columbia University and has dual
specializations in lie-span developmental psychology and clinical psychology Shetaught at the State University o New York at Geneseo and the University o RochesterAt the University o Massachusetts she received the Universityrsquos Distinguished eachingAward the Outstanding Advising Award and the College o Arts and SciencesOutstanding eacher Award In 2001 she received the Psi Chi Eastern Region FacultyAdvisor Award and in 2002 the Florence Denmark Psi Chi National Advisor Award In2003 she received both the APA Division 20 and Gerontological Society o AmericaMentoring Awards She served as the Departmental Honors Coordinator rom 1990ndash2010 and currently is the Psi Chi Faculty Advisor and the Director o the Offi ce oNational Scholarship Advisement in the Commonwealth Honors College Te author osixteen books and over 160 journal articles and book chapters Proessor Whitbourne isregarded as an expert on personality development in mid- and late lie She is on theAPA Membership Board was Chair o APArsquos Policy and Planning Board and was amember o the APA Committee or the Structure and Function o Council She is APACouncil Representative to Division 20 (Adult Development and Aging) having alsoserved as Division 20 President She is a Fellow o APArsquos Divisions 20 1 (GeneralPsychology) 2 (eaching o Psychology) 12 (Clinical Psychology) and 35 (Society orthe Psychology o Women) A Fellow o the Gerontological Society o America sheserves on the Executive Board o the Behavioral and Social Sciences Section In 2007
she was the Psi Chi Eastern Region Vice President and in 2009 was the Program Chairo the 2009 National Leadership Conerence Proessor Whitbourne served as an itemwriter or the Educational esting Service was a member o APArsquos High SchoolCurriculum National Standards Advisory Panel wrote the APA High School CurriculumGuidelines or Lie-Span Developmental Psychology and serves as an item writer or theExamination or Proessional Practice o Psychology and as Chair o the Council oProessional Geropsychology raining Programs Her 2010 book ldquoTe Search orFulfillmentrdquo was nominated or an APA William James Award In 2011 she wasrecognized with a Presidential Citation rom APA In addition to her academic writingshe edits a blog on Psychology Today entitled ldquoFulfillment at Any Agerdquo
Proessor Halgin received his PhD rom Fordham University and completed aellowship in the Department o Psychiatry at New York Hospital-Cornell MedicalCenter prior to joining the aculty o the University o Massachusetts in 1977 He is aBoard-Certified Clinical Psychologist with over our decades o clinical supervisory andconsulting experience At the University o Massachusetts he received the Distinguishedeaching Award the Alumni Associationrsquos Distinguished Faculty Award and wasnominated or the Carnegie Foundationrsquos US Proessor o the Year Award His teachingwas recognized by the Danorth Foundation and the Society or the eaching oPsychology Proessor Halgin is the author o sixty journal articles and book chaptersin the fields o psychotherapy clinical supervision and proessional issues in psychology
He is also the editor o Taking Sides Controversial Issues in Abnormal Psychology SixthEdition (McGraw-Hill) Proessor Halgin served as Chair o the Committee o Examinersor the Psychology Graduate Record Examination as an Associate Member o the EthicsCommittee o the American Psychological Association and currently serves on theMassachusetts Board o Registration o Psychologists
ABOUT THE AUTHORS
vi
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vii
Preface xvi
1 Overview to Understanding Abnormal Behavior 2
2 Diagnosis and Treatment 24
3 Assessment 46
4
Theoretical Perspectives 70 5 Neurodevelopmental Disorders 100
6 Schizophrenia Spectrum and Other Psychotic Disorders 136
7 Depressive and Bipolar Disorders 162
8 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders 184 9 Dissociative and Somatic Symptom Disorders 214
10 Feeding and Eating Disorders Elimination DisordersSleep-Wake Disorders and Disruptive Impulse-Controland Conduct Disorders 236
11 Paraphilic Disorders Sexual Dysfunctions and Gender Dysphoria 258
12 Substance-Related and Addictive Disorders 286
13 Neurocognitive Disorders 320
14 Personality Disorders 348
15 Ethical and Legal Issues 378
Glossary G-1
References R-1
Credits C-1
Name Index I-1
Subject Index I-9
BRIEF CONTENTS
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viii
Preface xvi
CHAPTER 1
Overview to Understanding AbnormalBehavior 2
Case Report Rebecca Hasbrouck 3
11 What Is Abnormal
Behavior 4
12 The Social Impact of Psychological Disorders 5
13 Defining Abnormality 6
14 What Causes Abnormal Behavior 7
Biological Causes 7
Psychological Causes 7
Sociocultural Causes 7
The Biopsychosocial Perspective 8
15 Prominent Themes in Abnormal Psychology
throughout History 9
Spiritual Approach 9
Humanitarian Approach 10
Scientific Approach 12
16 Research Methods in Abnormal Psychology 14
17 Experimental Design 14
Whatrsquos New in the DSM-5 Definition of a
Mental Disorder 15
18 Correlational Design 15
You Be the Judge Being Sane in Insane
Places 16
19 Types of Research Studies 17
Survey 17
REAL STORIES Vincent van Gogh
Psychosis 18
Laboratory Studies 19
The Case Study Method 20
Single Case Experimental Design 20
Investigations in Behavioral Genetics 20
Bringing It All Together Clinical
Perspectives 22
Return to the Case Rebecca Hasbrouck 22
SUMMARY 23
KEY TERMS 23
CHAPTER 2
Diagnosis and Treatment 24
Case Report PeterDickinson 25
21 Psychological Disorder
Experiences of Client and Clinician 26
The Client 26
The Clinician 27
22 The Diagnostic Process 27
Whatrsquos New in the DSM-5 Changes in
the DSM-5 Structure 28
The Diagnostic and Statistical Manual
(DSM-5) 28
Additional Information 28
Culture-Bound Syndromes 30
23 Steps in the Diagnostic Process 34
Diagnostic Procedures 34
Case Formulation 35
Cultural Formulation 35
24 Planning the Treatment 36
Goals of Treatment 36
You Be the Judge Psychologists as
Prescribers 37
Treatment Site 38
Psychiatric Hospitals 38
Specialized Inpatient Treatment Centers 38
Outpatient Treatment 39
Halfway Houses and Day Treatment Programs 39
Other Treatment Sites 39
Modality of Treatment 40
Determining the Best Approach to
Treatment 41
25The Course of Treatment 41
The Clinicianrsquos Role in Treatment 41
The Clientrsquos Role in Treatment 41
CONTENTS
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ix
REAL STORIES Daniel Johnston Bipolar
Disorder 42
26 The Outcome of Treatment 43
Return to the Case Peter Dickinson 44
SUMMARY 44
KEY TERMS 45
CHAPTER 3
Assessment 46
Case Report Ben Robsha m 47
31 Characteristics of Psychological
Assessments 48
32 Clinical Interview 49
33 Mental Status Examination 52
34 Intelligence Testing 52
Stanford-Binet Intelligence Test 53
Wechsler Intelligence Scales 53
35 Personality Testing 56
Self-Report Tests 56
Projective Testing 60
36 Behavioral Assessment 61
37 Multicultural Assessment 61
38 Neuropsychological Assessment 62
Whatrsquos New in the DSM-5 Section 3
Assessment Measures 63
You Be the Judge Psychologists in the
Legal System 64
39 Neuroimaging 65
REAL STORIES Ludwig van Beethoven
Bipolar Disorder 66
310 Putting It All Together 68
Return to the Case Ben Robsham 68
SUMMARY 69
KEY TERMS 69
CHAPTER 4
TheoreticalPerspectives 70
Case Report Meera
Krishnan 71
41 Theoretical Perspectives in Abnormal Psychology 72
42 Biological Perspective 72
Theories 72
Treatment 77
43 Trait Theory 80
Whatrsquos New in the DSM-5 Theoretical
Approaches 81
44 Psychodynamic Perspective 81
Freudrsquos Theory 81
Post-Freudian Psychodynamic Views 83
Treatment 86
45 Behavioral Perspective 86
Theories 86
You Be the Judge Evidence-Based
Practice 87
Treatment 88
46 Cognitive Perspective 89
Theories 89
Treatment 90
47 Humanistic Perspective 91
Theories 91
Treatment 93
48 Sociocultural Perspective 94
Theories 94
Treatment 94
REAL STORIES Sylvia Plath Major
Depressive Disorder 96
49 Biopsychosocial Perspectives on Theories and
Treatments An Integrative Approach 97
Return to the Case Meera Krishnan 98
SUMMARY 98
KEY TERMS 99
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CHAPTER 5
NeurodevelopmentalDisorders 100
Case Report Jason Newman 101
51 Intellectual Disability (Intellectual Developmental
Disorder) 103
Causes of Intellectual Disability 104
Whatrsquos New in the DSM-5
Neurodevelopmental Disorders 107
Treatment of Intellectual Disability 109
52 Autism Spectrum Disorder 110
Theories and Treatment of Autism
Spectrum Disorder 112
Rett Syndrome 115
High-Functioning Autism Spectrum Disorder
Formerly Called Aspergerrsquos Disorder 115
REAL STORIES Daniel Tammet Autism
Spectrum Disorder 116
53 Learning and Communication Disorders 118
Specific Learning Disorders 118
Communication Disorders 121
54 Attention-DeficitHyperactivity Disorder
(ADHD) 122
Characteristics of ADHD 122
ADHD in Adults 125
Theories and Treatment of ADHD 126
You Be the Judge Prescribing Psychiatric
Medications to Children 128
55 Motor Disorders 130
Developmental Coordination Disorder 130
Tic Disorders 131
Stereotypic Movement Disorder 132
56 Neurodevelopmental Disorders The Biopsychosocial
Perspective 132
Return to the Case Jason Newman 133
SUMMARY 133
KEY TERMS 134
CHAPTER 6
Schizophrenia Spectrumand Other PsychoticDisorders 136
Case Report David
Marshall 137
61 Schizophrenia 139
Whatrsquos New in the DSM-5 Schizophrenia
Subtypes and Dimensional Ratings 143
Course of Schizophrenia 143
You Be the Judge Schizophrenia
Diagnosis 145
62 Brief Psychotic Disorder 146
63 Schizophreniform Disorder 14764 Schizoaffective Disorder 147
65 Delusional Disorders 148
66 Theories and Treatment of Schizophrenia 150
Biological Perspectives 150
Theories 150
REAL STORIES Elyn Saks Schizophrenia 152
Treatments 153
Psychological Perspectives 154
Theories 154
Treatments 156
Sociocultural Perspectives 156
Theories 156
Treatments 158
67 Schizophrenia The Biopsychosocial
Perspective 159
Return to the Case David Marshall 160
SUMMARY 160
KEY TERMS 161
CHAPTER 7
Depressive and
Bipolar Disorders 162Case Report Janice Butterf ield 163
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71 Depressive Disorders 164
Major Depressive Disorder 164
Persistent Depressive Disorder (Dysthymia) 166
Disruptive Mood Dysregulation Disorder 166
Premenstrual Dysphoric Disorder 167
72 Disorders Involving Alternations in Mood 167
Bipolar Disorder 167
REAL STORIES Carrie Fisher Bipolar
Disorder 168
Cyclothymic Disorder 170
73 Theories and Treatment of
Depressive and Bipolar Disorder 171
Biological Perspectives 171
Whatrsquos New in the DSM-5 Depressive
and Bipolar Disorders 174
Psychological Perspectives 176
Psychodynamic Approaches 176
Behavioral and Cognitive -Behavioral Approaches 176
Interpersonal Approaches 178
Sociocultural Perspectives 179
You Be the Judge Do-Not-Resuscitate
Orders for Suicidal Patients 180
74 Suicide 180
75 Depressive and Bipolar Disorders The Biopsychosocial
Perspective 182
Return to the Case Janice Butterfield 182
SUMMARY 183
KEY TERMS 183
CHAPTER 8
Anxiety Obsessive-Compulsive andTrauma- and Stressor-Related Disorders 184
Case Report Barba ra Wilder 185
81 Anxiety Disorders 186
Separation Anxiety Disorder 187
Theories and Treatment of Separation Anxiety Disorder 187
Selective Mutism 188
Specific Phobias 189
Theories and Treatment of Specific Phobias 190
Social Anxiety Disorder 192
Theories and Treatment of Social Anxiety Disorder 192
Panic Disorder and Agoraphobia 193
Panic Disorder 193
Agoraphobiar 194
Theories and Treatment of Panic Disorder and Agoraphobia 194
Generalized Anxiety Disorder 195
REAL STORIES Paula Deen Panic Disorder
with Agoraphobia 196
Theories and Treatment of Generalized Anxiety Disorder 197
82 Obsessive-Compulsive and Related Disorders 198
Whatrsquos New in the DSM-5 Definition and
Categorization of Anxiety Disorders 199
Theories and Treatment of Obsessive-Compulsive
Disorder 199
You Be the Judge Psychiatric
Neurosurgery 201
Body Dysmorphic Disorder 201
Hoarding Disorder 203
Trichotillomania (Hair-Pulling Disorder) 204
Excoriation (Skin-Picking) Disorder 206
83 Trauma- and Stressor-Related Disorders 206
Reactive Attachment Disorder and Disinhibited
Social Engagement Disorder 207
Acute Stress Disorder and Post-Traumatic Stress
Disorder 207
Theories and Treatment of Post-Traumatic Stress Disorder 208
84 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders The Biopsychosocial
Perspective 210
Return to the Case Barbara Wilder 210
SUMMARY 211
KEY TERMS 212
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CHAPTER 9
Dissociative andSomatic SymptomDisorders 214
Case Report Rose
Marston 215
91 Dissociative Disorders 216
Major Forms of Dissociative Disorders 216
Theories and Treatment of Dissociative
Disorders 217
REAL STORIES Herschel Walker
Dissociative Identity Disorder 218
You Be the Judge Dissociative Identity
Disorder 220
92 Somatic Symptom and Related Disorders 222
Somatic Symptom Disorder 222
Illness Anxiety Disorder 223
Conversion Disorder (Functional Neurological
Symptom Disorder) 223
Conditions Related to Somatic Symptom
Disorders 224
Theories and Treatment of Somatic Symptom andRelated Disorders 225
Whatrsquos New in the DSM-5 Somatic
Symptom and Related Disorders 227
93 Psychological Factors Affecting
Medical Condition 227
Relevant Concepts for Understanding
Psychological Factors Affecting Medical
Condition 228
Stress and Coping 228
Emotional Expression 231
Personality Style 232
Applications to Behavioral Medicine 232
94 Dissociative and Somatic Symptom Disorders
The Biopsychosocial Perspective 233
Return to the Case Rose Marston 234
SUMMARY 234
KEY TERMS 235
CHAPTER 10
Feeding and EatingDisorders EliminationDisorders Sleep-WakeDisorders andDisruptive Impulse-
Control and ConductDisorders 236
Case Report Rosa
Nomirez 237
101 Eating Disorders 238
Characteristics of Anorexia Nervosa 239
REAL STORIES Portia de Rossi Anorexia
Nervosa 240Characteristics of Bulimia Nervosa 242
Binge-Eating Disorder 243
Theories and Treatment of Eating Disorders 243
Whatrsquos New in the DSM-5 Reclassifying
Eating Elimination Sleep-Wake and Disruptive
Impulse-Control and Conduct Disorders 245
AvoidantRestrictive Food Intake Disorder 245
Eating Disorders Associated with Childhood 246
102 Elimination Disorders 246
103 Sleep-Wake Disorders 247
104 Disruptive Impulse-Control and Conduct Disorders 249
Oppositional Defiant Disorder 249
Intermitten t Explosive Disorder 250
Conduct Disorder 252
Impulse-Control Disorders 252
Pyromania 252
You Be the Judge Legal Implications of
Impulse-Control Disorders 253
Kleptomania 254
105 Eating Elimination Sleep-Wake and Impulse-Control
Disorder The Biopsychosocial Perspective 255
Return to the Case Rosa Nomirez 255
SUMMARY 256
KEY TERMS 257
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xiii
CHAPTER 11
Paraphilic DisordersSexual Dysfunctionsand Gender Dysphoria 258
Case Report Shaun Boyden 259
111 What Patterns of Sexual Behavior Represent
Psychological Disorders 260
112 Paraphilic Disorders 262
Pedophilic Disorder 263
Exhibitionistic Disorder 264
Voyeuristic Disorder 264
Fetishistic Disorder 265
Frotteuristic Disorder 266
Sexual Masochism and Sexual Sadism
Disorders 266
Transvestic Disorder 267
Theories and Treatment of Paraphilic
Disorders 267
Biological Perspectives 268
Whatrsquos New in the DSM-5 The
Reorganization of Sexual Disorders 269
Psychological Perspectives 269
113 Sexual Dysfunctions 270
Arousal Disorders 271
Disorders Involving Orgasm 274
You Be the Judge Treatment for Sex
Offenders 275
Disorders Involving Pain 276
Theories and Treatment of SexualDysfunctions 276
Biological Perspectives 276
Psychological Perspectives 277
REAL STORIES Sue William Silverman Sex
Addiction 278
114 Gender Dysphoria 280
Theories and Treatment of Gender
Dysphoria 282
115 Paraphilic Disorders Sexual Dysfunctions and Gender
Dysphoria The Biopsychosocial Perspective 282
Return to the Case Shaun Boyden 284
SUMMARY 284
KEY TERMS 285
CHAPTER 12
Substance-Relatedand Addictive Disorders 286
Case Report Carl Wadsworth 287
121 Key Features of Substance
Disorders 289
Whatrsquos New in the DSM-5 Combining Abuse and
Dependence 290
122 Disorders Associated with Specific
Substances 290
Alcohol 292
Theories and Treatment of Alcohol
Use Disorders 295
Biological Perspectives 295
Psychological Perspectives 297
Sociocultural Perspective 298
Stimulants 299
Amphetamines 299
Cocaine 300
Cannabis 301
Hallucinogens 303
Opioids 306
You Be the Judge Prescribing
Prescription Drugs 307
Sedatives Hypnotics and Anxiolytics 308
Caffeine 309
REAL STORIES Robert Downey Jr
Substance Use Disorder 310
Tobacco 311
Inhalants 311
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Theories and Treatment of Substance Use
Disorders 311
Biologica l Perspectives 312
Psychological Perspectives 312
123 Non-Substance-Related Disorders 313
Gambling Disorder 313
124 Substance Disorders The Biopsychosocial
Perspective 316
Return to the Case
Carl Wadsworth 316
SUMMARY 317
KEY TERMS 318
CHAPTER 13
NeurocognitiveDisorders 320
Case Report Irene Heller 321
131 Characteristics of Neurocognitive Disorders 322
132 Delirium 324
133 Neurocognitive Disorder due to Alzheimerrsquos
Disease 327
Prevalence of Alzheimerrsquos Disease 328
Whatrsquos New in the DSM-5
Recategorization of Neurocognitive
Disorders 329
Stages of Alzheimerrsquos Disease 329
Diagnosis of Alzheimerrsquos Disease 330
Theories and Treatment of Alzheimerrsquos
Disease 333
Theories 333
You Be the Judge Early Diagnosis of
Alzheimerrsquos Disease 334
Treatment 336
REAL STORIES Ronald Reagan
Alzheimerrsquos Disease 338
134 Neurocognitive Disorders due to Neurological Disor-
ders Other than Alzheimerrsquos Disease 340
135 Neurocognitive Disorder due to TraumaticBrain Injury 343
136 Neurocognitive Disorders due to Substances
Medications and HIV Infection 344
137 Neurocognitive Disorders due to Another General
Medical Condition 344
138 Neurocognitive Disorders The Biopsychosocial
Perspective 345
Return to the Case Irene Heller 346
SUMMARY 346
KEY TERMS 347
CHAPTER 14
Personality Disorders 348
Case Report Harold Morrill 349
141 The Nature of Personality
Disorders 350
Whatrsquos New in the DSM-5
Dimensionalizing the Personality
Disorders 351
Personality Disorders in DSM-5 351
Alternative Personality Disorder Diagnostic System
in Section 3 of the DSM-5 352
142 Cluster A Personality Disorders 355
Paranoid Personality Disorder 355
Schizoid Personality Disorder 356Schizotypal Personality Disorder 357
143 Cluster B Personality Disorders 357
Antisocial Personality Disorder 357
Characteristics of Antisocial Personality
Disorder 358
Theories of Antisocial Personality
Disorder 360
You Be the Judge Antisocial PersonalityDisorder and Moral Culpability 361
Biological Perspectives 361
REAL STORIES Ted Bundy Antisocial
Personality Disorder 362
Psychological Perspectives 363
Treatment of Antisocial Personality
Disorder 364
Borderline Personality Disorder 364Characteristics of Borderline Personality
Disorder (BPD) 365
Theories and Treatment of BPD 366
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Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
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You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
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xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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xx
CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
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xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
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vi Chapter 15 Ethical and Legal Issues
Susan Krauss Whitbourne and Richard Halgin are Proessors o Psychologyat the University o Massachusetts Amherst Both teach large undergraduate classes inaddition to teaching and supervising doctoral students in developmental and clinicalpsychology Teir clinical experience has covered both inpatient and outpatient settingsProessors Whitbourne and Halgin are Fellows o the American PsychologicalAssociation Tey co-edited A Case Book in Abnormal Psychology From the Files ofExperts (Oxord University Press) containing case studies written by leading internationalauthorities in the field o psychopathology
Proessor Whitbourne received her PhD rom Columbia University and has dual
specializations in lie-span developmental psychology and clinical psychology Shetaught at the State University o New York at Geneseo and the University o RochesterAt the University o Massachusetts she received the Universityrsquos Distinguished eachingAward the Outstanding Advising Award and the College o Arts and SciencesOutstanding eacher Award In 2001 she received the Psi Chi Eastern Region FacultyAdvisor Award and in 2002 the Florence Denmark Psi Chi National Advisor Award In2003 she received both the APA Division 20 and Gerontological Society o AmericaMentoring Awards She served as the Departmental Honors Coordinator rom 1990ndash2010 and currently is the Psi Chi Faculty Advisor and the Director o the Offi ce oNational Scholarship Advisement in the Commonwealth Honors College Te author osixteen books and over 160 journal articles and book chapters Proessor Whitbourne isregarded as an expert on personality development in mid- and late lie She is on theAPA Membership Board was Chair o APArsquos Policy and Planning Board and was amember o the APA Committee or the Structure and Function o Council She is APACouncil Representative to Division 20 (Adult Development and Aging) having alsoserved as Division 20 President She is a Fellow o APArsquos Divisions 20 1 (GeneralPsychology) 2 (eaching o Psychology) 12 (Clinical Psychology) and 35 (Society orthe Psychology o Women) A Fellow o the Gerontological Society o America sheserves on the Executive Board o the Behavioral and Social Sciences Section In 2007
she was the Psi Chi Eastern Region Vice President and in 2009 was the Program Chairo the 2009 National Leadership Conerence Proessor Whitbourne served as an itemwriter or the Educational esting Service was a member o APArsquos High SchoolCurriculum National Standards Advisory Panel wrote the APA High School CurriculumGuidelines or Lie-Span Developmental Psychology and serves as an item writer or theExamination or Proessional Practice o Psychology and as Chair o the Council oProessional Geropsychology raining Programs Her 2010 book ldquoTe Search orFulfillmentrdquo was nominated or an APA William James Award In 2011 she wasrecognized with a Presidential Citation rom APA In addition to her academic writingshe edits a blog on Psychology Today entitled ldquoFulfillment at Any Agerdquo
Proessor Halgin received his PhD rom Fordham University and completed aellowship in the Department o Psychiatry at New York Hospital-Cornell MedicalCenter prior to joining the aculty o the University o Massachusetts in 1977 He is aBoard-Certified Clinical Psychologist with over our decades o clinical supervisory andconsulting experience At the University o Massachusetts he received the Distinguishedeaching Award the Alumni Associationrsquos Distinguished Faculty Award and wasnominated or the Carnegie Foundationrsquos US Proessor o the Year Award His teachingwas recognized by the Danorth Foundation and the Society or the eaching oPsychology Proessor Halgin is the author o sixty journal articles and book chaptersin the fields o psychotherapy clinical supervision and proessional issues in psychology
He is also the editor o Taking Sides Controversial Issues in Abnormal Psychology SixthEdition (McGraw-Hill) Proessor Halgin served as Chair o the Committee o Examinersor the Psychology Graduate Record Examination as an Associate Member o the EthicsCommittee o the American Psychological Association and currently serves on theMassachusetts Board o Registration o Psychologists
ABOUT THE AUTHORS
vi
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vii
Preface xvi
1 Overview to Understanding Abnormal Behavior 2
2 Diagnosis and Treatment 24
3 Assessment 46
4
Theoretical Perspectives 70 5 Neurodevelopmental Disorders 100
6 Schizophrenia Spectrum and Other Psychotic Disorders 136
7 Depressive and Bipolar Disorders 162
8 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders 184 9 Dissociative and Somatic Symptom Disorders 214
10 Feeding and Eating Disorders Elimination DisordersSleep-Wake Disorders and Disruptive Impulse-Controland Conduct Disorders 236
11 Paraphilic Disorders Sexual Dysfunctions and Gender Dysphoria 258
12 Substance-Related and Addictive Disorders 286
13 Neurocognitive Disorders 320
14 Personality Disorders 348
15 Ethical and Legal Issues 378
Glossary G-1
References R-1
Credits C-1
Name Index I-1
Subject Index I-9
BRIEF CONTENTS
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viii
Preface xvi
CHAPTER 1
Overview to Understanding AbnormalBehavior 2
Case Report Rebecca Hasbrouck 3
11 What Is Abnormal
Behavior 4
12 The Social Impact of Psychological Disorders 5
13 Defining Abnormality 6
14 What Causes Abnormal Behavior 7
Biological Causes 7
Psychological Causes 7
Sociocultural Causes 7
The Biopsychosocial Perspective 8
15 Prominent Themes in Abnormal Psychology
throughout History 9
Spiritual Approach 9
Humanitarian Approach 10
Scientific Approach 12
16 Research Methods in Abnormal Psychology 14
17 Experimental Design 14
Whatrsquos New in the DSM-5 Definition of a
Mental Disorder 15
18 Correlational Design 15
You Be the Judge Being Sane in Insane
Places 16
19 Types of Research Studies 17
Survey 17
REAL STORIES Vincent van Gogh
Psychosis 18
Laboratory Studies 19
The Case Study Method 20
Single Case Experimental Design 20
Investigations in Behavioral Genetics 20
Bringing It All Together Clinical
Perspectives 22
Return to the Case Rebecca Hasbrouck 22
SUMMARY 23
KEY TERMS 23
CHAPTER 2
Diagnosis and Treatment 24
Case Report PeterDickinson 25
21 Psychological Disorder
Experiences of Client and Clinician 26
The Client 26
The Clinician 27
22 The Diagnostic Process 27
Whatrsquos New in the DSM-5 Changes in
the DSM-5 Structure 28
The Diagnostic and Statistical Manual
(DSM-5) 28
Additional Information 28
Culture-Bound Syndromes 30
23 Steps in the Diagnostic Process 34
Diagnostic Procedures 34
Case Formulation 35
Cultural Formulation 35
24 Planning the Treatment 36
Goals of Treatment 36
You Be the Judge Psychologists as
Prescribers 37
Treatment Site 38
Psychiatric Hospitals 38
Specialized Inpatient Treatment Centers 38
Outpatient Treatment 39
Halfway Houses and Day Treatment Programs 39
Other Treatment Sites 39
Modality of Treatment 40
Determining the Best Approach to
Treatment 41
25The Course of Treatment 41
The Clinicianrsquos Role in Treatment 41
The Clientrsquos Role in Treatment 41
CONTENTS
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ix
REAL STORIES Daniel Johnston Bipolar
Disorder 42
26 The Outcome of Treatment 43
Return to the Case Peter Dickinson 44
SUMMARY 44
KEY TERMS 45
CHAPTER 3
Assessment 46
Case Report Ben Robsha m 47
31 Characteristics of Psychological
Assessments 48
32 Clinical Interview 49
33 Mental Status Examination 52
34 Intelligence Testing 52
Stanford-Binet Intelligence Test 53
Wechsler Intelligence Scales 53
35 Personality Testing 56
Self-Report Tests 56
Projective Testing 60
36 Behavioral Assessment 61
37 Multicultural Assessment 61
38 Neuropsychological Assessment 62
Whatrsquos New in the DSM-5 Section 3
Assessment Measures 63
You Be the Judge Psychologists in the
Legal System 64
39 Neuroimaging 65
REAL STORIES Ludwig van Beethoven
Bipolar Disorder 66
310 Putting It All Together 68
Return to the Case Ben Robsham 68
SUMMARY 69
KEY TERMS 69
CHAPTER 4
TheoreticalPerspectives 70
Case Report Meera
Krishnan 71
41 Theoretical Perspectives in Abnormal Psychology 72
42 Biological Perspective 72
Theories 72
Treatment 77
43 Trait Theory 80
Whatrsquos New in the DSM-5 Theoretical
Approaches 81
44 Psychodynamic Perspective 81
Freudrsquos Theory 81
Post-Freudian Psychodynamic Views 83
Treatment 86
45 Behavioral Perspective 86
Theories 86
You Be the Judge Evidence-Based
Practice 87
Treatment 88
46 Cognitive Perspective 89
Theories 89
Treatment 90
47 Humanistic Perspective 91
Theories 91
Treatment 93
48 Sociocultural Perspective 94
Theories 94
Treatment 94
REAL STORIES Sylvia Plath Major
Depressive Disorder 96
49 Biopsychosocial Perspectives on Theories and
Treatments An Integrative Approach 97
Return to the Case Meera Krishnan 98
SUMMARY 98
KEY TERMS 99
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CHAPTER 5
NeurodevelopmentalDisorders 100
Case Report Jason Newman 101
51 Intellectual Disability (Intellectual Developmental
Disorder) 103
Causes of Intellectual Disability 104
Whatrsquos New in the DSM-5
Neurodevelopmental Disorders 107
Treatment of Intellectual Disability 109
52 Autism Spectrum Disorder 110
Theories and Treatment of Autism
Spectrum Disorder 112
Rett Syndrome 115
High-Functioning Autism Spectrum Disorder
Formerly Called Aspergerrsquos Disorder 115
REAL STORIES Daniel Tammet Autism
Spectrum Disorder 116
53 Learning and Communication Disorders 118
Specific Learning Disorders 118
Communication Disorders 121
54 Attention-DeficitHyperactivity Disorder
(ADHD) 122
Characteristics of ADHD 122
ADHD in Adults 125
Theories and Treatment of ADHD 126
You Be the Judge Prescribing Psychiatric
Medications to Children 128
55 Motor Disorders 130
Developmental Coordination Disorder 130
Tic Disorders 131
Stereotypic Movement Disorder 132
56 Neurodevelopmental Disorders The Biopsychosocial
Perspective 132
Return to the Case Jason Newman 133
SUMMARY 133
KEY TERMS 134
CHAPTER 6
Schizophrenia Spectrumand Other PsychoticDisorders 136
Case Report David
Marshall 137
61 Schizophrenia 139
Whatrsquos New in the DSM-5 Schizophrenia
Subtypes and Dimensional Ratings 143
Course of Schizophrenia 143
You Be the Judge Schizophrenia
Diagnosis 145
62 Brief Psychotic Disorder 146
63 Schizophreniform Disorder 14764 Schizoaffective Disorder 147
65 Delusional Disorders 148
66 Theories and Treatment of Schizophrenia 150
Biological Perspectives 150
Theories 150
REAL STORIES Elyn Saks Schizophrenia 152
Treatments 153
Psychological Perspectives 154
Theories 154
Treatments 156
Sociocultural Perspectives 156
Theories 156
Treatments 158
67 Schizophrenia The Biopsychosocial
Perspective 159
Return to the Case David Marshall 160
SUMMARY 160
KEY TERMS 161
CHAPTER 7
Depressive and
Bipolar Disorders 162Case Report Janice Butterf ield 163
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71 Depressive Disorders 164
Major Depressive Disorder 164
Persistent Depressive Disorder (Dysthymia) 166
Disruptive Mood Dysregulation Disorder 166
Premenstrual Dysphoric Disorder 167
72 Disorders Involving Alternations in Mood 167
Bipolar Disorder 167
REAL STORIES Carrie Fisher Bipolar
Disorder 168
Cyclothymic Disorder 170
73 Theories and Treatment of
Depressive and Bipolar Disorder 171
Biological Perspectives 171
Whatrsquos New in the DSM-5 Depressive
and Bipolar Disorders 174
Psychological Perspectives 176
Psychodynamic Approaches 176
Behavioral and Cognitive -Behavioral Approaches 176
Interpersonal Approaches 178
Sociocultural Perspectives 179
You Be the Judge Do-Not-Resuscitate
Orders for Suicidal Patients 180
74 Suicide 180
75 Depressive and Bipolar Disorders The Biopsychosocial
Perspective 182
Return to the Case Janice Butterfield 182
SUMMARY 183
KEY TERMS 183
CHAPTER 8
Anxiety Obsessive-Compulsive andTrauma- and Stressor-Related Disorders 184
Case Report Barba ra Wilder 185
81 Anxiety Disorders 186
Separation Anxiety Disorder 187
Theories and Treatment of Separation Anxiety Disorder 187
Selective Mutism 188
Specific Phobias 189
Theories and Treatment of Specific Phobias 190
Social Anxiety Disorder 192
Theories and Treatment of Social Anxiety Disorder 192
Panic Disorder and Agoraphobia 193
Panic Disorder 193
Agoraphobiar 194
Theories and Treatment of Panic Disorder and Agoraphobia 194
Generalized Anxiety Disorder 195
REAL STORIES Paula Deen Panic Disorder
with Agoraphobia 196
Theories and Treatment of Generalized Anxiety Disorder 197
82 Obsessive-Compulsive and Related Disorders 198
Whatrsquos New in the DSM-5 Definition and
Categorization of Anxiety Disorders 199
Theories and Treatment of Obsessive-Compulsive
Disorder 199
You Be the Judge Psychiatric
Neurosurgery 201
Body Dysmorphic Disorder 201
Hoarding Disorder 203
Trichotillomania (Hair-Pulling Disorder) 204
Excoriation (Skin-Picking) Disorder 206
83 Trauma- and Stressor-Related Disorders 206
Reactive Attachment Disorder and Disinhibited
Social Engagement Disorder 207
Acute Stress Disorder and Post-Traumatic Stress
Disorder 207
Theories and Treatment of Post-Traumatic Stress Disorder 208
84 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders The Biopsychosocial
Perspective 210
Return to the Case Barbara Wilder 210
SUMMARY 211
KEY TERMS 212
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CHAPTER 9
Dissociative andSomatic SymptomDisorders 214
Case Report Rose
Marston 215
91 Dissociative Disorders 216
Major Forms of Dissociative Disorders 216
Theories and Treatment of Dissociative
Disorders 217
REAL STORIES Herschel Walker
Dissociative Identity Disorder 218
You Be the Judge Dissociative Identity
Disorder 220
92 Somatic Symptom and Related Disorders 222
Somatic Symptom Disorder 222
Illness Anxiety Disorder 223
Conversion Disorder (Functional Neurological
Symptom Disorder) 223
Conditions Related to Somatic Symptom
Disorders 224
Theories and Treatment of Somatic Symptom andRelated Disorders 225
Whatrsquos New in the DSM-5 Somatic
Symptom and Related Disorders 227
93 Psychological Factors Affecting
Medical Condition 227
Relevant Concepts for Understanding
Psychological Factors Affecting Medical
Condition 228
Stress and Coping 228
Emotional Expression 231
Personality Style 232
Applications to Behavioral Medicine 232
94 Dissociative and Somatic Symptom Disorders
The Biopsychosocial Perspective 233
Return to the Case Rose Marston 234
SUMMARY 234
KEY TERMS 235
CHAPTER 10
Feeding and EatingDisorders EliminationDisorders Sleep-WakeDisorders andDisruptive Impulse-
Control and ConductDisorders 236
Case Report Rosa
Nomirez 237
101 Eating Disorders 238
Characteristics of Anorexia Nervosa 239
REAL STORIES Portia de Rossi Anorexia
Nervosa 240Characteristics of Bulimia Nervosa 242
Binge-Eating Disorder 243
Theories and Treatment of Eating Disorders 243
Whatrsquos New in the DSM-5 Reclassifying
Eating Elimination Sleep-Wake and Disruptive
Impulse-Control and Conduct Disorders 245
AvoidantRestrictive Food Intake Disorder 245
Eating Disorders Associated with Childhood 246
102 Elimination Disorders 246
103 Sleep-Wake Disorders 247
104 Disruptive Impulse-Control and Conduct Disorders 249
Oppositional Defiant Disorder 249
Intermitten t Explosive Disorder 250
Conduct Disorder 252
Impulse-Control Disorders 252
Pyromania 252
You Be the Judge Legal Implications of
Impulse-Control Disorders 253
Kleptomania 254
105 Eating Elimination Sleep-Wake and Impulse-Control
Disorder The Biopsychosocial Perspective 255
Return to the Case Rosa Nomirez 255
SUMMARY 256
KEY TERMS 257
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xiii
CHAPTER 11
Paraphilic DisordersSexual Dysfunctionsand Gender Dysphoria 258
Case Report Shaun Boyden 259
111 What Patterns of Sexual Behavior Represent
Psychological Disorders 260
112 Paraphilic Disorders 262
Pedophilic Disorder 263
Exhibitionistic Disorder 264
Voyeuristic Disorder 264
Fetishistic Disorder 265
Frotteuristic Disorder 266
Sexual Masochism and Sexual Sadism
Disorders 266
Transvestic Disorder 267
Theories and Treatment of Paraphilic
Disorders 267
Biological Perspectives 268
Whatrsquos New in the DSM-5 The
Reorganization of Sexual Disorders 269
Psychological Perspectives 269
113 Sexual Dysfunctions 270
Arousal Disorders 271
Disorders Involving Orgasm 274
You Be the Judge Treatment for Sex
Offenders 275
Disorders Involving Pain 276
Theories and Treatment of SexualDysfunctions 276
Biological Perspectives 276
Psychological Perspectives 277
REAL STORIES Sue William Silverman Sex
Addiction 278
114 Gender Dysphoria 280
Theories and Treatment of Gender
Dysphoria 282
115 Paraphilic Disorders Sexual Dysfunctions and Gender
Dysphoria The Biopsychosocial Perspective 282
Return to the Case Shaun Boyden 284
SUMMARY 284
KEY TERMS 285
CHAPTER 12
Substance-Relatedand Addictive Disorders 286
Case Report Carl Wadsworth 287
121 Key Features of Substance
Disorders 289
Whatrsquos New in the DSM-5 Combining Abuse and
Dependence 290
122 Disorders Associated with Specific
Substances 290
Alcohol 292
Theories and Treatment of Alcohol
Use Disorders 295
Biological Perspectives 295
Psychological Perspectives 297
Sociocultural Perspective 298
Stimulants 299
Amphetamines 299
Cocaine 300
Cannabis 301
Hallucinogens 303
Opioids 306
You Be the Judge Prescribing
Prescription Drugs 307
Sedatives Hypnotics and Anxiolytics 308
Caffeine 309
REAL STORIES Robert Downey Jr
Substance Use Disorder 310
Tobacco 311
Inhalants 311
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xiv
Theories and Treatment of Substance Use
Disorders 311
Biologica l Perspectives 312
Psychological Perspectives 312
123 Non-Substance-Related Disorders 313
Gambling Disorder 313
124 Substance Disorders The Biopsychosocial
Perspective 316
Return to the Case
Carl Wadsworth 316
SUMMARY 317
KEY TERMS 318
CHAPTER 13
NeurocognitiveDisorders 320
Case Report Irene Heller 321
131 Characteristics of Neurocognitive Disorders 322
132 Delirium 324
133 Neurocognitive Disorder due to Alzheimerrsquos
Disease 327
Prevalence of Alzheimerrsquos Disease 328
Whatrsquos New in the DSM-5
Recategorization of Neurocognitive
Disorders 329
Stages of Alzheimerrsquos Disease 329
Diagnosis of Alzheimerrsquos Disease 330
Theories and Treatment of Alzheimerrsquos
Disease 333
Theories 333
You Be the Judge Early Diagnosis of
Alzheimerrsquos Disease 334
Treatment 336
REAL STORIES Ronald Reagan
Alzheimerrsquos Disease 338
134 Neurocognitive Disorders due to Neurological Disor-
ders Other than Alzheimerrsquos Disease 340
135 Neurocognitive Disorder due to TraumaticBrain Injury 343
136 Neurocognitive Disorders due to Substances
Medications and HIV Infection 344
137 Neurocognitive Disorders due to Another General
Medical Condition 344
138 Neurocognitive Disorders The Biopsychosocial
Perspective 345
Return to the Case Irene Heller 346
SUMMARY 346
KEY TERMS 347
CHAPTER 14
Personality Disorders 348
Case Report Harold Morrill 349
141 The Nature of Personality
Disorders 350
Whatrsquos New in the DSM-5
Dimensionalizing the Personality
Disorders 351
Personality Disorders in DSM-5 351
Alternative Personality Disorder Diagnostic System
in Section 3 of the DSM-5 352
142 Cluster A Personality Disorders 355
Paranoid Personality Disorder 355
Schizoid Personality Disorder 356Schizotypal Personality Disorder 357
143 Cluster B Personality Disorders 357
Antisocial Personality Disorder 357
Characteristics of Antisocial Personality
Disorder 358
Theories of Antisocial Personality
Disorder 360
You Be the Judge Antisocial PersonalityDisorder and Moral Culpability 361
Biological Perspectives 361
REAL STORIES Ted Bundy Antisocial
Personality Disorder 362
Psychological Perspectives 363
Treatment of Antisocial Personality
Disorder 364
Borderline Personality Disorder 364Characteristics of Borderline Personality
Disorder (BPD) 365
Theories and Treatment of BPD 366
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xv
Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
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You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
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xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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xx
CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
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xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
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vii
Preface xvi
1 Overview to Understanding Abnormal Behavior 2
2 Diagnosis and Treatment 24
3 Assessment 46
4
Theoretical Perspectives 70 5 Neurodevelopmental Disorders 100
6 Schizophrenia Spectrum and Other Psychotic Disorders 136
7 Depressive and Bipolar Disorders 162
8 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders 184 9 Dissociative and Somatic Symptom Disorders 214
10 Feeding and Eating Disorders Elimination DisordersSleep-Wake Disorders and Disruptive Impulse-Controland Conduct Disorders 236
11 Paraphilic Disorders Sexual Dysfunctions and Gender Dysphoria 258
12 Substance-Related and Addictive Disorders 286
13 Neurocognitive Disorders 320
14 Personality Disorders 348
15 Ethical and Legal Issues 378
Glossary G-1
References R-1
Credits C-1
Name Index I-1
Subject Index I-9
BRIEF CONTENTS
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Preface xvi
CHAPTER 1
Overview to Understanding AbnormalBehavior 2
Case Report Rebecca Hasbrouck 3
11 What Is Abnormal
Behavior 4
12 The Social Impact of Psychological Disorders 5
13 Defining Abnormality 6
14 What Causes Abnormal Behavior 7
Biological Causes 7
Psychological Causes 7
Sociocultural Causes 7
The Biopsychosocial Perspective 8
15 Prominent Themes in Abnormal Psychology
throughout History 9
Spiritual Approach 9
Humanitarian Approach 10
Scientific Approach 12
16 Research Methods in Abnormal Psychology 14
17 Experimental Design 14
Whatrsquos New in the DSM-5 Definition of a
Mental Disorder 15
18 Correlational Design 15
You Be the Judge Being Sane in Insane
Places 16
19 Types of Research Studies 17
Survey 17
REAL STORIES Vincent van Gogh
Psychosis 18
Laboratory Studies 19
The Case Study Method 20
Single Case Experimental Design 20
Investigations in Behavioral Genetics 20
Bringing It All Together Clinical
Perspectives 22
Return to the Case Rebecca Hasbrouck 22
SUMMARY 23
KEY TERMS 23
CHAPTER 2
Diagnosis and Treatment 24
Case Report PeterDickinson 25
21 Psychological Disorder
Experiences of Client and Clinician 26
The Client 26
The Clinician 27
22 The Diagnostic Process 27
Whatrsquos New in the DSM-5 Changes in
the DSM-5 Structure 28
The Diagnostic and Statistical Manual
(DSM-5) 28
Additional Information 28
Culture-Bound Syndromes 30
23 Steps in the Diagnostic Process 34
Diagnostic Procedures 34
Case Formulation 35
Cultural Formulation 35
24 Planning the Treatment 36
Goals of Treatment 36
You Be the Judge Psychologists as
Prescribers 37
Treatment Site 38
Psychiatric Hospitals 38
Specialized Inpatient Treatment Centers 38
Outpatient Treatment 39
Halfway Houses and Day Treatment Programs 39
Other Treatment Sites 39
Modality of Treatment 40
Determining the Best Approach to
Treatment 41
25The Course of Treatment 41
The Clinicianrsquos Role in Treatment 41
The Clientrsquos Role in Treatment 41
CONTENTS
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ix
REAL STORIES Daniel Johnston Bipolar
Disorder 42
26 The Outcome of Treatment 43
Return to the Case Peter Dickinson 44
SUMMARY 44
KEY TERMS 45
CHAPTER 3
Assessment 46
Case Report Ben Robsha m 47
31 Characteristics of Psychological
Assessments 48
32 Clinical Interview 49
33 Mental Status Examination 52
34 Intelligence Testing 52
Stanford-Binet Intelligence Test 53
Wechsler Intelligence Scales 53
35 Personality Testing 56
Self-Report Tests 56
Projective Testing 60
36 Behavioral Assessment 61
37 Multicultural Assessment 61
38 Neuropsychological Assessment 62
Whatrsquos New in the DSM-5 Section 3
Assessment Measures 63
You Be the Judge Psychologists in the
Legal System 64
39 Neuroimaging 65
REAL STORIES Ludwig van Beethoven
Bipolar Disorder 66
310 Putting It All Together 68
Return to the Case Ben Robsham 68
SUMMARY 69
KEY TERMS 69
CHAPTER 4
TheoreticalPerspectives 70
Case Report Meera
Krishnan 71
41 Theoretical Perspectives in Abnormal Psychology 72
42 Biological Perspective 72
Theories 72
Treatment 77
43 Trait Theory 80
Whatrsquos New in the DSM-5 Theoretical
Approaches 81
44 Psychodynamic Perspective 81
Freudrsquos Theory 81
Post-Freudian Psychodynamic Views 83
Treatment 86
45 Behavioral Perspective 86
Theories 86
You Be the Judge Evidence-Based
Practice 87
Treatment 88
46 Cognitive Perspective 89
Theories 89
Treatment 90
47 Humanistic Perspective 91
Theories 91
Treatment 93
48 Sociocultural Perspective 94
Theories 94
Treatment 94
REAL STORIES Sylvia Plath Major
Depressive Disorder 96
49 Biopsychosocial Perspectives on Theories and
Treatments An Integrative Approach 97
Return to the Case Meera Krishnan 98
SUMMARY 98
KEY TERMS 99
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CHAPTER 5
NeurodevelopmentalDisorders 100
Case Report Jason Newman 101
51 Intellectual Disability (Intellectual Developmental
Disorder) 103
Causes of Intellectual Disability 104
Whatrsquos New in the DSM-5
Neurodevelopmental Disorders 107
Treatment of Intellectual Disability 109
52 Autism Spectrum Disorder 110
Theories and Treatment of Autism
Spectrum Disorder 112
Rett Syndrome 115
High-Functioning Autism Spectrum Disorder
Formerly Called Aspergerrsquos Disorder 115
REAL STORIES Daniel Tammet Autism
Spectrum Disorder 116
53 Learning and Communication Disorders 118
Specific Learning Disorders 118
Communication Disorders 121
54 Attention-DeficitHyperactivity Disorder
(ADHD) 122
Characteristics of ADHD 122
ADHD in Adults 125
Theories and Treatment of ADHD 126
You Be the Judge Prescribing Psychiatric
Medications to Children 128
55 Motor Disorders 130
Developmental Coordination Disorder 130
Tic Disorders 131
Stereotypic Movement Disorder 132
56 Neurodevelopmental Disorders The Biopsychosocial
Perspective 132
Return to the Case Jason Newman 133
SUMMARY 133
KEY TERMS 134
CHAPTER 6
Schizophrenia Spectrumand Other PsychoticDisorders 136
Case Report David
Marshall 137
61 Schizophrenia 139
Whatrsquos New in the DSM-5 Schizophrenia
Subtypes and Dimensional Ratings 143
Course of Schizophrenia 143
You Be the Judge Schizophrenia
Diagnosis 145
62 Brief Psychotic Disorder 146
63 Schizophreniform Disorder 14764 Schizoaffective Disorder 147
65 Delusional Disorders 148
66 Theories and Treatment of Schizophrenia 150
Biological Perspectives 150
Theories 150
REAL STORIES Elyn Saks Schizophrenia 152
Treatments 153
Psychological Perspectives 154
Theories 154
Treatments 156
Sociocultural Perspectives 156
Theories 156
Treatments 158
67 Schizophrenia The Biopsychosocial
Perspective 159
Return to the Case David Marshall 160
SUMMARY 160
KEY TERMS 161
CHAPTER 7
Depressive and
Bipolar Disorders 162Case Report Janice Butterf ield 163
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xi
71 Depressive Disorders 164
Major Depressive Disorder 164
Persistent Depressive Disorder (Dysthymia) 166
Disruptive Mood Dysregulation Disorder 166
Premenstrual Dysphoric Disorder 167
72 Disorders Involving Alternations in Mood 167
Bipolar Disorder 167
REAL STORIES Carrie Fisher Bipolar
Disorder 168
Cyclothymic Disorder 170
73 Theories and Treatment of
Depressive and Bipolar Disorder 171
Biological Perspectives 171
Whatrsquos New in the DSM-5 Depressive
and Bipolar Disorders 174
Psychological Perspectives 176
Psychodynamic Approaches 176
Behavioral and Cognitive -Behavioral Approaches 176
Interpersonal Approaches 178
Sociocultural Perspectives 179
You Be the Judge Do-Not-Resuscitate
Orders for Suicidal Patients 180
74 Suicide 180
75 Depressive and Bipolar Disorders The Biopsychosocial
Perspective 182
Return to the Case Janice Butterfield 182
SUMMARY 183
KEY TERMS 183
CHAPTER 8
Anxiety Obsessive-Compulsive andTrauma- and Stressor-Related Disorders 184
Case Report Barba ra Wilder 185
81 Anxiety Disorders 186
Separation Anxiety Disorder 187
Theories and Treatment of Separation Anxiety Disorder 187
Selective Mutism 188
Specific Phobias 189
Theories and Treatment of Specific Phobias 190
Social Anxiety Disorder 192
Theories and Treatment of Social Anxiety Disorder 192
Panic Disorder and Agoraphobia 193
Panic Disorder 193
Agoraphobiar 194
Theories and Treatment of Panic Disorder and Agoraphobia 194
Generalized Anxiety Disorder 195
REAL STORIES Paula Deen Panic Disorder
with Agoraphobia 196
Theories and Treatment of Generalized Anxiety Disorder 197
82 Obsessive-Compulsive and Related Disorders 198
Whatrsquos New in the DSM-5 Definition and
Categorization of Anxiety Disorders 199
Theories and Treatment of Obsessive-Compulsive
Disorder 199
You Be the Judge Psychiatric
Neurosurgery 201
Body Dysmorphic Disorder 201
Hoarding Disorder 203
Trichotillomania (Hair-Pulling Disorder) 204
Excoriation (Skin-Picking) Disorder 206
83 Trauma- and Stressor-Related Disorders 206
Reactive Attachment Disorder and Disinhibited
Social Engagement Disorder 207
Acute Stress Disorder and Post-Traumatic Stress
Disorder 207
Theories and Treatment of Post-Traumatic Stress Disorder 208
84 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders The Biopsychosocial
Perspective 210
Return to the Case Barbara Wilder 210
SUMMARY 211
KEY TERMS 212
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xii
CHAPTER 9
Dissociative andSomatic SymptomDisorders 214
Case Report Rose
Marston 215
91 Dissociative Disorders 216
Major Forms of Dissociative Disorders 216
Theories and Treatment of Dissociative
Disorders 217
REAL STORIES Herschel Walker
Dissociative Identity Disorder 218
You Be the Judge Dissociative Identity
Disorder 220
92 Somatic Symptom and Related Disorders 222
Somatic Symptom Disorder 222
Illness Anxiety Disorder 223
Conversion Disorder (Functional Neurological
Symptom Disorder) 223
Conditions Related to Somatic Symptom
Disorders 224
Theories and Treatment of Somatic Symptom andRelated Disorders 225
Whatrsquos New in the DSM-5 Somatic
Symptom and Related Disorders 227
93 Psychological Factors Affecting
Medical Condition 227
Relevant Concepts for Understanding
Psychological Factors Affecting Medical
Condition 228
Stress and Coping 228
Emotional Expression 231
Personality Style 232
Applications to Behavioral Medicine 232
94 Dissociative and Somatic Symptom Disorders
The Biopsychosocial Perspective 233
Return to the Case Rose Marston 234
SUMMARY 234
KEY TERMS 235
CHAPTER 10
Feeding and EatingDisorders EliminationDisorders Sleep-WakeDisorders andDisruptive Impulse-
Control and ConductDisorders 236
Case Report Rosa
Nomirez 237
101 Eating Disorders 238
Characteristics of Anorexia Nervosa 239
REAL STORIES Portia de Rossi Anorexia
Nervosa 240Characteristics of Bulimia Nervosa 242
Binge-Eating Disorder 243
Theories and Treatment of Eating Disorders 243
Whatrsquos New in the DSM-5 Reclassifying
Eating Elimination Sleep-Wake and Disruptive
Impulse-Control and Conduct Disorders 245
AvoidantRestrictive Food Intake Disorder 245
Eating Disorders Associated with Childhood 246
102 Elimination Disorders 246
103 Sleep-Wake Disorders 247
104 Disruptive Impulse-Control and Conduct Disorders 249
Oppositional Defiant Disorder 249
Intermitten t Explosive Disorder 250
Conduct Disorder 252
Impulse-Control Disorders 252
Pyromania 252
You Be the Judge Legal Implications of
Impulse-Control Disorders 253
Kleptomania 254
105 Eating Elimination Sleep-Wake and Impulse-Control
Disorder The Biopsychosocial Perspective 255
Return to the Case Rosa Nomirez 255
SUMMARY 256
KEY TERMS 257
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xiii
CHAPTER 11
Paraphilic DisordersSexual Dysfunctionsand Gender Dysphoria 258
Case Report Shaun Boyden 259
111 What Patterns of Sexual Behavior Represent
Psychological Disorders 260
112 Paraphilic Disorders 262
Pedophilic Disorder 263
Exhibitionistic Disorder 264
Voyeuristic Disorder 264
Fetishistic Disorder 265
Frotteuristic Disorder 266
Sexual Masochism and Sexual Sadism
Disorders 266
Transvestic Disorder 267
Theories and Treatment of Paraphilic
Disorders 267
Biological Perspectives 268
Whatrsquos New in the DSM-5 The
Reorganization of Sexual Disorders 269
Psychological Perspectives 269
113 Sexual Dysfunctions 270
Arousal Disorders 271
Disorders Involving Orgasm 274
You Be the Judge Treatment for Sex
Offenders 275
Disorders Involving Pain 276
Theories and Treatment of SexualDysfunctions 276
Biological Perspectives 276
Psychological Perspectives 277
REAL STORIES Sue William Silverman Sex
Addiction 278
114 Gender Dysphoria 280
Theories and Treatment of Gender
Dysphoria 282
115 Paraphilic Disorders Sexual Dysfunctions and Gender
Dysphoria The Biopsychosocial Perspective 282
Return to the Case Shaun Boyden 284
SUMMARY 284
KEY TERMS 285
CHAPTER 12
Substance-Relatedand Addictive Disorders 286
Case Report Carl Wadsworth 287
121 Key Features of Substance
Disorders 289
Whatrsquos New in the DSM-5 Combining Abuse and
Dependence 290
122 Disorders Associated with Specific
Substances 290
Alcohol 292
Theories and Treatment of Alcohol
Use Disorders 295
Biological Perspectives 295
Psychological Perspectives 297
Sociocultural Perspective 298
Stimulants 299
Amphetamines 299
Cocaine 300
Cannabis 301
Hallucinogens 303
Opioids 306
You Be the Judge Prescribing
Prescription Drugs 307
Sedatives Hypnotics and Anxiolytics 308
Caffeine 309
REAL STORIES Robert Downey Jr
Substance Use Disorder 310
Tobacco 311
Inhalants 311
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xiv
Theories and Treatment of Substance Use
Disorders 311
Biologica l Perspectives 312
Psychological Perspectives 312
123 Non-Substance-Related Disorders 313
Gambling Disorder 313
124 Substance Disorders The Biopsychosocial
Perspective 316
Return to the Case
Carl Wadsworth 316
SUMMARY 317
KEY TERMS 318
CHAPTER 13
NeurocognitiveDisorders 320
Case Report Irene Heller 321
131 Characteristics of Neurocognitive Disorders 322
132 Delirium 324
133 Neurocognitive Disorder due to Alzheimerrsquos
Disease 327
Prevalence of Alzheimerrsquos Disease 328
Whatrsquos New in the DSM-5
Recategorization of Neurocognitive
Disorders 329
Stages of Alzheimerrsquos Disease 329
Diagnosis of Alzheimerrsquos Disease 330
Theories and Treatment of Alzheimerrsquos
Disease 333
Theories 333
You Be the Judge Early Diagnosis of
Alzheimerrsquos Disease 334
Treatment 336
REAL STORIES Ronald Reagan
Alzheimerrsquos Disease 338
134 Neurocognitive Disorders due to Neurological Disor-
ders Other than Alzheimerrsquos Disease 340
135 Neurocognitive Disorder due to TraumaticBrain Injury 343
136 Neurocognitive Disorders due to Substances
Medications and HIV Infection 344
137 Neurocognitive Disorders due to Another General
Medical Condition 344
138 Neurocognitive Disorders The Biopsychosocial
Perspective 345
Return to the Case Irene Heller 346
SUMMARY 346
KEY TERMS 347
CHAPTER 14
Personality Disorders 348
Case Report Harold Morrill 349
141 The Nature of Personality
Disorders 350
Whatrsquos New in the DSM-5
Dimensionalizing the Personality
Disorders 351
Personality Disorders in DSM-5 351
Alternative Personality Disorder Diagnostic System
in Section 3 of the DSM-5 352
142 Cluster A Personality Disorders 355
Paranoid Personality Disorder 355
Schizoid Personality Disorder 356Schizotypal Personality Disorder 357
143 Cluster B Personality Disorders 357
Antisocial Personality Disorder 357
Characteristics of Antisocial Personality
Disorder 358
Theories of Antisocial Personality
Disorder 360
You Be the Judge Antisocial PersonalityDisorder and Moral Culpability 361
Biological Perspectives 361
REAL STORIES Ted Bundy Antisocial
Personality Disorder 362
Psychological Perspectives 363
Treatment of Antisocial Personality
Disorder 364
Borderline Personality Disorder 364Characteristics of Borderline Personality
Disorder (BPD) 365
Theories and Treatment of BPD 366
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xv
Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
whi33389_ch06_136 161indd Page 143 62013 448 PM F 469 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
whi33389_ch08_184 213indd Page 201 240613 911 AM F 468 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
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How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
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xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
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viii
Preface xvi
CHAPTER 1
Overview to Understanding AbnormalBehavior 2
Case Report Rebecca Hasbrouck 3
11 What Is Abnormal
Behavior 4
12 The Social Impact of Psychological Disorders 5
13 Defining Abnormality 6
14 What Causes Abnormal Behavior 7
Biological Causes 7
Psychological Causes 7
Sociocultural Causes 7
The Biopsychosocial Perspective 8
15 Prominent Themes in Abnormal Psychology
throughout History 9
Spiritual Approach 9
Humanitarian Approach 10
Scientific Approach 12
16 Research Methods in Abnormal Psychology 14
17 Experimental Design 14
Whatrsquos New in the DSM-5 Definition of a
Mental Disorder 15
18 Correlational Design 15
You Be the Judge Being Sane in Insane
Places 16
19 Types of Research Studies 17
Survey 17
REAL STORIES Vincent van Gogh
Psychosis 18
Laboratory Studies 19
The Case Study Method 20
Single Case Experimental Design 20
Investigations in Behavioral Genetics 20
Bringing It All Together Clinical
Perspectives 22
Return to the Case Rebecca Hasbrouck 22
SUMMARY 23
KEY TERMS 23
CHAPTER 2
Diagnosis and Treatment 24
Case Report PeterDickinson 25
21 Psychological Disorder
Experiences of Client and Clinician 26
The Client 26
The Clinician 27
22 The Diagnostic Process 27
Whatrsquos New in the DSM-5 Changes in
the DSM-5 Structure 28
The Diagnostic and Statistical Manual
(DSM-5) 28
Additional Information 28
Culture-Bound Syndromes 30
23 Steps in the Diagnostic Process 34
Diagnostic Procedures 34
Case Formulation 35
Cultural Formulation 35
24 Planning the Treatment 36
Goals of Treatment 36
You Be the Judge Psychologists as
Prescribers 37
Treatment Site 38
Psychiatric Hospitals 38
Specialized Inpatient Treatment Centers 38
Outpatient Treatment 39
Halfway Houses and Day Treatment Programs 39
Other Treatment Sites 39
Modality of Treatment 40
Determining the Best Approach to
Treatment 41
25The Course of Treatment 41
The Clinicianrsquos Role in Treatment 41
The Clientrsquos Role in Treatment 41
CONTENTS
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ix
REAL STORIES Daniel Johnston Bipolar
Disorder 42
26 The Outcome of Treatment 43
Return to the Case Peter Dickinson 44
SUMMARY 44
KEY TERMS 45
CHAPTER 3
Assessment 46
Case Report Ben Robsha m 47
31 Characteristics of Psychological
Assessments 48
32 Clinical Interview 49
33 Mental Status Examination 52
34 Intelligence Testing 52
Stanford-Binet Intelligence Test 53
Wechsler Intelligence Scales 53
35 Personality Testing 56
Self-Report Tests 56
Projective Testing 60
36 Behavioral Assessment 61
37 Multicultural Assessment 61
38 Neuropsychological Assessment 62
Whatrsquos New in the DSM-5 Section 3
Assessment Measures 63
You Be the Judge Psychologists in the
Legal System 64
39 Neuroimaging 65
REAL STORIES Ludwig van Beethoven
Bipolar Disorder 66
310 Putting It All Together 68
Return to the Case Ben Robsham 68
SUMMARY 69
KEY TERMS 69
CHAPTER 4
TheoreticalPerspectives 70
Case Report Meera
Krishnan 71
41 Theoretical Perspectives in Abnormal Psychology 72
42 Biological Perspective 72
Theories 72
Treatment 77
43 Trait Theory 80
Whatrsquos New in the DSM-5 Theoretical
Approaches 81
44 Psychodynamic Perspective 81
Freudrsquos Theory 81
Post-Freudian Psychodynamic Views 83
Treatment 86
45 Behavioral Perspective 86
Theories 86
You Be the Judge Evidence-Based
Practice 87
Treatment 88
46 Cognitive Perspective 89
Theories 89
Treatment 90
47 Humanistic Perspective 91
Theories 91
Treatment 93
48 Sociocultural Perspective 94
Theories 94
Treatment 94
REAL STORIES Sylvia Plath Major
Depressive Disorder 96
49 Biopsychosocial Perspectives on Theories and
Treatments An Integrative Approach 97
Return to the Case Meera Krishnan 98
SUMMARY 98
KEY TERMS 99
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CHAPTER 5
NeurodevelopmentalDisorders 100
Case Report Jason Newman 101
51 Intellectual Disability (Intellectual Developmental
Disorder) 103
Causes of Intellectual Disability 104
Whatrsquos New in the DSM-5
Neurodevelopmental Disorders 107
Treatment of Intellectual Disability 109
52 Autism Spectrum Disorder 110
Theories and Treatment of Autism
Spectrum Disorder 112
Rett Syndrome 115
High-Functioning Autism Spectrum Disorder
Formerly Called Aspergerrsquos Disorder 115
REAL STORIES Daniel Tammet Autism
Spectrum Disorder 116
53 Learning and Communication Disorders 118
Specific Learning Disorders 118
Communication Disorders 121
54 Attention-DeficitHyperactivity Disorder
(ADHD) 122
Characteristics of ADHD 122
ADHD in Adults 125
Theories and Treatment of ADHD 126
You Be the Judge Prescribing Psychiatric
Medications to Children 128
55 Motor Disorders 130
Developmental Coordination Disorder 130
Tic Disorders 131
Stereotypic Movement Disorder 132
56 Neurodevelopmental Disorders The Biopsychosocial
Perspective 132
Return to the Case Jason Newman 133
SUMMARY 133
KEY TERMS 134
CHAPTER 6
Schizophrenia Spectrumand Other PsychoticDisorders 136
Case Report David
Marshall 137
61 Schizophrenia 139
Whatrsquos New in the DSM-5 Schizophrenia
Subtypes and Dimensional Ratings 143
Course of Schizophrenia 143
You Be the Judge Schizophrenia
Diagnosis 145
62 Brief Psychotic Disorder 146
63 Schizophreniform Disorder 14764 Schizoaffective Disorder 147
65 Delusional Disorders 148
66 Theories and Treatment of Schizophrenia 150
Biological Perspectives 150
Theories 150
REAL STORIES Elyn Saks Schizophrenia 152
Treatments 153
Psychological Perspectives 154
Theories 154
Treatments 156
Sociocultural Perspectives 156
Theories 156
Treatments 158
67 Schizophrenia The Biopsychosocial
Perspective 159
Return to the Case David Marshall 160
SUMMARY 160
KEY TERMS 161
CHAPTER 7
Depressive and
Bipolar Disorders 162Case Report Janice Butterf ield 163
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71 Depressive Disorders 164
Major Depressive Disorder 164
Persistent Depressive Disorder (Dysthymia) 166
Disruptive Mood Dysregulation Disorder 166
Premenstrual Dysphoric Disorder 167
72 Disorders Involving Alternations in Mood 167
Bipolar Disorder 167
REAL STORIES Carrie Fisher Bipolar
Disorder 168
Cyclothymic Disorder 170
73 Theories and Treatment of
Depressive and Bipolar Disorder 171
Biological Perspectives 171
Whatrsquos New in the DSM-5 Depressive
and Bipolar Disorders 174
Psychological Perspectives 176
Psychodynamic Approaches 176
Behavioral and Cognitive -Behavioral Approaches 176
Interpersonal Approaches 178
Sociocultural Perspectives 179
You Be the Judge Do-Not-Resuscitate
Orders for Suicidal Patients 180
74 Suicide 180
75 Depressive and Bipolar Disorders The Biopsychosocial
Perspective 182
Return to the Case Janice Butterfield 182
SUMMARY 183
KEY TERMS 183
CHAPTER 8
Anxiety Obsessive-Compulsive andTrauma- and Stressor-Related Disorders 184
Case Report Barba ra Wilder 185
81 Anxiety Disorders 186
Separation Anxiety Disorder 187
Theories and Treatment of Separation Anxiety Disorder 187
Selective Mutism 188
Specific Phobias 189
Theories and Treatment of Specific Phobias 190
Social Anxiety Disorder 192
Theories and Treatment of Social Anxiety Disorder 192
Panic Disorder and Agoraphobia 193
Panic Disorder 193
Agoraphobiar 194
Theories and Treatment of Panic Disorder and Agoraphobia 194
Generalized Anxiety Disorder 195
REAL STORIES Paula Deen Panic Disorder
with Agoraphobia 196
Theories and Treatment of Generalized Anxiety Disorder 197
82 Obsessive-Compulsive and Related Disorders 198
Whatrsquos New in the DSM-5 Definition and
Categorization of Anxiety Disorders 199
Theories and Treatment of Obsessive-Compulsive
Disorder 199
You Be the Judge Psychiatric
Neurosurgery 201
Body Dysmorphic Disorder 201
Hoarding Disorder 203
Trichotillomania (Hair-Pulling Disorder) 204
Excoriation (Skin-Picking) Disorder 206
83 Trauma- and Stressor-Related Disorders 206
Reactive Attachment Disorder and Disinhibited
Social Engagement Disorder 207
Acute Stress Disorder and Post-Traumatic Stress
Disorder 207
Theories and Treatment of Post-Traumatic Stress Disorder 208
84 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders The Biopsychosocial
Perspective 210
Return to the Case Barbara Wilder 210
SUMMARY 211
KEY TERMS 212
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CHAPTER 9
Dissociative andSomatic SymptomDisorders 214
Case Report Rose
Marston 215
91 Dissociative Disorders 216
Major Forms of Dissociative Disorders 216
Theories and Treatment of Dissociative
Disorders 217
REAL STORIES Herschel Walker
Dissociative Identity Disorder 218
You Be the Judge Dissociative Identity
Disorder 220
92 Somatic Symptom and Related Disorders 222
Somatic Symptom Disorder 222
Illness Anxiety Disorder 223
Conversion Disorder (Functional Neurological
Symptom Disorder) 223
Conditions Related to Somatic Symptom
Disorders 224
Theories and Treatment of Somatic Symptom andRelated Disorders 225
Whatrsquos New in the DSM-5 Somatic
Symptom and Related Disorders 227
93 Psychological Factors Affecting
Medical Condition 227
Relevant Concepts for Understanding
Psychological Factors Affecting Medical
Condition 228
Stress and Coping 228
Emotional Expression 231
Personality Style 232
Applications to Behavioral Medicine 232
94 Dissociative and Somatic Symptom Disorders
The Biopsychosocial Perspective 233
Return to the Case Rose Marston 234
SUMMARY 234
KEY TERMS 235
CHAPTER 10
Feeding and EatingDisorders EliminationDisorders Sleep-WakeDisorders andDisruptive Impulse-
Control and ConductDisorders 236
Case Report Rosa
Nomirez 237
101 Eating Disorders 238
Characteristics of Anorexia Nervosa 239
REAL STORIES Portia de Rossi Anorexia
Nervosa 240Characteristics of Bulimia Nervosa 242
Binge-Eating Disorder 243
Theories and Treatment of Eating Disorders 243
Whatrsquos New in the DSM-5 Reclassifying
Eating Elimination Sleep-Wake and Disruptive
Impulse-Control and Conduct Disorders 245
AvoidantRestrictive Food Intake Disorder 245
Eating Disorders Associated with Childhood 246
102 Elimination Disorders 246
103 Sleep-Wake Disorders 247
104 Disruptive Impulse-Control and Conduct Disorders 249
Oppositional Defiant Disorder 249
Intermitten t Explosive Disorder 250
Conduct Disorder 252
Impulse-Control Disorders 252
Pyromania 252
You Be the Judge Legal Implications of
Impulse-Control Disorders 253
Kleptomania 254
105 Eating Elimination Sleep-Wake and Impulse-Control
Disorder The Biopsychosocial Perspective 255
Return to the Case Rosa Nomirez 255
SUMMARY 256
KEY TERMS 257
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xiii
CHAPTER 11
Paraphilic DisordersSexual Dysfunctionsand Gender Dysphoria 258
Case Report Shaun Boyden 259
111 What Patterns of Sexual Behavior Represent
Psychological Disorders 260
112 Paraphilic Disorders 262
Pedophilic Disorder 263
Exhibitionistic Disorder 264
Voyeuristic Disorder 264
Fetishistic Disorder 265
Frotteuristic Disorder 266
Sexual Masochism and Sexual Sadism
Disorders 266
Transvestic Disorder 267
Theories and Treatment of Paraphilic
Disorders 267
Biological Perspectives 268
Whatrsquos New in the DSM-5 The
Reorganization of Sexual Disorders 269
Psychological Perspectives 269
113 Sexual Dysfunctions 270
Arousal Disorders 271
Disorders Involving Orgasm 274
You Be the Judge Treatment for Sex
Offenders 275
Disorders Involving Pain 276
Theories and Treatment of SexualDysfunctions 276
Biological Perspectives 276
Psychological Perspectives 277
REAL STORIES Sue William Silverman Sex
Addiction 278
114 Gender Dysphoria 280
Theories and Treatment of Gender
Dysphoria 282
115 Paraphilic Disorders Sexual Dysfunctions and Gender
Dysphoria The Biopsychosocial Perspective 282
Return to the Case Shaun Boyden 284
SUMMARY 284
KEY TERMS 285
CHAPTER 12
Substance-Relatedand Addictive Disorders 286
Case Report Carl Wadsworth 287
121 Key Features of Substance
Disorders 289
Whatrsquos New in the DSM-5 Combining Abuse and
Dependence 290
122 Disorders Associated with Specific
Substances 290
Alcohol 292
Theories and Treatment of Alcohol
Use Disorders 295
Biological Perspectives 295
Psychological Perspectives 297
Sociocultural Perspective 298
Stimulants 299
Amphetamines 299
Cocaine 300
Cannabis 301
Hallucinogens 303
Opioids 306
You Be the Judge Prescribing
Prescription Drugs 307
Sedatives Hypnotics and Anxiolytics 308
Caffeine 309
REAL STORIES Robert Downey Jr
Substance Use Disorder 310
Tobacco 311
Inhalants 311
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Theories and Treatment of Substance Use
Disorders 311
Biologica l Perspectives 312
Psychological Perspectives 312
123 Non-Substance-Related Disorders 313
Gambling Disorder 313
124 Substance Disorders The Biopsychosocial
Perspective 316
Return to the Case
Carl Wadsworth 316
SUMMARY 317
KEY TERMS 318
CHAPTER 13
NeurocognitiveDisorders 320
Case Report Irene Heller 321
131 Characteristics of Neurocognitive Disorders 322
132 Delirium 324
133 Neurocognitive Disorder due to Alzheimerrsquos
Disease 327
Prevalence of Alzheimerrsquos Disease 328
Whatrsquos New in the DSM-5
Recategorization of Neurocognitive
Disorders 329
Stages of Alzheimerrsquos Disease 329
Diagnosis of Alzheimerrsquos Disease 330
Theories and Treatment of Alzheimerrsquos
Disease 333
Theories 333
You Be the Judge Early Diagnosis of
Alzheimerrsquos Disease 334
Treatment 336
REAL STORIES Ronald Reagan
Alzheimerrsquos Disease 338
134 Neurocognitive Disorders due to Neurological Disor-
ders Other than Alzheimerrsquos Disease 340
135 Neurocognitive Disorder due to TraumaticBrain Injury 343
136 Neurocognitive Disorders due to Substances
Medications and HIV Infection 344
137 Neurocognitive Disorders due to Another General
Medical Condition 344
138 Neurocognitive Disorders The Biopsychosocial
Perspective 345
Return to the Case Irene Heller 346
SUMMARY 346
KEY TERMS 347
CHAPTER 14
Personality Disorders 348
Case Report Harold Morrill 349
141 The Nature of Personality
Disorders 350
Whatrsquos New in the DSM-5
Dimensionalizing the Personality
Disorders 351
Personality Disorders in DSM-5 351
Alternative Personality Disorder Diagnostic System
in Section 3 of the DSM-5 352
142 Cluster A Personality Disorders 355
Paranoid Personality Disorder 355
Schizoid Personality Disorder 356Schizotypal Personality Disorder 357
143 Cluster B Personality Disorders 357
Antisocial Personality Disorder 357
Characteristics of Antisocial Personality
Disorder 358
Theories of Antisocial Personality
Disorder 360
You Be the Judge Antisocial PersonalityDisorder and Moral Culpability 361
Biological Perspectives 361
REAL STORIES Ted Bundy Antisocial
Personality Disorder 362
Psychological Perspectives 363
Treatment of Antisocial Personality
Disorder 364
Borderline Personality Disorder 364Characteristics of Borderline Personality
Disorder (BPD) 365
Theories and Treatment of BPD 366
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xv
Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
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You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
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xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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xx
CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
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xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
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ix
REAL STORIES Daniel Johnston Bipolar
Disorder 42
26 The Outcome of Treatment 43
Return to the Case Peter Dickinson 44
SUMMARY 44
KEY TERMS 45
CHAPTER 3
Assessment 46
Case Report Ben Robsha m 47
31 Characteristics of Psychological
Assessments 48
32 Clinical Interview 49
33 Mental Status Examination 52
34 Intelligence Testing 52
Stanford-Binet Intelligence Test 53
Wechsler Intelligence Scales 53
35 Personality Testing 56
Self-Report Tests 56
Projective Testing 60
36 Behavioral Assessment 61
37 Multicultural Assessment 61
38 Neuropsychological Assessment 62
Whatrsquos New in the DSM-5 Section 3
Assessment Measures 63
You Be the Judge Psychologists in the
Legal System 64
39 Neuroimaging 65
REAL STORIES Ludwig van Beethoven
Bipolar Disorder 66
310 Putting It All Together 68
Return to the Case Ben Robsham 68
SUMMARY 69
KEY TERMS 69
CHAPTER 4
TheoreticalPerspectives 70
Case Report Meera
Krishnan 71
41 Theoretical Perspectives in Abnormal Psychology 72
42 Biological Perspective 72
Theories 72
Treatment 77
43 Trait Theory 80
Whatrsquos New in the DSM-5 Theoretical
Approaches 81
44 Psychodynamic Perspective 81
Freudrsquos Theory 81
Post-Freudian Psychodynamic Views 83
Treatment 86
45 Behavioral Perspective 86
Theories 86
You Be the Judge Evidence-Based
Practice 87
Treatment 88
46 Cognitive Perspective 89
Theories 89
Treatment 90
47 Humanistic Perspective 91
Theories 91
Treatment 93
48 Sociocultural Perspective 94
Theories 94
Treatment 94
REAL STORIES Sylvia Plath Major
Depressive Disorder 96
49 Biopsychosocial Perspectives on Theories and
Treatments An Integrative Approach 97
Return to the Case Meera Krishnan 98
SUMMARY 98
KEY TERMS 99
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CHAPTER 5
NeurodevelopmentalDisorders 100
Case Report Jason Newman 101
51 Intellectual Disability (Intellectual Developmental
Disorder) 103
Causes of Intellectual Disability 104
Whatrsquos New in the DSM-5
Neurodevelopmental Disorders 107
Treatment of Intellectual Disability 109
52 Autism Spectrum Disorder 110
Theories and Treatment of Autism
Spectrum Disorder 112
Rett Syndrome 115
High-Functioning Autism Spectrum Disorder
Formerly Called Aspergerrsquos Disorder 115
REAL STORIES Daniel Tammet Autism
Spectrum Disorder 116
53 Learning and Communication Disorders 118
Specific Learning Disorders 118
Communication Disorders 121
54 Attention-DeficitHyperactivity Disorder
(ADHD) 122
Characteristics of ADHD 122
ADHD in Adults 125
Theories and Treatment of ADHD 126
You Be the Judge Prescribing Psychiatric
Medications to Children 128
55 Motor Disorders 130
Developmental Coordination Disorder 130
Tic Disorders 131
Stereotypic Movement Disorder 132
56 Neurodevelopmental Disorders The Biopsychosocial
Perspective 132
Return to the Case Jason Newman 133
SUMMARY 133
KEY TERMS 134
CHAPTER 6
Schizophrenia Spectrumand Other PsychoticDisorders 136
Case Report David
Marshall 137
61 Schizophrenia 139
Whatrsquos New in the DSM-5 Schizophrenia
Subtypes and Dimensional Ratings 143
Course of Schizophrenia 143
You Be the Judge Schizophrenia
Diagnosis 145
62 Brief Psychotic Disorder 146
63 Schizophreniform Disorder 14764 Schizoaffective Disorder 147
65 Delusional Disorders 148
66 Theories and Treatment of Schizophrenia 150
Biological Perspectives 150
Theories 150
REAL STORIES Elyn Saks Schizophrenia 152
Treatments 153
Psychological Perspectives 154
Theories 154
Treatments 156
Sociocultural Perspectives 156
Theories 156
Treatments 158
67 Schizophrenia The Biopsychosocial
Perspective 159
Return to the Case David Marshall 160
SUMMARY 160
KEY TERMS 161
CHAPTER 7
Depressive and
Bipolar Disorders 162Case Report Janice Butterf ield 163
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xi
71 Depressive Disorders 164
Major Depressive Disorder 164
Persistent Depressive Disorder (Dysthymia) 166
Disruptive Mood Dysregulation Disorder 166
Premenstrual Dysphoric Disorder 167
72 Disorders Involving Alternations in Mood 167
Bipolar Disorder 167
REAL STORIES Carrie Fisher Bipolar
Disorder 168
Cyclothymic Disorder 170
73 Theories and Treatment of
Depressive and Bipolar Disorder 171
Biological Perspectives 171
Whatrsquos New in the DSM-5 Depressive
and Bipolar Disorders 174
Psychological Perspectives 176
Psychodynamic Approaches 176
Behavioral and Cognitive -Behavioral Approaches 176
Interpersonal Approaches 178
Sociocultural Perspectives 179
You Be the Judge Do-Not-Resuscitate
Orders for Suicidal Patients 180
74 Suicide 180
75 Depressive and Bipolar Disorders The Biopsychosocial
Perspective 182
Return to the Case Janice Butterfield 182
SUMMARY 183
KEY TERMS 183
CHAPTER 8
Anxiety Obsessive-Compulsive andTrauma- and Stressor-Related Disorders 184
Case Report Barba ra Wilder 185
81 Anxiety Disorders 186
Separation Anxiety Disorder 187
Theories and Treatment of Separation Anxiety Disorder 187
Selective Mutism 188
Specific Phobias 189
Theories and Treatment of Specific Phobias 190
Social Anxiety Disorder 192
Theories and Treatment of Social Anxiety Disorder 192
Panic Disorder and Agoraphobia 193
Panic Disorder 193
Agoraphobiar 194
Theories and Treatment of Panic Disorder and Agoraphobia 194
Generalized Anxiety Disorder 195
REAL STORIES Paula Deen Panic Disorder
with Agoraphobia 196
Theories and Treatment of Generalized Anxiety Disorder 197
82 Obsessive-Compulsive and Related Disorders 198
Whatrsquos New in the DSM-5 Definition and
Categorization of Anxiety Disorders 199
Theories and Treatment of Obsessive-Compulsive
Disorder 199
You Be the Judge Psychiatric
Neurosurgery 201
Body Dysmorphic Disorder 201
Hoarding Disorder 203
Trichotillomania (Hair-Pulling Disorder) 204
Excoriation (Skin-Picking) Disorder 206
83 Trauma- and Stressor-Related Disorders 206
Reactive Attachment Disorder and Disinhibited
Social Engagement Disorder 207
Acute Stress Disorder and Post-Traumatic Stress
Disorder 207
Theories and Treatment of Post-Traumatic Stress Disorder 208
84 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders The Biopsychosocial
Perspective 210
Return to the Case Barbara Wilder 210
SUMMARY 211
KEY TERMS 212
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CHAPTER 9
Dissociative andSomatic SymptomDisorders 214
Case Report Rose
Marston 215
91 Dissociative Disorders 216
Major Forms of Dissociative Disorders 216
Theories and Treatment of Dissociative
Disorders 217
REAL STORIES Herschel Walker
Dissociative Identity Disorder 218
You Be the Judge Dissociative Identity
Disorder 220
92 Somatic Symptom and Related Disorders 222
Somatic Symptom Disorder 222
Illness Anxiety Disorder 223
Conversion Disorder (Functional Neurological
Symptom Disorder) 223
Conditions Related to Somatic Symptom
Disorders 224
Theories and Treatment of Somatic Symptom andRelated Disorders 225
Whatrsquos New in the DSM-5 Somatic
Symptom and Related Disorders 227
93 Psychological Factors Affecting
Medical Condition 227
Relevant Concepts for Understanding
Psychological Factors Affecting Medical
Condition 228
Stress and Coping 228
Emotional Expression 231
Personality Style 232
Applications to Behavioral Medicine 232
94 Dissociative and Somatic Symptom Disorders
The Biopsychosocial Perspective 233
Return to the Case Rose Marston 234
SUMMARY 234
KEY TERMS 235
CHAPTER 10
Feeding and EatingDisorders EliminationDisorders Sleep-WakeDisorders andDisruptive Impulse-
Control and ConductDisorders 236
Case Report Rosa
Nomirez 237
101 Eating Disorders 238
Characteristics of Anorexia Nervosa 239
REAL STORIES Portia de Rossi Anorexia
Nervosa 240Characteristics of Bulimia Nervosa 242
Binge-Eating Disorder 243
Theories and Treatment of Eating Disorders 243
Whatrsquos New in the DSM-5 Reclassifying
Eating Elimination Sleep-Wake and Disruptive
Impulse-Control and Conduct Disorders 245
AvoidantRestrictive Food Intake Disorder 245
Eating Disorders Associated with Childhood 246
102 Elimination Disorders 246
103 Sleep-Wake Disorders 247
104 Disruptive Impulse-Control and Conduct Disorders 249
Oppositional Defiant Disorder 249
Intermitten t Explosive Disorder 250
Conduct Disorder 252
Impulse-Control Disorders 252
Pyromania 252
You Be the Judge Legal Implications of
Impulse-Control Disorders 253
Kleptomania 254
105 Eating Elimination Sleep-Wake and Impulse-Control
Disorder The Biopsychosocial Perspective 255
Return to the Case Rosa Nomirez 255
SUMMARY 256
KEY TERMS 257
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xiii
CHAPTER 11
Paraphilic DisordersSexual Dysfunctionsand Gender Dysphoria 258
Case Report Shaun Boyden 259
111 What Patterns of Sexual Behavior Represent
Psychological Disorders 260
112 Paraphilic Disorders 262
Pedophilic Disorder 263
Exhibitionistic Disorder 264
Voyeuristic Disorder 264
Fetishistic Disorder 265
Frotteuristic Disorder 266
Sexual Masochism and Sexual Sadism
Disorders 266
Transvestic Disorder 267
Theories and Treatment of Paraphilic
Disorders 267
Biological Perspectives 268
Whatrsquos New in the DSM-5 The
Reorganization of Sexual Disorders 269
Psychological Perspectives 269
113 Sexual Dysfunctions 270
Arousal Disorders 271
Disorders Involving Orgasm 274
You Be the Judge Treatment for Sex
Offenders 275
Disorders Involving Pain 276
Theories and Treatment of SexualDysfunctions 276
Biological Perspectives 276
Psychological Perspectives 277
REAL STORIES Sue William Silverman Sex
Addiction 278
114 Gender Dysphoria 280
Theories and Treatment of Gender
Dysphoria 282
115 Paraphilic Disorders Sexual Dysfunctions and Gender
Dysphoria The Biopsychosocial Perspective 282
Return to the Case Shaun Boyden 284
SUMMARY 284
KEY TERMS 285
CHAPTER 12
Substance-Relatedand Addictive Disorders 286
Case Report Carl Wadsworth 287
121 Key Features of Substance
Disorders 289
Whatrsquos New in the DSM-5 Combining Abuse and
Dependence 290
122 Disorders Associated with Specific
Substances 290
Alcohol 292
Theories and Treatment of Alcohol
Use Disorders 295
Biological Perspectives 295
Psychological Perspectives 297
Sociocultural Perspective 298
Stimulants 299
Amphetamines 299
Cocaine 300
Cannabis 301
Hallucinogens 303
Opioids 306
You Be the Judge Prescribing
Prescription Drugs 307
Sedatives Hypnotics and Anxiolytics 308
Caffeine 309
REAL STORIES Robert Downey Jr
Substance Use Disorder 310
Tobacco 311
Inhalants 311
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xiv
Theories and Treatment of Substance Use
Disorders 311
Biologica l Perspectives 312
Psychological Perspectives 312
123 Non-Substance-Related Disorders 313
Gambling Disorder 313
124 Substance Disorders The Biopsychosocial
Perspective 316
Return to the Case
Carl Wadsworth 316
SUMMARY 317
KEY TERMS 318
CHAPTER 13
NeurocognitiveDisorders 320
Case Report Irene Heller 321
131 Characteristics of Neurocognitive Disorders 322
132 Delirium 324
133 Neurocognitive Disorder due to Alzheimerrsquos
Disease 327
Prevalence of Alzheimerrsquos Disease 328
Whatrsquos New in the DSM-5
Recategorization of Neurocognitive
Disorders 329
Stages of Alzheimerrsquos Disease 329
Diagnosis of Alzheimerrsquos Disease 330
Theories and Treatment of Alzheimerrsquos
Disease 333
Theories 333
You Be the Judge Early Diagnosis of
Alzheimerrsquos Disease 334
Treatment 336
REAL STORIES Ronald Reagan
Alzheimerrsquos Disease 338
134 Neurocognitive Disorders due to Neurological Disor-
ders Other than Alzheimerrsquos Disease 340
135 Neurocognitive Disorder due to TraumaticBrain Injury 343
136 Neurocognitive Disorders due to Substances
Medications and HIV Infection 344
137 Neurocognitive Disorders due to Another General
Medical Condition 344
138 Neurocognitive Disorders The Biopsychosocial
Perspective 345
Return to the Case Irene Heller 346
SUMMARY 346
KEY TERMS 347
CHAPTER 14
Personality Disorders 348
Case Report Harold Morrill 349
141 The Nature of Personality
Disorders 350
Whatrsquos New in the DSM-5
Dimensionalizing the Personality
Disorders 351
Personality Disorders in DSM-5 351
Alternative Personality Disorder Diagnostic System
in Section 3 of the DSM-5 352
142 Cluster A Personality Disorders 355
Paranoid Personality Disorder 355
Schizoid Personality Disorder 356Schizotypal Personality Disorder 357
143 Cluster B Personality Disorders 357
Antisocial Personality Disorder 357
Characteristics of Antisocial Personality
Disorder 358
Theories of Antisocial Personality
Disorder 360
You Be the Judge Antisocial PersonalityDisorder and Moral Culpability 361
Biological Perspectives 361
REAL STORIES Ted Bundy Antisocial
Personality Disorder 362
Psychological Perspectives 363
Treatment of Antisocial Personality
Disorder 364
Borderline Personality Disorder 364Characteristics of Borderline Personality
Disorder (BPD) 365
Theories and Treatment of BPD 366
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Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
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You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
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xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
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xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
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x
CHAPTER 5
NeurodevelopmentalDisorders 100
Case Report Jason Newman 101
51 Intellectual Disability (Intellectual Developmental
Disorder) 103
Causes of Intellectual Disability 104
Whatrsquos New in the DSM-5
Neurodevelopmental Disorders 107
Treatment of Intellectual Disability 109
52 Autism Spectrum Disorder 110
Theories and Treatment of Autism
Spectrum Disorder 112
Rett Syndrome 115
High-Functioning Autism Spectrum Disorder
Formerly Called Aspergerrsquos Disorder 115
REAL STORIES Daniel Tammet Autism
Spectrum Disorder 116
53 Learning and Communication Disorders 118
Specific Learning Disorders 118
Communication Disorders 121
54 Attention-DeficitHyperactivity Disorder
(ADHD) 122
Characteristics of ADHD 122
ADHD in Adults 125
Theories and Treatment of ADHD 126
You Be the Judge Prescribing Psychiatric
Medications to Children 128
55 Motor Disorders 130
Developmental Coordination Disorder 130
Tic Disorders 131
Stereotypic Movement Disorder 132
56 Neurodevelopmental Disorders The Biopsychosocial
Perspective 132
Return to the Case Jason Newman 133
SUMMARY 133
KEY TERMS 134
CHAPTER 6
Schizophrenia Spectrumand Other PsychoticDisorders 136
Case Report David
Marshall 137
61 Schizophrenia 139
Whatrsquos New in the DSM-5 Schizophrenia
Subtypes and Dimensional Ratings 143
Course of Schizophrenia 143
You Be the Judge Schizophrenia
Diagnosis 145
62 Brief Psychotic Disorder 146
63 Schizophreniform Disorder 14764 Schizoaffective Disorder 147
65 Delusional Disorders 148
66 Theories and Treatment of Schizophrenia 150
Biological Perspectives 150
Theories 150
REAL STORIES Elyn Saks Schizophrenia 152
Treatments 153
Psychological Perspectives 154
Theories 154
Treatments 156
Sociocultural Perspectives 156
Theories 156
Treatments 158
67 Schizophrenia The Biopsychosocial
Perspective 159
Return to the Case David Marshall 160
SUMMARY 160
KEY TERMS 161
CHAPTER 7
Depressive and
Bipolar Disorders 162Case Report Janice Butterf ield 163
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xi
71 Depressive Disorders 164
Major Depressive Disorder 164
Persistent Depressive Disorder (Dysthymia) 166
Disruptive Mood Dysregulation Disorder 166
Premenstrual Dysphoric Disorder 167
72 Disorders Involving Alternations in Mood 167
Bipolar Disorder 167
REAL STORIES Carrie Fisher Bipolar
Disorder 168
Cyclothymic Disorder 170
73 Theories and Treatment of
Depressive and Bipolar Disorder 171
Biological Perspectives 171
Whatrsquos New in the DSM-5 Depressive
and Bipolar Disorders 174
Psychological Perspectives 176
Psychodynamic Approaches 176
Behavioral and Cognitive -Behavioral Approaches 176
Interpersonal Approaches 178
Sociocultural Perspectives 179
You Be the Judge Do-Not-Resuscitate
Orders for Suicidal Patients 180
74 Suicide 180
75 Depressive and Bipolar Disorders The Biopsychosocial
Perspective 182
Return to the Case Janice Butterfield 182
SUMMARY 183
KEY TERMS 183
CHAPTER 8
Anxiety Obsessive-Compulsive andTrauma- and Stressor-Related Disorders 184
Case Report Barba ra Wilder 185
81 Anxiety Disorders 186
Separation Anxiety Disorder 187
Theories and Treatment of Separation Anxiety Disorder 187
Selective Mutism 188
Specific Phobias 189
Theories and Treatment of Specific Phobias 190
Social Anxiety Disorder 192
Theories and Treatment of Social Anxiety Disorder 192
Panic Disorder and Agoraphobia 193
Panic Disorder 193
Agoraphobiar 194
Theories and Treatment of Panic Disorder and Agoraphobia 194
Generalized Anxiety Disorder 195
REAL STORIES Paula Deen Panic Disorder
with Agoraphobia 196
Theories and Treatment of Generalized Anxiety Disorder 197
82 Obsessive-Compulsive and Related Disorders 198
Whatrsquos New in the DSM-5 Definition and
Categorization of Anxiety Disorders 199
Theories and Treatment of Obsessive-Compulsive
Disorder 199
You Be the Judge Psychiatric
Neurosurgery 201
Body Dysmorphic Disorder 201
Hoarding Disorder 203
Trichotillomania (Hair-Pulling Disorder) 204
Excoriation (Skin-Picking) Disorder 206
83 Trauma- and Stressor-Related Disorders 206
Reactive Attachment Disorder and Disinhibited
Social Engagement Disorder 207
Acute Stress Disorder and Post-Traumatic Stress
Disorder 207
Theories and Treatment of Post-Traumatic Stress Disorder 208
84 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders The Biopsychosocial
Perspective 210
Return to the Case Barbara Wilder 210
SUMMARY 211
KEY TERMS 212
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CHAPTER 9
Dissociative andSomatic SymptomDisorders 214
Case Report Rose
Marston 215
91 Dissociative Disorders 216
Major Forms of Dissociative Disorders 216
Theories and Treatment of Dissociative
Disorders 217
REAL STORIES Herschel Walker
Dissociative Identity Disorder 218
You Be the Judge Dissociative Identity
Disorder 220
92 Somatic Symptom and Related Disorders 222
Somatic Symptom Disorder 222
Illness Anxiety Disorder 223
Conversion Disorder (Functional Neurological
Symptom Disorder) 223
Conditions Related to Somatic Symptom
Disorders 224
Theories and Treatment of Somatic Symptom andRelated Disorders 225
Whatrsquos New in the DSM-5 Somatic
Symptom and Related Disorders 227
93 Psychological Factors Affecting
Medical Condition 227
Relevant Concepts for Understanding
Psychological Factors Affecting Medical
Condition 228
Stress and Coping 228
Emotional Expression 231
Personality Style 232
Applications to Behavioral Medicine 232
94 Dissociative and Somatic Symptom Disorders
The Biopsychosocial Perspective 233
Return to the Case Rose Marston 234
SUMMARY 234
KEY TERMS 235
CHAPTER 10
Feeding and EatingDisorders EliminationDisorders Sleep-WakeDisorders andDisruptive Impulse-
Control and ConductDisorders 236
Case Report Rosa
Nomirez 237
101 Eating Disorders 238
Characteristics of Anorexia Nervosa 239
REAL STORIES Portia de Rossi Anorexia
Nervosa 240Characteristics of Bulimia Nervosa 242
Binge-Eating Disorder 243
Theories and Treatment of Eating Disorders 243
Whatrsquos New in the DSM-5 Reclassifying
Eating Elimination Sleep-Wake and Disruptive
Impulse-Control and Conduct Disorders 245
AvoidantRestrictive Food Intake Disorder 245
Eating Disorders Associated with Childhood 246
102 Elimination Disorders 246
103 Sleep-Wake Disorders 247
104 Disruptive Impulse-Control and Conduct Disorders 249
Oppositional Defiant Disorder 249
Intermitten t Explosive Disorder 250
Conduct Disorder 252
Impulse-Control Disorders 252
Pyromania 252
You Be the Judge Legal Implications of
Impulse-Control Disorders 253
Kleptomania 254
105 Eating Elimination Sleep-Wake and Impulse-Control
Disorder The Biopsychosocial Perspective 255
Return to the Case Rosa Nomirez 255
SUMMARY 256
KEY TERMS 257
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xiii
CHAPTER 11
Paraphilic DisordersSexual Dysfunctionsand Gender Dysphoria 258
Case Report Shaun Boyden 259
111 What Patterns of Sexual Behavior Represent
Psychological Disorders 260
112 Paraphilic Disorders 262
Pedophilic Disorder 263
Exhibitionistic Disorder 264
Voyeuristic Disorder 264
Fetishistic Disorder 265
Frotteuristic Disorder 266
Sexual Masochism and Sexual Sadism
Disorders 266
Transvestic Disorder 267
Theories and Treatment of Paraphilic
Disorders 267
Biological Perspectives 268
Whatrsquos New in the DSM-5 The
Reorganization of Sexual Disorders 269
Psychological Perspectives 269
113 Sexual Dysfunctions 270
Arousal Disorders 271
Disorders Involving Orgasm 274
You Be the Judge Treatment for Sex
Offenders 275
Disorders Involving Pain 276
Theories and Treatment of SexualDysfunctions 276
Biological Perspectives 276
Psychological Perspectives 277
REAL STORIES Sue William Silverman Sex
Addiction 278
114 Gender Dysphoria 280
Theories and Treatment of Gender
Dysphoria 282
115 Paraphilic Disorders Sexual Dysfunctions and Gender
Dysphoria The Biopsychosocial Perspective 282
Return to the Case Shaun Boyden 284
SUMMARY 284
KEY TERMS 285
CHAPTER 12
Substance-Relatedand Addictive Disorders 286
Case Report Carl Wadsworth 287
121 Key Features of Substance
Disorders 289
Whatrsquos New in the DSM-5 Combining Abuse and
Dependence 290
122 Disorders Associated with Specific
Substances 290
Alcohol 292
Theories and Treatment of Alcohol
Use Disorders 295
Biological Perspectives 295
Psychological Perspectives 297
Sociocultural Perspective 298
Stimulants 299
Amphetamines 299
Cocaine 300
Cannabis 301
Hallucinogens 303
Opioids 306
You Be the Judge Prescribing
Prescription Drugs 307
Sedatives Hypnotics and Anxiolytics 308
Caffeine 309
REAL STORIES Robert Downey Jr
Substance Use Disorder 310
Tobacco 311
Inhalants 311
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xiv
Theories and Treatment of Substance Use
Disorders 311
Biologica l Perspectives 312
Psychological Perspectives 312
123 Non-Substance-Related Disorders 313
Gambling Disorder 313
124 Substance Disorders The Biopsychosocial
Perspective 316
Return to the Case
Carl Wadsworth 316
SUMMARY 317
KEY TERMS 318
CHAPTER 13
NeurocognitiveDisorders 320
Case Report Irene Heller 321
131 Characteristics of Neurocognitive Disorders 322
132 Delirium 324
133 Neurocognitive Disorder due to Alzheimerrsquos
Disease 327
Prevalence of Alzheimerrsquos Disease 328
Whatrsquos New in the DSM-5
Recategorization of Neurocognitive
Disorders 329
Stages of Alzheimerrsquos Disease 329
Diagnosis of Alzheimerrsquos Disease 330
Theories and Treatment of Alzheimerrsquos
Disease 333
Theories 333
You Be the Judge Early Diagnosis of
Alzheimerrsquos Disease 334
Treatment 336
REAL STORIES Ronald Reagan
Alzheimerrsquos Disease 338
134 Neurocognitive Disorders due to Neurological Disor-
ders Other than Alzheimerrsquos Disease 340
135 Neurocognitive Disorder due to TraumaticBrain Injury 343
136 Neurocognitive Disorders due to Substances
Medications and HIV Infection 344
137 Neurocognitive Disorders due to Another General
Medical Condition 344
138 Neurocognitive Disorders The Biopsychosocial
Perspective 345
Return to the Case Irene Heller 346
SUMMARY 346
KEY TERMS 347
CHAPTER 14
Personality Disorders 348
Case Report Harold Morrill 349
141 The Nature of Personality
Disorders 350
Whatrsquos New in the DSM-5
Dimensionalizing the Personality
Disorders 351
Personality Disorders in DSM-5 351
Alternative Personality Disorder Diagnostic System
in Section 3 of the DSM-5 352
142 Cluster A Personality Disorders 355
Paranoid Personality Disorder 355
Schizoid Personality Disorder 356Schizotypal Personality Disorder 357
143 Cluster B Personality Disorders 357
Antisocial Personality Disorder 357
Characteristics of Antisocial Personality
Disorder 358
Theories of Antisocial Personality
Disorder 360
You Be the Judge Antisocial PersonalityDisorder and Moral Culpability 361
Biological Perspectives 361
REAL STORIES Ted Bundy Antisocial
Personality Disorder 362
Psychological Perspectives 363
Treatment of Antisocial Personality
Disorder 364
Borderline Personality Disorder 364Characteristics of Borderline Personality
Disorder (BPD) 365
Theories and Treatment of BPD 366
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xv
Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
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You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
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xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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xx
CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
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A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
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71 Depressive Disorders 164
Major Depressive Disorder 164
Persistent Depressive Disorder (Dysthymia) 166
Disruptive Mood Dysregulation Disorder 166
Premenstrual Dysphoric Disorder 167
72 Disorders Involving Alternations in Mood 167
Bipolar Disorder 167
REAL STORIES Carrie Fisher Bipolar
Disorder 168
Cyclothymic Disorder 170
73 Theories and Treatment of
Depressive and Bipolar Disorder 171
Biological Perspectives 171
Whatrsquos New in the DSM-5 Depressive
and Bipolar Disorders 174
Psychological Perspectives 176
Psychodynamic Approaches 176
Behavioral and Cognitive -Behavioral Approaches 176
Interpersonal Approaches 178
Sociocultural Perspectives 179
You Be the Judge Do-Not-Resuscitate
Orders for Suicidal Patients 180
74 Suicide 180
75 Depressive and Bipolar Disorders The Biopsychosocial
Perspective 182
Return to the Case Janice Butterfield 182
SUMMARY 183
KEY TERMS 183
CHAPTER 8
Anxiety Obsessive-Compulsive andTrauma- and Stressor-Related Disorders 184
Case Report Barba ra Wilder 185
81 Anxiety Disorders 186
Separation Anxiety Disorder 187
Theories and Treatment of Separation Anxiety Disorder 187
Selective Mutism 188
Specific Phobias 189
Theories and Treatment of Specific Phobias 190
Social Anxiety Disorder 192
Theories and Treatment of Social Anxiety Disorder 192
Panic Disorder and Agoraphobia 193
Panic Disorder 193
Agoraphobiar 194
Theories and Treatment of Panic Disorder and Agoraphobia 194
Generalized Anxiety Disorder 195
REAL STORIES Paula Deen Panic Disorder
with Agoraphobia 196
Theories and Treatment of Generalized Anxiety Disorder 197
82 Obsessive-Compulsive and Related Disorders 198
Whatrsquos New in the DSM-5 Definition and
Categorization of Anxiety Disorders 199
Theories and Treatment of Obsessive-Compulsive
Disorder 199
You Be the Judge Psychiatric
Neurosurgery 201
Body Dysmorphic Disorder 201
Hoarding Disorder 203
Trichotillomania (Hair-Pulling Disorder) 204
Excoriation (Skin-Picking) Disorder 206
83 Trauma- and Stressor-Related Disorders 206
Reactive Attachment Disorder and Disinhibited
Social Engagement Disorder 207
Acute Stress Disorder and Post-Traumatic Stress
Disorder 207
Theories and Treatment of Post-Traumatic Stress Disorder 208
84 Anxiety Obsessive-Compulsive and Trauma-
and Stressor-Related Disorders The Biopsychosocial
Perspective 210
Return to the Case Barbara Wilder 210
SUMMARY 211
KEY TERMS 212
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CHAPTER 9
Dissociative andSomatic SymptomDisorders 214
Case Report Rose
Marston 215
91 Dissociative Disorders 216
Major Forms of Dissociative Disorders 216
Theories and Treatment of Dissociative
Disorders 217
REAL STORIES Herschel Walker
Dissociative Identity Disorder 218
You Be the Judge Dissociative Identity
Disorder 220
92 Somatic Symptom and Related Disorders 222
Somatic Symptom Disorder 222
Illness Anxiety Disorder 223
Conversion Disorder (Functional Neurological
Symptom Disorder) 223
Conditions Related to Somatic Symptom
Disorders 224
Theories and Treatment of Somatic Symptom andRelated Disorders 225
Whatrsquos New in the DSM-5 Somatic
Symptom and Related Disorders 227
93 Psychological Factors Affecting
Medical Condition 227
Relevant Concepts for Understanding
Psychological Factors Affecting Medical
Condition 228
Stress and Coping 228
Emotional Expression 231
Personality Style 232
Applications to Behavioral Medicine 232
94 Dissociative and Somatic Symptom Disorders
The Biopsychosocial Perspective 233
Return to the Case Rose Marston 234
SUMMARY 234
KEY TERMS 235
CHAPTER 10
Feeding and EatingDisorders EliminationDisorders Sleep-WakeDisorders andDisruptive Impulse-
Control and ConductDisorders 236
Case Report Rosa
Nomirez 237
101 Eating Disorders 238
Characteristics of Anorexia Nervosa 239
REAL STORIES Portia de Rossi Anorexia
Nervosa 240Characteristics of Bulimia Nervosa 242
Binge-Eating Disorder 243
Theories and Treatment of Eating Disorders 243
Whatrsquos New in the DSM-5 Reclassifying
Eating Elimination Sleep-Wake and Disruptive
Impulse-Control and Conduct Disorders 245
AvoidantRestrictive Food Intake Disorder 245
Eating Disorders Associated with Childhood 246
102 Elimination Disorders 246
103 Sleep-Wake Disorders 247
104 Disruptive Impulse-Control and Conduct Disorders 249
Oppositional Defiant Disorder 249
Intermitten t Explosive Disorder 250
Conduct Disorder 252
Impulse-Control Disorders 252
Pyromania 252
You Be the Judge Legal Implications of
Impulse-Control Disorders 253
Kleptomania 254
105 Eating Elimination Sleep-Wake and Impulse-Control
Disorder The Biopsychosocial Perspective 255
Return to the Case Rosa Nomirez 255
SUMMARY 256
KEY TERMS 257
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xiii
CHAPTER 11
Paraphilic DisordersSexual Dysfunctionsand Gender Dysphoria 258
Case Report Shaun Boyden 259
111 What Patterns of Sexual Behavior Represent
Psychological Disorders 260
112 Paraphilic Disorders 262
Pedophilic Disorder 263
Exhibitionistic Disorder 264
Voyeuristic Disorder 264
Fetishistic Disorder 265
Frotteuristic Disorder 266
Sexual Masochism and Sexual Sadism
Disorders 266
Transvestic Disorder 267
Theories and Treatment of Paraphilic
Disorders 267
Biological Perspectives 268
Whatrsquos New in the DSM-5 The
Reorganization of Sexual Disorders 269
Psychological Perspectives 269
113 Sexual Dysfunctions 270
Arousal Disorders 271
Disorders Involving Orgasm 274
You Be the Judge Treatment for Sex
Offenders 275
Disorders Involving Pain 276
Theories and Treatment of SexualDysfunctions 276
Biological Perspectives 276
Psychological Perspectives 277
REAL STORIES Sue William Silverman Sex
Addiction 278
114 Gender Dysphoria 280
Theories and Treatment of Gender
Dysphoria 282
115 Paraphilic Disorders Sexual Dysfunctions and Gender
Dysphoria The Biopsychosocial Perspective 282
Return to the Case Shaun Boyden 284
SUMMARY 284
KEY TERMS 285
CHAPTER 12
Substance-Relatedand Addictive Disorders 286
Case Report Carl Wadsworth 287
121 Key Features of Substance
Disorders 289
Whatrsquos New in the DSM-5 Combining Abuse and
Dependence 290
122 Disorders Associated with Specific
Substances 290
Alcohol 292
Theories and Treatment of Alcohol
Use Disorders 295
Biological Perspectives 295
Psychological Perspectives 297
Sociocultural Perspective 298
Stimulants 299
Amphetamines 299
Cocaine 300
Cannabis 301
Hallucinogens 303
Opioids 306
You Be the Judge Prescribing
Prescription Drugs 307
Sedatives Hypnotics and Anxiolytics 308
Caffeine 309
REAL STORIES Robert Downey Jr
Substance Use Disorder 310
Tobacco 311
Inhalants 311
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xiv
Theories and Treatment of Substance Use
Disorders 311
Biologica l Perspectives 312
Psychological Perspectives 312
123 Non-Substance-Related Disorders 313
Gambling Disorder 313
124 Substance Disorders The Biopsychosocial
Perspective 316
Return to the Case
Carl Wadsworth 316
SUMMARY 317
KEY TERMS 318
CHAPTER 13
NeurocognitiveDisorders 320
Case Report Irene Heller 321
131 Characteristics of Neurocognitive Disorders 322
132 Delirium 324
133 Neurocognitive Disorder due to Alzheimerrsquos
Disease 327
Prevalence of Alzheimerrsquos Disease 328
Whatrsquos New in the DSM-5
Recategorization of Neurocognitive
Disorders 329
Stages of Alzheimerrsquos Disease 329
Diagnosis of Alzheimerrsquos Disease 330
Theories and Treatment of Alzheimerrsquos
Disease 333
Theories 333
You Be the Judge Early Diagnosis of
Alzheimerrsquos Disease 334
Treatment 336
REAL STORIES Ronald Reagan
Alzheimerrsquos Disease 338
134 Neurocognitive Disorders due to Neurological Disor-
ders Other than Alzheimerrsquos Disease 340
135 Neurocognitive Disorder due to TraumaticBrain Injury 343
136 Neurocognitive Disorders due to Substances
Medications and HIV Infection 344
137 Neurocognitive Disorders due to Another General
Medical Condition 344
138 Neurocognitive Disorders The Biopsychosocial
Perspective 345
Return to the Case Irene Heller 346
SUMMARY 346
KEY TERMS 347
CHAPTER 14
Personality Disorders 348
Case Report Harold Morrill 349
141 The Nature of Personality
Disorders 350
Whatrsquos New in the DSM-5
Dimensionalizing the Personality
Disorders 351
Personality Disorders in DSM-5 351
Alternative Personality Disorder Diagnostic System
in Section 3 of the DSM-5 352
142 Cluster A Personality Disorders 355
Paranoid Personality Disorder 355
Schizoid Personality Disorder 356Schizotypal Personality Disorder 357
143 Cluster B Personality Disorders 357
Antisocial Personality Disorder 357
Characteristics of Antisocial Personality
Disorder 358
Theories of Antisocial Personality
Disorder 360
You Be the Judge Antisocial PersonalityDisorder and Moral Culpability 361
Biological Perspectives 361
REAL STORIES Ted Bundy Antisocial
Personality Disorder 362
Psychological Perspectives 363
Treatment of Antisocial Personality
Disorder 364
Borderline Personality Disorder 364Characteristics of Borderline Personality
Disorder (BPD) 365
Theories and Treatment of BPD 366
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xv
Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
whi33389_ch06_136 161indd Page 143 62013 448 PM F 469 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
whi33389_ch08_184 213indd Page 201 240613 911 AM F 468 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
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xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
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xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
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xii
CHAPTER 9
Dissociative andSomatic SymptomDisorders 214
Case Report Rose
Marston 215
91 Dissociative Disorders 216
Major Forms of Dissociative Disorders 216
Theories and Treatment of Dissociative
Disorders 217
REAL STORIES Herschel Walker
Dissociative Identity Disorder 218
You Be the Judge Dissociative Identity
Disorder 220
92 Somatic Symptom and Related Disorders 222
Somatic Symptom Disorder 222
Illness Anxiety Disorder 223
Conversion Disorder (Functional Neurological
Symptom Disorder) 223
Conditions Related to Somatic Symptom
Disorders 224
Theories and Treatment of Somatic Symptom andRelated Disorders 225
Whatrsquos New in the DSM-5 Somatic
Symptom and Related Disorders 227
93 Psychological Factors Affecting
Medical Condition 227
Relevant Concepts for Understanding
Psychological Factors Affecting Medical
Condition 228
Stress and Coping 228
Emotional Expression 231
Personality Style 232
Applications to Behavioral Medicine 232
94 Dissociative and Somatic Symptom Disorders
The Biopsychosocial Perspective 233
Return to the Case Rose Marston 234
SUMMARY 234
KEY TERMS 235
CHAPTER 10
Feeding and EatingDisorders EliminationDisorders Sleep-WakeDisorders andDisruptive Impulse-
Control and ConductDisorders 236
Case Report Rosa
Nomirez 237
101 Eating Disorders 238
Characteristics of Anorexia Nervosa 239
REAL STORIES Portia de Rossi Anorexia
Nervosa 240Characteristics of Bulimia Nervosa 242
Binge-Eating Disorder 243
Theories and Treatment of Eating Disorders 243
Whatrsquos New in the DSM-5 Reclassifying
Eating Elimination Sleep-Wake and Disruptive
Impulse-Control and Conduct Disorders 245
AvoidantRestrictive Food Intake Disorder 245
Eating Disorders Associated with Childhood 246
102 Elimination Disorders 246
103 Sleep-Wake Disorders 247
104 Disruptive Impulse-Control and Conduct Disorders 249
Oppositional Defiant Disorder 249
Intermitten t Explosive Disorder 250
Conduct Disorder 252
Impulse-Control Disorders 252
Pyromania 252
You Be the Judge Legal Implications of
Impulse-Control Disorders 253
Kleptomania 254
105 Eating Elimination Sleep-Wake and Impulse-Control
Disorder The Biopsychosocial Perspective 255
Return to the Case Rosa Nomirez 255
SUMMARY 256
KEY TERMS 257
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xiii
CHAPTER 11
Paraphilic DisordersSexual Dysfunctionsand Gender Dysphoria 258
Case Report Shaun Boyden 259
111 What Patterns of Sexual Behavior Represent
Psychological Disorders 260
112 Paraphilic Disorders 262
Pedophilic Disorder 263
Exhibitionistic Disorder 264
Voyeuristic Disorder 264
Fetishistic Disorder 265
Frotteuristic Disorder 266
Sexual Masochism and Sexual Sadism
Disorders 266
Transvestic Disorder 267
Theories and Treatment of Paraphilic
Disorders 267
Biological Perspectives 268
Whatrsquos New in the DSM-5 The
Reorganization of Sexual Disorders 269
Psychological Perspectives 269
113 Sexual Dysfunctions 270
Arousal Disorders 271
Disorders Involving Orgasm 274
You Be the Judge Treatment for Sex
Offenders 275
Disorders Involving Pain 276
Theories and Treatment of SexualDysfunctions 276
Biological Perspectives 276
Psychological Perspectives 277
REAL STORIES Sue William Silverman Sex
Addiction 278
114 Gender Dysphoria 280
Theories and Treatment of Gender
Dysphoria 282
115 Paraphilic Disorders Sexual Dysfunctions and Gender
Dysphoria The Biopsychosocial Perspective 282
Return to the Case Shaun Boyden 284
SUMMARY 284
KEY TERMS 285
CHAPTER 12
Substance-Relatedand Addictive Disorders 286
Case Report Carl Wadsworth 287
121 Key Features of Substance
Disorders 289
Whatrsquos New in the DSM-5 Combining Abuse and
Dependence 290
122 Disorders Associated with Specific
Substances 290
Alcohol 292
Theories and Treatment of Alcohol
Use Disorders 295
Biological Perspectives 295
Psychological Perspectives 297
Sociocultural Perspective 298
Stimulants 299
Amphetamines 299
Cocaine 300
Cannabis 301
Hallucinogens 303
Opioids 306
You Be the Judge Prescribing
Prescription Drugs 307
Sedatives Hypnotics and Anxiolytics 308
Caffeine 309
REAL STORIES Robert Downey Jr
Substance Use Disorder 310
Tobacco 311
Inhalants 311
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xiv
Theories and Treatment of Substance Use
Disorders 311
Biologica l Perspectives 312
Psychological Perspectives 312
123 Non-Substance-Related Disorders 313
Gambling Disorder 313
124 Substance Disorders The Biopsychosocial
Perspective 316
Return to the Case
Carl Wadsworth 316
SUMMARY 317
KEY TERMS 318
CHAPTER 13
NeurocognitiveDisorders 320
Case Report Irene Heller 321
131 Characteristics of Neurocognitive Disorders 322
132 Delirium 324
133 Neurocognitive Disorder due to Alzheimerrsquos
Disease 327
Prevalence of Alzheimerrsquos Disease 328
Whatrsquos New in the DSM-5
Recategorization of Neurocognitive
Disorders 329
Stages of Alzheimerrsquos Disease 329
Diagnosis of Alzheimerrsquos Disease 330
Theories and Treatment of Alzheimerrsquos
Disease 333
Theories 333
You Be the Judge Early Diagnosis of
Alzheimerrsquos Disease 334
Treatment 336
REAL STORIES Ronald Reagan
Alzheimerrsquos Disease 338
134 Neurocognitive Disorders due to Neurological Disor-
ders Other than Alzheimerrsquos Disease 340
135 Neurocognitive Disorder due to TraumaticBrain Injury 343
136 Neurocognitive Disorders due to Substances
Medications and HIV Infection 344
137 Neurocognitive Disorders due to Another General
Medical Condition 344
138 Neurocognitive Disorders The Biopsychosocial
Perspective 345
Return to the Case Irene Heller 346
SUMMARY 346
KEY TERMS 347
CHAPTER 14
Personality Disorders 348
Case Report Harold Morrill 349
141 The Nature of Personality
Disorders 350
Whatrsquos New in the DSM-5
Dimensionalizing the Personality
Disorders 351
Personality Disorders in DSM-5 351
Alternative Personality Disorder Diagnostic System
in Section 3 of the DSM-5 352
142 Cluster A Personality Disorders 355
Paranoid Personality Disorder 355
Schizoid Personality Disorder 356Schizotypal Personality Disorder 357
143 Cluster B Personality Disorders 357
Antisocial Personality Disorder 357
Characteristics of Antisocial Personality
Disorder 358
Theories of Antisocial Personality
Disorder 360
You Be the Judge Antisocial PersonalityDisorder and Moral Culpability 361
Biological Perspectives 361
REAL STORIES Ted Bundy Antisocial
Personality Disorder 362
Psychological Perspectives 363
Treatment of Antisocial Personality
Disorder 364
Borderline Personality Disorder 364Characteristics of Borderline Personality
Disorder (BPD) 365
Theories and Treatment of BPD 366
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xv
Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
whi33389_ch06_136 161indd Page 143 62013 448 PM F 469 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
whi33389_ch08_184 213indd Page 201 240613 911 AM F 468 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
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xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
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xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
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xiii
CHAPTER 11
Paraphilic DisordersSexual Dysfunctionsand Gender Dysphoria 258
Case Report Shaun Boyden 259
111 What Patterns of Sexual Behavior Represent
Psychological Disorders 260
112 Paraphilic Disorders 262
Pedophilic Disorder 263
Exhibitionistic Disorder 264
Voyeuristic Disorder 264
Fetishistic Disorder 265
Frotteuristic Disorder 266
Sexual Masochism and Sexual Sadism
Disorders 266
Transvestic Disorder 267
Theories and Treatment of Paraphilic
Disorders 267
Biological Perspectives 268
Whatrsquos New in the DSM-5 The
Reorganization of Sexual Disorders 269
Psychological Perspectives 269
113 Sexual Dysfunctions 270
Arousal Disorders 271
Disorders Involving Orgasm 274
You Be the Judge Treatment for Sex
Offenders 275
Disorders Involving Pain 276
Theories and Treatment of SexualDysfunctions 276
Biological Perspectives 276
Psychological Perspectives 277
REAL STORIES Sue William Silverman Sex
Addiction 278
114 Gender Dysphoria 280
Theories and Treatment of Gender
Dysphoria 282
115 Paraphilic Disorders Sexual Dysfunctions and Gender
Dysphoria The Biopsychosocial Perspective 282
Return to the Case Shaun Boyden 284
SUMMARY 284
KEY TERMS 285
CHAPTER 12
Substance-Relatedand Addictive Disorders 286
Case Report Carl Wadsworth 287
121 Key Features of Substance
Disorders 289
Whatrsquos New in the DSM-5 Combining Abuse and
Dependence 290
122 Disorders Associated with Specific
Substances 290
Alcohol 292
Theories and Treatment of Alcohol
Use Disorders 295
Biological Perspectives 295
Psychological Perspectives 297
Sociocultural Perspective 298
Stimulants 299
Amphetamines 299
Cocaine 300
Cannabis 301
Hallucinogens 303
Opioids 306
You Be the Judge Prescribing
Prescription Drugs 307
Sedatives Hypnotics and Anxiolytics 308
Caffeine 309
REAL STORIES Robert Downey Jr
Substance Use Disorder 310
Tobacco 311
Inhalants 311
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xiv
Theories and Treatment of Substance Use
Disorders 311
Biologica l Perspectives 312
Psychological Perspectives 312
123 Non-Substance-Related Disorders 313
Gambling Disorder 313
124 Substance Disorders The Biopsychosocial
Perspective 316
Return to the Case
Carl Wadsworth 316
SUMMARY 317
KEY TERMS 318
CHAPTER 13
NeurocognitiveDisorders 320
Case Report Irene Heller 321
131 Characteristics of Neurocognitive Disorders 322
132 Delirium 324
133 Neurocognitive Disorder due to Alzheimerrsquos
Disease 327
Prevalence of Alzheimerrsquos Disease 328
Whatrsquos New in the DSM-5
Recategorization of Neurocognitive
Disorders 329
Stages of Alzheimerrsquos Disease 329
Diagnosis of Alzheimerrsquos Disease 330
Theories and Treatment of Alzheimerrsquos
Disease 333
Theories 333
You Be the Judge Early Diagnosis of
Alzheimerrsquos Disease 334
Treatment 336
REAL STORIES Ronald Reagan
Alzheimerrsquos Disease 338
134 Neurocognitive Disorders due to Neurological Disor-
ders Other than Alzheimerrsquos Disease 340
135 Neurocognitive Disorder due to TraumaticBrain Injury 343
136 Neurocognitive Disorders due to Substances
Medications and HIV Infection 344
137 Neurocognitive Disorders due to Another General
Medical Condition 344
138 Neurocognitive Disorders The Biopsychosocial
Perspective 345
Return to the Case Irene Heller 346
SUMMARY 346
KEY TERMS 347
CHAPTER 14
Personality Disorders 348
Case Report Harold Morrill 349
141 The Nature of Personality
Disorders 350
Whatrsquos New in the DSM-5
Dimensionalizing the Personality
Disorders 351
Personality Disorders in DSM-5 351
Alternative Personality Disorder Diagnostic System
in Section 3 of the DSM-5 352
142 Cluster A Personality Disorders 355
Paranoid Personality Disorder 355
Schizoid Personality Disorder 356Schizotypal Personality Disorder 357
143 Cluster B Personality Disorders 357
Antisocial Personality Disorder 357
Characteristics of Antisocial Personality
Disorder 358
Theories of Antisocial Personality
Disorder 360
You Be the Judge Antisocial PersonalityDisorder and Moral Culpability 361
Biological Perspectives 361
REAL STORIES Ted Bundy Antisocial
Personality Disorder 362
Psychological Perspectives 363
Treatment of Antisocial Personality
Disorder 364
Borderline Personality Disorder 364Characteristics of Borderline Personality
Disorder (BPD) 365
Theories and Treatment of BPD 366
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xv
Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
whi33389_ch06_136 161indd Page 143 62013 448 PM F 469 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
whi33389_ch08_184 213indd Page 201 240613 911 AM F 468 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
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xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
7232019 Whi33389 Fm i Xxiii
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
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xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
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xiv
Theories and Treatment of Substance Use
Disorders 311
Biologica l Perspectives 312
Psychological Perspectives 312
123 Non-Substance-Related Disorders 313
Gambling Disorder 313
124 Substance Disorders The Biopsychosocial
Perspective 316
Return to the Case
Carl Wadsworth 316
SUMMARY 317
KEY TERMS 318
CHAPTER 13
NeurocognitiveDisorders 320
Case Report Irene Heller 321
131 Characteristics of Neurocognitive Disorders 322
132 Delirium 324
133 Neurocognitive Disorder due to Alzheimerrsquos
Disease 327
Prevalence of Alzheimerrsquos Disease 328
Whatrsquos New in the DSM-5
Recategorization of Neurocognitive
Disorders 329
Stages of Alzheimerrsquos Disease 329
Diagnosis of Alzheimerrsquos Disease 330
Theories and Treatment of Alzheimerrsquos
Disease 333
Theories 333
You Be the Judge Early Diagnosis of
Alzheimerrsquos Disease 334
Treatment 336
REAL STORIES Ronald Reagan
Alzheimerrsquos Disease 338
134 Neurocognitive Disorders due to Neurological Disor-
ders Other than Alzheimerrsquos Disease 340
135 Neurocognitive Disorder due to TraumaticBrain Injury 343
136 Neurocognitive Disorders due to Substances
Medications and HIV Infection 344
137 Neurocognitive Disorders due to Another General
Medical Condition 344
138 Neurocognitive Disorders The Biopsychosocial
Perspective 345
Return to the Case Irene Heller 346
SUMMARY 346
KEY TERMS 347
CHAPTER 14
Personality Disorders 348
Case Report Harold Morrill 349
141 The Nature of Personality
Disorders 350
Whatrsquos New in the DSM-5
Dimensionalizing the Personality
Disorders 351
Personality Disorders in DSM-5 351
Alternative Personality Disorder Diagnostic System
in Section 3 of the DSM-5 352
142 Cluster A Personality Disorders 355
Paranoid Personality Disorder 355
Schizoid Personality Disorder 356Schizotypal Personality Disorder 357
143 Cluster B Personality Disorders 357
Antisocial Personality Disorder 357
Characteristics of Antisocial Personality
Disorder 358
Theories of Antisocial Personality
Disorder 360
You Be the Judge Antisocial PersonalityDisorder and Moral Culpability 361
Biological Perspectives 361
REAL STORIES Ted Bundy Antisocial
Personality Disorder 362
Psychological Perspectives 363
Treatment of Antisocial Personality
Disorder 364
Borderline Personality Disorder 364Characteristics of Borderline Personality
Disorder (BPD) 365
Theories and Treatment of BPD 366
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Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
whi33389_ch06_136 161indd Page 143 62013 448 PM F 469 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
whi33389_ch08_184 213indd Page 201 240613 911 AM F 468 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
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How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
7232019 Whi33389 Fm i Xxiii
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xx
CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
7232019 Whi33389 Fm i Xxiii
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
7232019 Whi33389 Fm i Xxiii
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2323
xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
7232019 Whi33389 Fm i Xxiii
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xv
Histrionic Personality Disorder 368
Narcissistic Personality Disorder 368
144 Cluster C Personality Disorders 371
Avoidant Personality Disorder 371
Dependent Personality Disorder 372
Obsessive-Compulsive Personality Disorder 373
145 Personality Disorders The Biopsychosocial
Perspective 375
Return to the Case Harold Morrill 375
SUMMARY 376
KEY TERMS 377
CHAPTER 15
Ethical and Legal
Issues 378
Case Report Mark Chen 379
151 Ethical Standards 380
Competence 382
Whatrsquos New in the DSM-5 Ethical
Implications of the New Diagnostic
System 382
Informed Consent 384
Confidentiality 385
Relationships with Clients Students and Research
Collaborators 390
You Be the Judge Multiple Relationships
Between Clients and Psychologists 391
Record Keeping 392
152 Ethical and Legal Issues in Providing
Services 392
Commitment of Clients 392
Right to Treatment 393
Refusal of Treatment and Least RestrictiveAlternative 394
153 Forensic Issues in Psychological
Treatment 395
The Insanity Defense 395
REAL STORIES Susanna Kaysen
Involuntary Commitment 396
Competency to Stand Trial 400
Understanding the Purpose of Punishment 400
Concluding Perspectives on Forensic Issues 400
Return to the Case Mark Chen 401
SUMMARY 401
KEY TERMS 402
Glossary G-1
References R-1Credits C-1
Name Index I-1
Subject Index I-9
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xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
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You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
whi33389_ch08_184 213indd Page 201 240613 911 AM F 468 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
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xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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xx
CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
7232019 Whi33389 Fm i Xxiii
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2223
xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2323
xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 1623
xvi
PREFACE
Re1047298ecting the latest edition o the Diagnostic and Statistical Manual (DSM-5) and available as a print book andSmartbook (McGraw-Hillrsquos adaptive reading experience) Abnormal Psychology Clinical Perspectives and PsychologicalDisorders provides a complete solution or your course
McGraw-Hill ConnectAbnormal Psychology
Abnormal Psychology is available to instructors andstudents in traditional print ormat as well as online withinMcGraw-Hillrsquos Connectreg Abnormal Psychology anintegrated assignment and assessment platorm Connectrsquosonline tools make managing assignments easier orinstructorsmdashand make learning and studying moremotivating and effi cient or students
Experience Adaptive Reading with
SmartBook
McGraw-Hill SmartBook trade is the first and only adaptivereading experience available or the higher education marketPowered by an intelligent diagnostic and adaptive engineSmartBook acilitates and personalizes the reading process byidentiying what content a student knows and doesnrsquot know
through adaptive assessments As the student reads SmartBookconstantly adapts to ensure the student is ocused on thecontent he or she needs the most to close any knowledge gaps
abilities and limitations identiying what they knowmdashandmore importantly what they donrsquot know Using Bloomrsquosaxonomy and a highly sophisticated ldquosmartrdquo algorithmLearnSmart creates a customized study plan unique toevery studentrsquos demonstrated needs With virtually noadministrative overhead instructors using LearnSmart arereporting an increase in student perormance by one lettergrade or more
New Faces Interactive
Faces Interactive is an assignable and assessable learningenvironment that allows students to ldquointeractrdquo with realpeople living with psychological disorders Trough itsunique interactive video program Faces presents studentswith an opportunity to develop their critical thinking skillsand gain a deeper understanding o psychological disorderswelve different disorders are presented including ADHDBorderline Personality Disorder Schizophrenia and Post-raumatic Stress Disorder Faces Interactive is availableexclusively through Connect
Experience a New Classroom
Dynamic with LearnSmartHow many students think they know what they know butstruggle on the first exam McGraw-Hillrsquos LearnSmart trade adaptive learning system identifies studentsrsquo metacognitive
Real-Time Reports
Tese printable exportable reports show how well eachstudent (or section) is perorming on each course segmentInstructors can use this eature to spot problem areasbeore they crop up on an exam
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Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
whi33389_ch06_136 161indd Page 143 62013 448 PM F 469 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
whi33389_ch08_184 213indd Page 201 240613 911 AM F 468 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
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xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
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xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
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CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
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xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
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xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
7232019 Whi33389 Fm i Xxiii
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xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
7232019 Whi33389 Fm i Xxiii
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xvii
Accessible Storytelling
Approach and Empirically
Supported Research
Te seventh edition o Abnormal Psychology ocuses onproviding an accurate understandable concise and up-to-date view o this rapidly evolving field In particular wehave taken a thorough look at the literature and synthesized
the inormation to provide the most relevant theories andresearch or you to study We have added new eatures togive you an appreciation or the ethical issues that conrontmental health proessionals and the current controversies inthe field around changes in the diagnostic system ldquoYou Bethe Judgerdquo presents you with controversial ethical questionsspecific to the content o the chapter ldquoWhatrsquos New in the
DSM-5rdquo eature summarizes the changes rom DSM-IV-TR to DSM-5 We have also revised each chapter based on
principles o what is called ldquoevidence-based treatmentrdquoTese eatures will give you a contemporary view o thefield as it is now and will also provide you with a solid basisor understanding how this ever-changing field continues toprogress In writing the seventh edition we have significantlysharpened the ocus o each chapter to provide you with as vibrant a picture as possible o this remarkable field inpsychology I yoursquove seen a previous edition you will notice
a distinct change that while still ocused on ldquotalking to thestudentrdquo does so in a way that re1047298ects the learning style otodayrsquos students We realize that students take many credithours and that each course (particularly in psychology)seems to be getting increasingly demanding Tereore wewant you to be able to grasp the material in the leastamount o time but with similar depth as students ound inour previous editions
Whatrsquos New in the DSM-5
Schizophrenia Subtypes and Dimensional Ratings
The DSM-5 authors implemented major changes in their approach to diagnosingschizophrenia As we mentioned at the beginning of the chapter they eliminatedthe subtypes of schizophrenia Instead using a scale that is in Section 3 cliniciansassign a diagnosis of schizophrenia to which they can add a rating of the individualrsquossymptoms along a set of dimensions as Table 63 shows By eliminating the subtypes of schizophrenia the DSM-5 authors sought to
improve both the diagnostic reliability and validity of the system They also soughtto have a more quantifiable basis for research on the disorderrsquos causes as well asfor treatment planning For example a clinician evaluating the results of cognitive-behavioral therapy could use the ratings of hallucination and delusion severityto determine whether the intervention is reducing the specific symptoms towardwhich they are targeting treatment The DSM-5 authors also decided to include cognitive impairment as adimension in the Section 3 severity ratings given the importance of cognitivedeficits in current understandings of the individualrsquos ability to carry out social andoccupational activities and to carry out the tasks involved in everyday living In thisregard a neuropsychological assessment could inform the diagnostic process(Reichenberg 2010) The DSM-5 authors considered but decided not to eliminate schizoaffectivedisorder as a separate entity Although not there yet the DSM-5 authors believe that clinicians will eventuallydiagnose schizophrenia as a ldquospectrumrdquo disorder This would mean potentially that
even diagnoses long in use in psychiatry would disappear including schizophreniformdisorder schizoaffective disorder and the two personality disorders associated withschizophrenic-like symptoms The current system in the DSM-5 represents a step in moving away from theold categorization system and toward the dimensional approach By includingseverity ratings rather than subtypes in Section 3 they are making it possible forclinicians and researchers to track individuals over time in a quantifiable fashion
whi33389_ch06_136 161indd Page 143 62013 448 PM F 469 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
You Be the Judge
Psychiatric Neurosurgery
As we discussed in Chapter 4 psychiatric neurosurgery is i ncreasingly being usedto give clinicians a tool for controlling the symptoms of obsessive-compulsivedisorder However to what extent is surgical intervention justifiable to control theexistence of psychological symptoms Moreover this surgery is not reversibleThe debate over psychosurgery goes back to the mid-twentieth century whenphysician Walter Freeman traveled around the country performing approximately18000 leucotomies in which he severed the frontal lobes from the rest of thebrain to control the unmanageable behaviors of psychiatric patients The idea was
that by severing the frontal lobes from the limbic system the patients would nolonger be controlled by their impulses As was true in the early twentieth century when clinicians employed lobotomies tomanage otherwise intractable symptoms of psychiatric patients is it possible thatfuture generations will look upon cingulotomies and similar interventions as excessivelypunitive and even barbaric On the other hand with symptoms that are so severe anddisabling is any method that can control them to be used even if imperfect Gillett (2011) raised these issues regarding the use of current psychosurgeriesBy altering the individualrsquos brain through such radical techniques psychiatrists aretampering with a complex system of interactions that make up the individualrsquospersonality Just because they ldquoworkrdquo and because no other methods arecurrently available does this justify making permanent changes to the individualrsquosbrain The victims of the leucotomies performed by Freeman ldquoimprovedrdquo in thattheir behavior became more docile but they were forever changed
Q You be the judge Is it appropriate to transform the person using permanentmethods whose basis for effectiveness cannot be scientifically established AsGillett concludes ldquoburn heat poke freeze shock cut stimulate or otherwiseshake (but not stir) the brain and you will affect the psycherdquo (p 43)
whi33389_ch08_184 213indd Page 201 240613 911 AM F 468 201MH02079whixxxxx_disk1of1xxxxxxxxxxwhixxxxx_pagefiles
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 1823
xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 1923
xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2023
xx
CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2123
xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2223
xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2323
xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 1823
xviii
How Will You Study
ldquoAbnormalrdquo Human
Behavior
Te field o abnormal psychology covers the ull spectrumo human behavior throughout the lie span From inancythrough later adulthood the process o developmentpropels us through a vast range o experiences Some o
these experiences invariably include encounters withdistressing emotions behaviors inner experiences andinteractions with other people Tere is no sharp dividingline between ldquonormalrdquo and ldquoabnormalrdquo as you will learn inthis book nor do people spend their entire lives in one orthe other o these realms Abnormal psychology is particularly ascinating becauseit re1047298ects so many possible variations in human behaviorparticularly as these evolve over time in an individualrsquos lieLearning about abnormal psychology can be a goal or you
in and o itsel but you more than likely will find yourseldrawn to its practical applications as a basis or learninghow to help others Whether or not you decide to enter ahelping proession however you will find knowledge o thisfield useul in whatever proession you decide to pursue aswell as your everyday lie
Clinical Perspectives on
Psychological Disorders
Te subtitle o this seventh edition Clinical Perspectives onPsychological Disorders re1047298ects the emphasis in each o theprior editions on the experience o clients and clinicians intheir efforts to acilitate each individualrsquos maximumunctioning We present an actual case study at thebeginning o each chapter that typifies the disorders in thatchapter At the end o the chapter we return to the casestudy with the outcome o a prescribed treatment on thebasis o the best available evidence Troughout the chapterwe translate the symptoms o each disorder into terms that
capture the core essence o the disorder Our philosophy isthat students should be able to appreciate the undamentalnature o each disorder without necessarily having tomemorize diagnostic criteria In that way students can gaina basic understanding that will serve them well regardlesso their ultimate proessional goals
The Biopsychosocial Approach
An understanding o psychological disorders requires anintegrative approach particularly as researchers begin tounderstand increasingly the connections among themultiple dimensions that in1047298uence people throughout lie
We are adopting the biopsychosocial approachmdashincorporating biological psychological and socioculturalcontributions to psychological disorders Neuroscienceresearch is increasingly becoming relevant to theunderstanding o psychopathology but at the same time soare issues related to social context including diversity osocial class race and ethnicity Tese actors combine incomplex ways and throughout the book we explain howthey apply to particular psychological disorders
The Life-Span Approach
Individuals grow and change throughout lie and we eelthat it is essential to capture the developmental dimensionin helping students understand the evolution opsychological disorders over time Tereore we haveincorporated research and theories that provide relevantunderstandings o how the disorders that we cover emergeand modulate rom childhood through adulthood We alsoemphasize the interactive and reciprocal effects o ldquonaturerdquo(genetics) and ldquonurturerdquo (the environment) as contributorsto psychological disorders
The Human Experience of
Psychological Disorders
Above all the study o abnormal psychology is the study oprooundly human experiences o this end we havedeveloped a biographical eature entitled ldquoReal Storiesrdquo You will read narratives rom the actual experiences ocelebrities sports figures politicians authors musiciansand artists ranging rom Beethoven to Herschel WalkerEach Real Story is written to provide insight into theparticular disorder covered within the chapter By readingthese ascinating biographical pieces you will come awaywith a more in-depth personal perspective to use inunderstanding the nature o the disorder
The Scientist-Practitioner Framework
We have developed this text using a scientist-practitionerramework In other words you will read about researchinormed by clinical practice We present research ontheories and treatments or each o the disorders based onthe principles o ldquoevidence-based practicerdquo Tis means thatthe approaches that we describe are tested throughextensive research inormed by clinical practice Manyresearchers in the field o abnormal psychology also treatclients in their own private offi ces hospitals or grouppractices As a result they approach their work in the lab
with the knowledge that their findings can ultimatelyprovide real help to real people
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 1923
xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2023
xx
CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2123
xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2223
xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2323
xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 1923
xix
Chapter-by-Chapter
Changes
Te most significant change in this updated edition is theintegration o the DSM-5 in every chapter where it appliesEven the table o contents has been reorganized to re1047298ectthis important new edition o the DSM Another major change you will notice is in the order oauthors Afer many years o teaching research and writing
the new first author (Proessor Whitbourne) is bringing herclassroom style into the writing o this text ProessorWhitbourne also writes a popular Psychology Today blogcalled ldquoFulfillment at Any Agerdquo and she has adapted thematerial in the previous editions to re1047298ect the empiricallyinormed but accessible reading style that has contributed tothe success o this blog In addition we added a research assistant to the team whobrings a more youthul and contemporary perspective toparticular eatures within the text An advanced clinical
psychology graduate student at American University at thetime o this writing Jennier OrsquoBrien wrote the ldquoReal Storiesrdquoeatures and the case studies that begin and end each chapterChanging any identifiable details she brought her work intothese cases rom her practicums at a college counselingcenter a Veterans Administration Hospital a judicial courtsystem and a womenrsquos therapy clinic In addition to heroutstanding academic credentials Jennier happens to beProessor Whitbournersquos younger daughter She is a member oPsi Chi APAGS (the APA Graduate Student association) andthe recipient o an outstanding undergraduate teachingassistant award Her dissertation research on the therapeuticalliance will provide new insights into understandingthis undamental component o effective psychotherapyShe currently works as a researcher at the VeteransAdministration Medical Center in Jamaica Plain Boston MA We have added two particularly exciting eatures to theseventh edition ound in most chapters
bull ldquoWhatrsquos New in DSM-5rdquo Tis eature summarizes thechanges rom DSM-IV-TR to DSM-5 Not only does ithighlight the new edition o the DSM but it alsodemonstrates how the definition and categorization opsychological disorders changes over time
bull ldquoYou Be the Judgerdquo Te ethical issues that psychologistsgrapple with are an integral part o research and practiceIn these boxed eatures we highlight a specific aspect oone o the disorders that we discuss in the chapter andpresent a question or you to answer You will be the
judge in deciding which position you want to take aferwe inorm you o both sides o the issue at stake
o make it easier or previous users o the text to seewhatrsquos changed a summary o the most importantrevisions to each chapter ollows
CHAPTER 1 Overview to
Understanding Abnormal Behavior
bull Reduced length o sections on history o abnormalpsychology
bull Clarified the biopsychosocial perspective section
bull Added a section on Behavioral Genetics
bull Expanded the discussion o the developmentalperspective
CHAPTER 2 Diagnosis and
Treatment
bull Replaced the description o the DSM-IV-TR with asection on the DSM-5
bull Added material on the International Classification ofDiseases (ICD) system
bull Provided greater ocus on evidence-based practice
CHAPTER 3 Assessment
bull Provided up-to-date inormation on the WAIS-IV andits use in assessment
bull Greatly expanded the section on neuropsychologicalassessment including computerized testing
bull Updated and expanded treatment o brain imagingmethods
bull Retained projective testing but with less ocus ondetailed interpretation o projective test data
CHAPTER 4 Theoretical Perspectives
bull Retained the classic psychodynamic theories but withupdates rom current research
bull Expanded greatly the discussion o biological theoriesand moved these to the beginning o the chapter
bull Provided more detail on the cognitive-behavioralperspective to use as a basis or subsequent chapters
that rely heavily on treatment based on thisperspective
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2023
xx
CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2123
xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2223
xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2323
xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2023
xx
CHAPTERS 5-14 Neurodevelopmental
Disorders to Personality Disorders
bull Where appropriate incorporated inormation about howDSM-5 changed conceptualization o these disordersincluding changes in terminology
bull Expanded the coverage o biological theories includingstudies on genetics epigenetics and neuroimaging
bull Completely updated treatment sections givingemphasis to those approaches to treatmentrecommended through evidence-based practice
bull Included newer therapies including mindulnessmeditation relaxation and Acceptance andCommitment Terapy
bull Revised tables and figures to provide more readilyaccessible pedagogy
CHAPTER 15 Ethical and
Legal Issues
bull Expanded the discussion o APArsquos Ethics Code includinga table that summarizes its most important eatures
bull Updated the cases with newer inormation including a
section on Kendrarsquos Law
bull Revised the section on orensic psychology includingexamples rom relevant case law
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2123
xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2223
xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2323
xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2123
xxi
Trough McGraw-Hillrsquos partnership with Blackboard
Abnormal Psychology Clinical Perspectives on PsychologicalDisorders offers a seamless integration o content and tools
bull Seamless gradebook between Blackboard and Connect
bull Single sign-on providing seamless integration betweenMcGraw-Hill content and Blackboard
bull Simplicity in assigning and engaging your studentswith course materials
Craf your teaching resources to
match the way you teach WithMcGraw-Hill Create wwwmcgrawhillcreatecom you caneasily rearrange chapters combine material rom othercontent sources and quickly upload content you havewritten such as your course syllabus or teaching notesFind the content you need in Create by searching throughthousands o leading McGraw-Hill textbooks Arrange yourbook to fit your teaching style Create even allows you topersonalize your bookrsquos appearance by selecting the coverand adding your name school and course inormationOrder a Create book and yoursquoll receive a complimentaryprint review copy in 3ndash5 business days or a complimentaryelectronic review copy (eComp) via e-mail in about anhour Go to wwwmcgrawhillcreatecom today and registerExperience how McGraw-Hill Create empowers you toteach your students your way
egrity Campus is a service thatmakes class time available all the
time by automatically capturing every lecture in asearchable ormat or students to review when they studyand complete assignments With a simple one-click startand stop process users capture all computer screens andcorresponding audio Students replay any part o any classwith easy-to-use browser-based viewing on a PC or MacEducators know that the more students can see hear andexperience class resources the better they learn Withegrity Campus students quickly recall key moments byusing egrity Campusrsquos unique search eature Tis search
helps students effi ciently find what they need when theyneed it across an entire semester o class recordings Help
turn all your studentsrsquo study time into learning momentsimmediately supported by your lecture
CourseSmart e-extbook Tis textis available as an eextbook at
wwwCourseSmartcom At CourseSmart your studentscan take advantage o significant savings off the cost o aprint textbook reduce their impact on the environmentand gain access to powerul Web tools or learningCourseSmart eextbooks can be viewed online ordownloaded to a computer Te eextbooks allow studentsto do ull text searches add highlighting and notesand share notes with classmates CourseSmart has thelargest selection o eextbooks available anywhere VisitwwwCourseSmartcom to learn more and to try a samplechapter
Support Materials
Te ollowing ancillaries are available to accompany Abnormal Psychology Seventh Edition Please contactyour McGraw-Hill sales representative or detailsconcerning policies prices and availability as somerestrictions may apply
For the Instructor
Te password-protected instructor side o the OnlineLearning Center at wwwmhhecomwhitbourne7e contains
the Instructorrsquos Manual est Bank files PowerPointPresentations Image Gallery and other valuable material tohelp you design and enhance your course Ask your localMcGraw-Hill representative or your password Te Instructorrsquos Manual provides many tools useul orteaching the seventh edition For each chapter the InstructorrsquosManual includes an overview o the chapter teachingobjectives suggestions and resources or lecture topicsclassroom activities and essay questions designed to helpstudents develop ideas or independent projects and papers
Te Test Bank contains over 2000 testing items Alltesting items are classified as conceptual or applied andreerenced to the appropriate learning objective All testquestions are compatible with EZest McGraw-HillrsquosComputerized est Bank program which runs on bothMacintosh and Windows computers and includes anediting eature that enables instructors to import their ownquestions scramble items and modiy questions to createtheir own tests Te PowerPoint Presentations are the key points o
each chapter and contain key illustrations graphs andtables or instructors to use during their lectures
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2223
xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2323
xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2223
xxii
Acknowledgments
Te ollowing instructors were instrumental in thedevelopment o the text offering their eedback and adviceas reviewers
David Alfano Community College of Rhode Island
Bryan Cochran University of Montana
Julie A Deisinger Saint Xavier University
Angela Fournier Bemidji State University Richard Helms Central Piedmont Community College
Heather Jennings Mercer County Community College
Joan Brandt Jensen Central Piedmont Community College
Cynthia Kalodner Towson University
Patricia Kemerer Ivy Tech Community College
Barbara Kennedy Brevard Community College-Palm Bay
Joseph Lowman University of North Carolina-Chapel Hill
Don Lucas Northwest Vista College
James A Markusic Missouri State University
Mark McKellop Juniata College
Maura Mitrushina California State University-Northridge
John Norland Blackhawk Technical College
Karen Clay Rhines Northampton Community College
Ty Schepis Texas State University
William R Scott Liberty University
Dr Wayne S Stein Brevard Community College
Marla Sturm Montgomery County Community College
Terry S Trepper Purdue University-Calumet
Naomi Wagner San Jose State University
Nevada Winrow Baltimore City Community College
A great book canrsquot come together without a great
publishing team Wersquod like to thank our editorial team allo whom worked with us through various stages o thepublishing process Special gratitude goes to our editorKrista Bettino whose vision helped us present the materialin a resh and student-oriented manner Barbara HeinssenDevelopment Manager aided in development and redesigno this new edition Anne Fuzellier Managing Editor andChantelle Walker Editorial Coordinator assisted usthrough the complex publication process Sarah ColwellDigital Development Editor and Neil Kahn Digital
Product Analyst ensured that the material is translatedinto digital media allowing greater access or students andinstructors Laura Byrnes Marketing Coordinator alsodeserves our special thanks
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2323
xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu
7232019 Whi33389 Fm i Xxiii
httpslidepdfcomreaderfullwhi33389-fm-i-xxiii 2323
xxiii
A Letter from the Author
I am very glad that you are choosing to read my textbook Te topic o abnormalpsychology has never been more ascinating or relevant We constantly hear mediareports o celebrities having meltdowns or which they receive quickie diagnoses thatmay or may not be accurate Given all o this misinormation in the mind o the publicI eel that itrsquos important or you to be educated in the science and practice o abnormalpsychology At the same time psychological science grabs almost as many headlines inall orms o news media It seems that everyone is eager to learn about the latest findingsranging rom the neuroscience o behavior to the effectiveness o the newest treatmentmethods Tese advances in brain-scanning methods and studies o psychotherapyeffectiveness are greatly increasing our understanding o how to help people withpsychological disorders Particularly ascinating are the DSM-5 changes Each revision o the DSM brings withit controversies and challenges and the DSM-5 is no exception Despite challenges to thenew ways that the DSM-5 defines and categorizes psychological disorders it is perhapsbased more than any earlier edition on a strong research base Scientists and practitionerswill continue to debate the best ways to interpret this research We all will benefit romthese dialogues
Te proession o clinical psychology is also undergoing rapid changes With changesin health care policy it is very likely that more and more proessionals ranging rompsychologists to mental health counselors will be employed in providing behavioralinterventions By taking this first step toward your education now you will be preparingyoursel or a career that is increasingly being recognized as vital to helping individualso all ages and all walks o lie to achieve their greatest ulfillment I hope you find this text as engaging to read as I ound to write Please eel ree toe-mail me with your questions and reactions to the material As a user o McGraw-HillrsquosConnect in my own introductory psychology class I can also vouch or its effectivenessin helping you achieve mastery o the content o abnormal psychology I am also available
to answer any questions you have rom an instructorrsquos point o view about how best toincorporate this bookrsquos digital media into your own teaching Tank you again or choosing to read this book
BestSusan Krauss Whitbourne PhDswhitbopsychumassedu