Abnormal Psychology 16th Ed PDF

psychology sixteenth edition James N. Butcher...

psychology sixteenth edition James N. Butcher University of Minnesota Jill M. Hooley Harvard University Susan Mineka Northwestern University Boston Columbus Indianapolis New York San Francisco Upper Saddle River Amsterdam Cape Town Dubai London Madrid Milan Munich Paris Montréal Toronto Delhi Mexico City São Paulo Sydney Hong Kong Seoul Singapore Taipei Tokyo A01_BUTC4286_16_SE_FM.indd 1 11/06/13 9:50 AM  Executive Editor: Erin Mitchell Art Director: Leslie Osher Director of Development: Sharon Geary Text and Cover Designer: Anne DeMarinis, DEMARINIS Development Editor: LeeAnn Doherty DESIGN LLC Editorial Assistant: Sarah Henrich Cover Art: Soren Hald/Stone/Getty Images IS2/Masterfile Director of Marketing: Brandy Dawson Media Project Manager: Pamela Weldin Marketing Manager: Jeremy Intal Full-Service Project Management: Saraswathi Muralidhar/ Marketing Assistant: Frank Alarcon PreMediaGlobal Team Lead: Amber Mackey Composition: PreMediaGlobal Senior Managing Editior: Linda Behrens Printer/Binder: R.R. Donnelley and Sons Project Manager, Production: Sherry Lewis Cover Printer: Lehigh-Phoenix Color/Hagerstown Senior Operations Specialist: Diane Peirano Text Font: 10/12 MinionPro-Regular Credits and acknowledgments borrowed from other sources and reproduced, with permission, in this textbook appear on appropriate page within text and pages 716–721. Copyright © 2014, 2013, 2010, by Pearson Education, Inc. All rights reserved. Printed in the United States of America. This publication is protected by Copyright and permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or likewise. To obtain permission(s) to use material from this work, please submit a written request to Pearson Education, Inc., Permissions Department, One Lake Street, Upper Saddle River, New Jersey 07458 or you may fax your request to 201-236-3290. Many of the designations by manufacturers and seller to distinguish their products are claimed as trademarks. Where those designations appear in this book, and the publisher was aware of a trademark claim, the designations have been printed in initial caps or all caps. Library of Congress Cataloging-in-Publication Data Butcher, James Neal. Abnormal psychology. — 16th ed. / James N. Butcher, University of Minnesota, Jill M. Hooley, Harvard University, Susan Mineka, Northwestern University.   p. cm Editions 1 through 11 published as: Abnormal psychology and modern life; 1st-7th under: James C. Coleman; 8th-11th under: Robert C. Carson. From 12th edition under: James Neal Butcher. Includes bibliographical references and index. ISBN-13: 978-0-205-94428-6 ISBN-10: 0-205-94428-0 I. Mineka, Susan. II. Hooley, Jill M. III. Title. RC454.B87 2014 616.89—dc23 2013012128 10 9 8 7 6 5 4 3 2 1 Student Edition ISBN-10: 0-205-94428-0 ISBN-13: 978-0-205-94428-6 Ala Carte ISBN-10: 0-205-96502-4 ISBN-13: 978-0-205-96502-1 A01_BUTC4286_16_SE_FM.indd 2 11/06/13 9:50 AM  brief 1 Abnormal Psychology: An Overview 1 2 Historical and Contemporary Views of Abnormal Behavior 28 3 Causal Factors and Viewpoints 54 4 Clinical Assessment and Diagnosis 100 5 Stress and Physical and Mental Health 128 6 Panic, Anxiety, Obsessions, and Their Disorders 162 7 Mood Disorders and Suicide 211 8 Somatic Symptom and Dissociative Disorders 263 9 Eating Disorders and Obesity 293 10 Personality Disorders 327 11 Substance-Related Disorders 367 12 Sexual Variants, Abuse, and Dysfunctions 404 13 Schizophrenia and Other Psychotic Disorders 443 14 Neurocognitive Disorders 482 15 Disorders of Childhood and Adolescence (Neurodevelopmental Disorders) 508 16 Therapy 548 17 Contemporary and Legal Issues in Abnormal Psychology 582 iii A01_BUTC4286_16_SE_FM.indd 3 11/06/13 9:50 AM rief Features xii     Preface xv     About the Authors xix 1 Abnormal Psychology: An Overview 1 developments in RESEARCH: Do Magnets Help with Repetitive-Stress Injury? Animal Research 25 24 What Do We Mean by Abnormality? 3 UNRESOLVED issues The DSM-5 and the Definition of Mental Disorder 5 Are We All Becoming Mentally Ill? The Expanding Horizons of Mental Disorder 26 the WORLD around us Extreme Generosity or Pathological Behavior? 6 summary 27  key terms 27 Why Do We Need to Classify Mental Disorders? 7 2 Thinking Critically about DSM-5: What Is the DSM and Why Was It Revised? 7 Historical and Contemporary What Are the Disadvantages of Classification? 8 Views of Abnormal How Can We Reduce Prejudicial Attitudes Toward Behavior 28 the Mentally Ill? 8 Historical Views of Abnormal Behavior 29 the WORLD around us Mad, Sick, Head Nuh Good: Mental Illness Demonology, Gods, and Magic 29 and Stigma in Jamaica 9 Hippocrates’ Early Medical Concepts 30 How Does Culture Affect What Is Considered Abnormal? 10 developments in THINKING: Culture-Specific Disorders 11 Melancholia Through the Ages 31 Early Philosophical Conceptions of Consciousness 31 How Common Are Mental Disorders? 12 Later Greek and Roman Thought 32 Prevalence and Incidence 12 Early Views of Mental Disorders in China 32 Prevalence Estimates for Mental Disorders 12 Views of Abnormality During the Middle Ages 33 Treatment 13 Mental Health Professionals 14 Toward Humanitarian Approaches 35 The Resurgence of Scientific Questioning in Europe 35 Research Approaches in Abnormal Psychology 14 The Establishment of Early Asylums 35 Sources of Information 15 Humanitarian Reform 36 Case Studies 15 Nineteenth-Century Views of the Causes and Self-Report Data 15 Treatment of Mental Disorders 40 Observational Approaches 16 Changing Attitudes Toward Mental Health in Forming and Testing Hypotheses 17 the Early Twentieth Century 40 Sampling and Generalization 17 the WORLD around us Chaining Mental Health Patients 41 Internal and External Validity 18 Mental Hospital Care in the Twentieth Century 41 Criterion and Comparison Groups 18 The Emergence of Contemporary Views Research Designs 19 of Abnormal Behavior 43 Studying the World as It Is: Correlational Research Designs 19 Biological Discoveries: Establishing the Link Measuring Correlation 19 Between the Brain and Mental Disorder 43 Statistical Significance 19 The Development of a Classification System 44 Effect Size 20 Development of the Psychological Basis of Mental Disorder 44 Meta-Analysis 21 developments in RESEARCH: Correlations and Causality 21 The Search for Medications to Cure Mental Disorders 45 Retrospective Versus Prospective Strategies 21 The Evolution of the Psychological Research Manipulating Variables: The Experimental Tradition: Experimental Psychology 47 Method in Abnormal Psychology 22 UNRESOLVED issues Studying the Efficacy of Therapy 22 Interpreting Historical Events 51 Single-Case Experimental Designs 23 summary 52  key terms 53 iv   A01_BUTC4286_16_SE_FM.indd 4 11/06/13 9:50 AM  Taking a Social or Behavioral History 102 3 Causal Factors and Viewpoints 54 Ensuring Culturally Sensitive Assessment Procedures The Influence of Professional Orientation 103 103 Reliability, Validity, and Standardization 104 Causes and Risk Factors for Abnormal Behavior 55 Trust and Rapport Between the Clinician and the Client 104 Necessary, Sufficient, and Contributory Causes 55 Assessment of the Physical Organism 105 Feedback and Bidirectionality in Abnormal Behavior 56 The General Physical Examination 105 Diathesis-Stress Models 57 The Neurological Examination 105 Viewpoints for Understanding the Causes The Neuropsychological Examination 107 of Abnormal Behavior 59 Psychosocial Assessment 108 The Biological Viewpoint and Biological Causal Factors 60 Assessment Interviews 108 Imbalances of Neurotransmitters and Hormones 60 The Clinical Observation of Behavior 109 Genetic Vulnerabilities 63 Psychological Tests 110 developments in THINKING: Nature, Nurture, and Psychopathology: developments in PRACTICE: A New Look at an Old Topic 66 The Automated Practice: Use of the Computer in Psychological Testing 111 Temperament 67 Brain Dysfunction and Neural Plasticity 68 The Case of Andrea C.: Experiencing Violence in the Workplace 117 The Impact of the Biological Viewpoint 69 developments in PRACTICE: The Psychological Viewpoints 70 Computer-Based MMPI-2 Report for Andrea C. 118 The Psychodynamic Perspectives 70 The Integration of Assessment Data 120 The Behavioral Perspective 75 Ethical Issues in Assessment 120 developments in THINKING: The Humanistic and Existential Perspectives 77 Classifying Abnormal Behavior 121 The Cognitive-Behavioral Perspective 79 Differing Models of Classification 122 What the Adoption of a Perspective Does and Does Not Do 82 Formal Diagnostic Classification of Mental Disorders 122 Criteria for Persistent Depressive Disorder (Dysthymia) 123 Psychological Causal Factors 83 Early Deprivation or Trauma 83 Thinking Critically about DSM-5: Completion Does Not Assure Acceptance 125 Inadequate Parenting Styles 86 summary 126  key terms 127 Marital Discord and Divorce 88 Maladaptive Peer Relationships 89 5 The Sociocultural Viewpoint 91 Stress and Physical and Mental Uncovering Sociocultural Factors Through Cross-Cultural Studies 91 Health 128 Sociocultural Causal Factors 93 Low Socioeconomic Status and Unemployment 94 What Is Stress? 130 Prejudice and Discrimination in Race, Gender, and Ethnicity 94 Stress and the DSM 130 the WORLD around us Factors Predisposing a Person to Stress 130 Culture and Attachment Relationships 95 Characteristics of Stressors 131 Social Change and Uncertainty 96 Measuring Life Stress 132 Urban Stressors: Violence and Homelessness 96 Resilience 132 The Impact of the Sociocultural Viewpoint 96 Stress and the Stress Response 133 UNRESOLVED issues Biological Costs of Stress 134 Theoretical Viewpoints and the Causes of Abnormal Behavior 97 The Mind–Body Connection 134 summary 98  key terms 99 Understanding the Immune System 134 Stress, Depression, and the Immune System 136 4 stress and physical health 137 Clinical Assessment and Diagnosis 100 Cardiovascular Disease 138 Hypertension 138 The Basic Elements in Assessment 101 Coronary Heart Disease 139 The Relationship Between Assessment and Diagnosis 102 Risk and Causal Factors in Cardiovascular Disease 140 CONTENTS  v A01_BUTC4286_16_SE_FM.indd 5 11/06/13 9:50 AM  the WORLD around us Prevalence, Age of Onset, and Gender Racial Discrimination and Cardiovascular Differences 168 Health in African Americans 142 Psychological Causal Factors 168 Treatment of Stress-Related Physical Biological Causal Factors 171 Disorders 143 Treatments 171 Biological Interventions 143 Social Phobias 173 Psychological Interventions 143 Prevalence, Age of Onset, and Gender Stress and Mental Health  145 Differences 173 Adjustment Disorder 145 Psychological Causal Factors 174 Adjustment Disorder Caused by Unemployment 145 Criteria for Social Anxiety Disorder (Social Phobia) 175 Posttraumatic Stress Disorder 145 Biological Causal Factors 176 Criteria for Posttraumatic Stress Disorder 146 Treatments 177 Thinking Critically about DSM-5: Panic Disorder 178 Changes to the Diagnostic Criteria for PTSD 147 Criteria for Panic Disorder 178 Acute Stress Disorder 148 Agoraphobia 179 Clinical Description 148 Criteria for Agoraphobia 179 Prevalence of PTSD in the General Population 148 Prevalence, Age of Onset, and Gender Differences 180 Rates of PTSD After Traumatic Experiences 149 Comorbidity with Other Disorders 181 Causal Factors in Posttraumatic Stress Disorder 152 The Timing of a First Panic Attack 181 Individual Risk Factors 153 Biological Causal Factors 181 Sociocultural Factors 154 Psychological Causal Factors 183 Long-Term Effects of Posttraumatic Stress 155 developments in RESEARCH: Nocturnal Panic Attacks 185 Prevention and Treatment of Stress Disorders 155 Treatments 187 Prevention 155 Generalized Anxiety Disorder 188 the WORLD around us Criteria for Generalised Anxiety Disorder 189 Does Playing Tetris After a Traumatic Prevalence, Age of Onset, and Gender Differences 190 Event Reduce Flashbacks? 156 Comorbidity with Other Disorders 190 Treatment for Stress Disorders 156 Psychological Causal Factors 190 Psychological Debriefing 157 Biological Causal Factors 192 the WORLD around us Treatments 193 Virtual Reality Exposure Treatment for PTSD in Military Personnel 158 Obsessive-Compulsive and Related Challenges in Studying Disaster Victims 159 Disorders 194 Obsessive-Compulsive Disorder 194 Trauma and Physical Health 159 Criteria for Obsessive-Compulsive Disorder 195 UNRESOLVED issues Why Is the Study of Trauma so Contentious? 160 Prevalence, Age of Onset, and Gender Differences 196 Comorbidity with Other Disorders 197 summary 160  key terms 161 Psychological Causal Factors 197 Biological Causal Factors 199 6 Panic, Anxiety, Obsessions, and Their Disorders 162 Treatments 201 Body Dysmorphic Disorder 202 Criteria for Body Dysmorphic Disorder 204 The Fear and Anxiety Response Patterns 164 Hoarding Disorder 206 Fear 164 Trichotillomania 206 Thinking Critically about DSM-5: Why is OCD No Longer Considered to Cultural Perspectives 206 Be an Anxiety Disorder? 164 Cultural Differences in Sources of Worry 207 Anxiety 165 Taijin Kyofusho 207 Overview of the Anxiety Disorders and UNRESOLVED issues Their Commonalities 165 The Choice of Treatments: Medications or Specific Phobias 166 Cognitive-Behavior Therapy? 208 Criteria for Specific Phobia 167 summary 209  key terms 210 vi  CONTENTS A01_BUTC4286_16_SE_FM.indd 6 11/06/13 9:50 AM  Suicide Prevention and Intervention 258 7 Mood Disorders and Suicide 211 Treatment of Mental Disorders 258 Crisis Intervention 259 Focus on High-Risk Groups and Other Measures 259 Mood Disorders: An Overview 212 UNRESOLVED issues Types of Mood Disorders 212 Is There a Right to Die? 259 Criteria for Major Depressive Disorder 213 summary 261  key terms 262 Criteria for Manic Episode 214 The Prevalence of Mood Disorders 214 Unipolar Depressive Disorders 214 Other Forms of Depression 215 Thinking Critically about DSM-5: 8 Somatic Symptom and Dissociative Disorders 263 Was It Wise to Drop the Bereavement Somatic Symptom and Related Disorders 264 Exclusion for Major Depression? 215 Somatic Symptom Disorders 265 developments in THINKING: Hypochondriasis 265 A New DSM-5 Diagnosis: Premenstrual Dysphoric Disorder 216 Criteria for Somatic Symptom Disorder 265 Dysthymic Disorder (Persistent Depressive Disorder) 216 Somatization Disorder 268 Criteria for Persistent Depressive Disorder (Dysthymia) 217 Pain Disorder 269 Major Depressive Disorder 218 Conversion Disorder (Functional Neurological Symptom Disorder) 270 Causal Factors in Unipolar Mood Disorders 221 Criteria for Illness Anxiety Disorder 270 Biological Causal Factors 221 Criteria for Conversion disorder 271 Psychological Causal Factors 226 Distinguishing Somatization, Pain, and Conversion Disorders developments in RESEARCH: from Malingering and Factitious Disorder 274 Why Do Sex Differences in Unipolar Depression Criteria for Factitious Disorder 274 Emerge During Adolescence? 235 the WORLD around us Bipolar and Related Disorders 237 Factitious Disorder Imposed on Another Cyclothymic Disorder 238 (Munchausen’s Syndrome by Proxy) 275 criteria for Cyclothymic Disorder 238 Dissociative Disorders 276 Bipolar Disorders (I and II) 239 Depersonalization/Derealization Disorder 276 Causal Factors in Bipolar Disorders 242 Criteria for Depersonalization/Derealization Disorder 277 Biological Causal Factors 242 Dissociative Amnesia and Dissociative Fugue 278 Psychological Causal Factors 244 Criteria for Dissociative Amnesia 278 Sociocultural Factors Affecting Unipolar Dissociative Identity Disorder (DID) 280 and Bipolar Disorders 244 Thinking Critically about DSM-5: Cross-Cultural Differences in Depressive Symptoms 244 Where Does Conversion Disorder Belong? 280 Cross-Cultural Differences in Prevalence 245 Criteria for Dissociative Identity Disorder 281 Demographic Differences in the United States 246 the WORLD around us Treatments and Outcomes 246 DID, Schizophrenia, and Split Personality: Pharmacotherapy 247 Clearing Up the Confusion 282 Alternative Biological Treatments 249 Sociocultural Factors in Dissociative Disorders 288 Psychotherapy 249 Treatment and Outcomes in Dissociative Disorders 288 Suicide: The Clinical Picture and the Causal Pattern 252 UNRESOLVED issues Who Attempts and Who Commits Suicide? 253 DID and the Reality of “Recovered Memories” 290 Suicide in Children 254 summary 291  key terms 292 Suicide in Adolescents and Young Adults 254 Other Psychosocial Factors Associated with Suicide 254 the WORLD around us Warning Signs for Student Suicide Biological Causal Factors 256 255 9 Eating Disorders and Obesity 293 Sociocultural Factors 256 Clinical Aspects of Eating Disorders 295 Suicidal Ambivalence 257 Anorexia Nervosa 295 Communication of Suicidal Intent 258 Criteria for Anorexia Nervosa 295 Suicide Notes 258 Bulimia Nervosa 297 CONTENTS  vii A01_BUTC4286_16_SE_FM.indd 7 11/06/13 9:50 AM  Criteria for Bulimia Nervosa 297 Binge Eating Disorder 298 Criteria for Binge-Eating Disorder 299 10 Personality Disorders 327 Age of Onset and Gender Differences 300 Clinical Features of Personality Disorders 328 Thinking Critically about DSM-5: Other Forms of Eating Disorders 300 Difficulties Doing Research on Personality Disorders 330 Prevalence of Eating Disorders 301 Difficulties in Diagnosing Personality Disorders 330 Medical Complications of Eating Disorders 301 Thinking Critically about DSM-5: Course and Outcome 302 Why Were No Changes Made to the Way Diagnostic Crossover 303 Personality Disorders Are Diagnosed? 331 Association of Eating Disorders With Other Difficulties in Studying the Causes of Personality Disorders 332 Forms of Psychopathology 303 Cluster A Personality Disorders 333 Eating Disorders Across Cultures 304 Paranoid Personality Disorder 333 the WORLD around us Criteria for Paranoid Personality Disorder 334 Ethnic Identity and Disordered Eating 305 Schizoid Personality Disorder 335 Risk and Causal Factors in Eating Criteria for Schizoid Personality Disorder 336 Disorders 306 Schizotypal Personality Disorder 336 Biological Factors 306 Criteria for Schizotypal Personality Disorder 337 Sociocultural Factors 307 Cluster B Personality Disorders 338 Family Influences 308 Histrionic Personality Disorder 338 Individual Risk Factors 309 Narcissistic Personality Disorder 339 Treatment of Eating Disorders 312 Criteria for Histrionic Personality Disorder 339 Treatment of Anorexia Nervosa 312 Criteria for Narcissistic Personality Disorder 340 Treatment of Bulimia Nervosa 313 Antisocial Personality Disorder 341 Treatment of Binge Eating Disorder 315 Borderline Personality Disorder 342 The Problem of Obesity 315 Criteria for Borderline Personality Disorder 342 Medical Issues 315 Thinking Critically about DSM-5: Definition and Prevalence 316 Nonsuicidal Self-Injury: Distinct Disorder or Symptom of Borderline Personality Disorder? 343 Weight Stigma 316 the WORLD around us Cluster C Personality Disorders 345 Do Negative Messages About Being Overweight Avoidant Personality Disorder 345 Encourage Overweight People to Eat More Criteria for Avoidant Personality Disorder 346 or Less? 317 Dependent Personality Disorder 347 Obesity and the DSM 317 Obsessive-Compulsive Personality Disorder 348 Risk and Causal Factors in Obesity 317 Criteria for Dependent Personality Disorder 348 The Role of Genes 317 Criteria for Obsessive-Compulsive Personality Disorder 349 Hormones Involved in Appetite and Weight General Sociocultural Causal Factors for Regulation 318 Personality Disorders 350 Sociocultural Influences 318 Family Influences 320 Treatments and Outcomes for Personality Disorders 350 Stress and “Comfort Food” 320 Adapting Therapeutic Techniques to Specific Personality Disorders 351 Pathways to Obesity 321 Treating Borderline Personality Disorder 351 Treatment of Obesity 321 Treating Other Personality Disorders 352 Lifestyle Modifications 321 Criteria for Antisocial Personality Disorder 353 Medications 322 Antisocial Personality Disorder and Psychopathy 353 Bariatric Surgery 322 Psychopathy and Antisocial Personality Disorder 353 The Importance of Prevention 323 The Clinical Picture in Psychopathy and UNRESOLVED issues Antisocial Personality Disorder 354 The Role of Public Policy in the Prevention Causal Factors in Psychopathy and Antisocial Personality 357 of Obesity 324 the WORLD around us summary 325  key terms 326 “Successful” Psychopaths 359 viii  CONTENTS A01_BUTC4286_16_SE_FM.indd 8 11/06/13 9:50 AM  A Developmental Perspective on Psychopathy and Antisocial Personality 360 Treatments and Outcomes in Psychopathic and Antisocial Personality 363 12 Sexual Variants, Abuse, and Dysfunctions 404 developments in PRACTICE: Sociocultural Influences on Sexual Prevention of Psychopathy and Antisocial Practices and Standards 406 Personality Disorder 364 Case 1: Degeneracy and Abstinence Theory 406 UNRESOLVED issues Case 2: Ritualized Homosexuality in Melanesia 407 DSM-5: How Can We Improve the Classification Case 3: Homosexuality and American Psychiatry 407 of Personality Disorders? 365 summary 365  key terms 366 Gender Dysphoria 409 The Paraphilias 409 Criteria for Several Different Paraphilic Disorders 410 11 Substance-Related Disorders 367 Causal Factors and Treatments for Paraphilias Gender Dysphoria 416 Criteria for Gender Dysphoria 417 416 Alcohol Related Disorders 369 Criteria for Gender Dysphoria in Adolescents and The Prevalence, Comorbidity, and Demographics Adults 418 of Alcohol Abuse and Dependence 369 Sexual Abuse 420 Criteria for Alcohol Use Disorder 370 Childhood Sexual Abuse 420 The Clinical Picture of Alcohol Related Disorders 371 Pedophilic Disorder 422 developments in RESEARCH: Thinking Critically about DSM-5: Fetal Alcohol Syndrome: How Much Drinking Pedophilia and Hebephilia 423 Is Too Much? 373 Incest 425 Biological Causal Factors in the Abuse of Rape 425 and Dependence on Alcohol 375 Treatment and Recidivism of Sex Offenders 428 Psychosocial Causal Factors in Alcohol Abuse and Dependence 377 the WORLD around us Megan’s Law 429 the WORLD around us Binge Drinking in College 380 Sexual Dysfunctions 431 Sociocultural Causal Factors 381 Criteria for Different Sexual Dysfunctions 432 Treatment of Alcohol-Related Disorders 381 Sexual Dysfunctions in Men 433 Drug Abuse and Dependence 386 Male Hypoactive Sexual Desire Disorder 434 Opium and Its Derivatives (Narcotics) 387 Female Sexual Interest/Arousal Disorder 436 Cocaine and Amphetamines (Stimulants) 390 UNRESOLVED issues Methamphetamine 392 How Harmful Is Childhood Sexual Abuse? 440 Thinking Critically about DSM-5: summary 441  key terms 442 Can Changes to the Diagnostic Criteria Result in Increased Drug 13 Use? 393 Schizophrenia and Other Barbiturates (Sedatives) 393 Psychotic Disorders 443 Hallucinogens: LSD and Related Drugs 394 Ecstasy 395 Schizophrenia 444 Marijuana 396 Origins of the Schizophrenia Construct 445 the WORLD around us Epidemiology 445 Should Marijuana Be Marketed and Sold Clinical Picture 446 Openly as a Medication? 397 Delusions 446 Stimulants: Caffeine and Nicotine 398 Criteria for Schizophrenia 447 Gambling Disorder 400 Hallucinations 448 Criteria for Gambling Disorder 400 Disorganized Speech and Behavior 448 UNRESOLVED issues the WORLD around us Exchanging Addictions: Is This an Effective Stress, Caffeine, and Hallucinations 449 Treatment Approach? 402 Positive and Negative Symptoms 450 summary 402  key terms 403 CONTENTS  ix A01_BUTC4286_16_SE_FM.indd 9 11/06/13 9:50 AM  Subtypes of Schizophrenia 450 Amnestic Disorder 500 Other Psychotic Disorders 451 Disorders Involving Head Injury 501 Criteria for Schizoaffective Disorder 451 Clinical Picture 502 Criteria for Schizophreniform Disorder 451 the WORLD around us Criteria for Delusional Disorder 452 Brain Damage in Professional Athletes 504 Criteria for Brief Psychotic Disorder 452 Treatments and Outcomes 505 Risk and Causal Factors 453 UNRESOLVED issues Genetic Factors 453 Should Healthy People Use Cognitive Enhancers? 506 the WORLD around us summary 506  key terms 507 The Genain Quadruplets 454 Prenatal Exposures 458 Genes and Environment in Schizophrenia: A Synthesis A Neurodevelopmental Perspective 460 459 15 Disorders of Childhood and Adolescence Thinking Critically about DSM-5: (Neurodevelopmental Attenuated Psychosis Syndrome 462 Disorders) 508 Structural and Functional Brain Abnormalities 462 Maladaptive Behavior in Different Life Periods 510 Psychosocial and Cultural Factors 470 Varying Clinical Pictures 510 A Diathesis-Stress Model of Schizophrenia 473 Special Psychological Vulnerabilities of Young Children 510 Treatments and Outcomes 475 The Classification of Childhood and Adolescent Disorders 511 Clinical Outcome 475 Pharmacological Approaches 476 Common Disorders of Childhood 511 Attention-Deficit/Hyperactivity Disorder 511 Psychosocial Approaches 477 Criteria for Attention-Deficit/Hyperactivity Disorder 512 UNRESOLVED issues Why Are Recovery Rates in Schizophrenia Not Improving? 480 Disruptive, Impulse-control and Conduct Disorder 515 Criteria for Conduct Disorder 515 summary 480  key terms 481 Anxiety and Depression in Children and Adolescents 518 Anxiety Disorders of Childhood and Adolescence 518 14 Neurocognitive Disorders 482 Criteria for Separation Anxiety Disorder Childhood Depression and Bipolar Disorder 519 521 developments in RESEARCH: Brain Impairment in Adults 484 Bipolar Disorder in Children and Adolescents: Thinking Critically about DSM-5: Is There an Epidemic? 523 Is the Inclusion of Mild Neurocognitive Disorder a Good Idea? 484 Elimination Disorders (Enuresis, Encopresis), Sleepwalking, and Tics 524 Clinical Signs of Brain Damage 484 Enuresis 525 Diffuse Versus Focal Damage 485 Encopresis 525 The Neurocognitive/Psychopathology Interaction 487 Sleepwalking 526 Delirium 488 Tic Disorders 526 Clinical Picture 488 Neurodevelopmental Disorders 527 Criteria for Delirium 489 Autism Spectrum Disorder 527 Treatments and Outcomes 489 Criteria for Autism Spectrum Disorder 528 Major Neurocognitive Disorder (Dementia) 489 developments in PRACTICE: Criteria for Major Neurocognitive Disorder (Dementia) 490 Can Virtual Reality Video Games Improve Treatment of Parkinson’s Disease 490 Children with Neurodevelopmental Disorders? 531 Huntington’s Disease 491 Specific Learning Disorders 532 Alzheimer’s Disease 491 Causal Factors in Learning Disorders 533 developments in RESEARCH: Treatments and Outcomes 533 Depression Increases the Risk of Alzheimer’s Disease 495 Thinking Critically about DSM-5: the WORLD around us Changes to the Diagnostic System are Exercising Your Way to a Healthier Brain? 498 Nominal for Some Disorders 533 Neurocognitive Disorder Associated with HIV-1 Infection 499 Intellectual Disability 534 Neurocognitive Disorder Associated with Vascular Disease 500 Levels of Intellectual Disability 534 x  CONTENTS A01_BUTC4286_16_SE_FM.indd 10 11/06/13 9:50 AM  Causal Factors in Intellectual Disability 535 Lithium and Other Mood-Stabilizing Drugs 575 Organic Retardation Syndromes 536 Electroconvulsive Therapy 576 Treatments, Outcomes, and Prevention 539 Neurosurgery 577 Planning Better Programs to Help the WORLD around us Children and Adolescents 541 Deep Brain Stimulation for Treatment-Resistant Depression 578 Special Factors Associated with Treatment UNRESOLVED issues of Children and Adolescents 541 Do Psychiatric medications Help or Harm? 579 the WORLD around us summary 580  key terms 581 The Impact of Child Abuse on Psychological Adjustment 542 Family Therapy as a Means of Helping Children 543 Child Advocacy Programs 543 UNRESOLVED issues Can Society Deal with Delinquent Behavior? 544 17 Contemporary and Legal Issues in Abnormal Psychology 582 summary 546  key Terms 547 Perspectives on Prevention 583 Universal Interventions 584 Selective Interventions 585 16 Therapy 548 An Overview of Treatment 549 Indicated Interventions Contemporary Society 588 588 Inpatient Mental Health Treatment in Why Do People Seek Therapy? 549 The Mental Hospital as a Therapeutic Community 588 Who Provides Psychotherapeutic Services? 550 Aftercare Programs 589 The Therapeutic Relationship 551 Deinstitutionalization 590 Measuring Success in Psychotherapy 552 Controversial Legal Issues and the Mentally Ill 591 Objectifying and Quantifying Change 552 Civil Commitment 591 Would Change Occur Anyway? 553 the WORLD around us Can Therapy Be Harmful? 553 Important Court Decisions for Patient Rights 592 the WORLD around us Assessment of “Dangerousness” 593 When Therapy Harms 554 the WORLD around us What Therapeutic Approaches Should Be Used? 554 Controversial Not Guilty Pleas: Can Altered Mind States or Personality Disorder Limit Responsibility for a Criminal Act? 594 Evidence-Based Treatment 554 The Insanity Defense 596 Medication or Psychotherapy? 555 Competence to Stand Trial 600 Combined Treatments 555 Does Having Mental Health Problems Result in Convicted Psychosocial Approaches to Treatment 556 Felons Being Returned to Prison After Being Released? 600 Behavior Therapy 556 Organized Efforts for Mental Health 601 Cognitive and Cognitive-Behavioral Therapy 559 U.S. Efforts for Mental Health 601 Humanistic-Experiential Therapies 561 International Efforts for Mental Health 603 Psychodynamic Therapies 563 Challenges for the Future 603 Couple and Family Therapy 566 The Need for Planning 604 Eclecticism and Integration 567 The Individual’s Contribution 604 Sociocultural Perspectives 568 UNRESOLVED issues Social Values and Psychotherapy 568 The HMOs and Mental Health Care 605 Psychotherapy and Cultural Diversity 569 summary 607  key terms 607 Biological Approaches to Treatment 569 Antipsychotic Drugs 569 Glossary 608 Antidepressant Drugs 570 References 629 Antianxiety Drugs 573 Credits 716 Thinking Critically about DSM-5: Name Index 722 What Are Some of the Clinical Implications Subject Index 751 of the Recent Changes? 574 CONTENTS  xi A01_BUTC4286_16_SE_FM.indd 11 11/06/13 9:50 AM rief developments in Research Ethnic Identity and Disordered Eating 305 Do Negative Messages About Being Overweight Encourage Do Magnets Help with Repetitive-Stress Injury? 24 Overweight People to Eat More or Less? 317 The Search for Medications to Cure Mental Disorders 45 “Successful” Psychopaths 359 Nocturnal Panic Attacks 185 Binge Drinking in College 380 Why Do Sex Differences in Unipolar Depression Should Marijuana Be Marketed and Sold Emerge During Adolescence? 235 Openly as a Medication? 397 Fetal Alcohol Syndrome: How Much Drinking Is Too Much? 373 Megan’s Law 429 Depression Increases the Risk of Alzheimer’s Disease 495 Stress, Caffeine, and Hallucinations 449 Bipolar Disorder in Children and Adolescents: The Genain Quadruplets 454 Is There an Epidemic? 523 Exercising Your Way to a Healthier Brain? 498 Brain Damage in Professional Athletes 504 developments in THINKING The Impact of Child Abuse on Psychological Adjustment 542 When Therapy Harms 554 Melancholia Through the Ages 31 Deep Brain Stimulation for Treatment-Resistant Depression 578 Nature, Nurture, and Psychopathology: A New Look at an Old Topic 66 Important Court Decisions for Patient Rights 592 The Humanistic and Existential Perspectives 77 Controversial Not Guilty Pleas: Can Altered Mind States or Personality Disorder Limit Responsibility for a Criminal Act? 594 A New Dsm-5 Diagnosis: Premenstrual Dysphoric Disorder 216 Unresolved issues developments in PRACTICE Are We All Becoming Mentally Ill? The Expanding The Automated Practice: Use of the Computer Horizons of Mental Disorder 26 in Psychological Testing 111 Interpreting Historical Events 51 Computer-Based MMPI-2 Report for Andrea C. 118 Theoretical Viewpoints and the Causes of Abnormal Behavior 97 Prevention of Psychopathy and Antisocial Personality Disorder 364 Why Is the Study of Trauma so Contentious? 160 Can Virtual Reality Video Games Improve Treatment of Children with Neurodevelopmental Disorders? 531 The Choice of Treatments: Medications or Cognitive-Behavior Therapy? 208 Is There a Right to Die? 259 DID and the Reality of “Recovered Memories” 290 the WORLD around us The Role of Public Policy in the Prevention of Obesity 324 Extreme Generosity or Pathological Behavior? 6 DSM-5: How Can We Improve the Classification Mad, Sick, Head Nuh Good: Mental Illness and Stigma in Jamaica 9 of Personality Disorders? 365 Chaining Mental Health Patients 41 Exchanging Addictions: Is This an Effective Culture and Attachment Relationships 95 Treatment Approach? 402 Racial Discrimination and Cardiovascular How Harmful Is Childhood Sexual Abuse? 440 Health in African Americans 142 Why are Recovery Rates in Schizophrenia Not Improving? 480 Does Playing Tetris After a Traumatic Event Reduce Flashbacks? 156 Should Healthy People Use Cognitive Enhancers? 506 Virtual Reality Exposure Treatment for Can Society Deal with Delinquent Behavior? 544 PTSD in Military Personnel 158 Do Psychiatric Medications Help or Harm? 579 Warning Signs for Student Suicide 255 The HMOs and Mental Health Care 605 Factitious Disorder Imposed on Another (Munchausen’s Syndrome by Proxy) 275 DID, Schizophrenia, and Split Personality: Clearing Up the Confusion 282 xii   A01_BUTC4286_16_SE_FM.indd 12 11/06/13 9:50 AM  DSM-5 Boxes Criteria for Gender Dysphoria 417 Criteria for Gender Dysphoria in Adolescents and Adults 418 Criteria for Persistent Depressive Disorder (Dysthymia) 123 Criteria for Different Sexual Dysfunctions 432 Criteria for Posttraumatic Stress Disorder 146 Criteria for Schizophrenia 447 Criteria for Specific Phobia 167 Criteria for Schizoaffective Disorder 451 Criteria for Social Anxiety Disorder (Social Phobia) 175 Criteria for Schizophreniform Disorder 451 Criteria for Panic Disorder 178 Criteria for Delusional Disorder 452 Criteria for Agoraphobia 179 Criteria for Brief Psychotic Disorder 452 Criteria for Generalized Anxiety Disorder 189 Criteria for Delirium 489 Criteria for Obsessive-Compulsive Disorder 195 Criteria for Major Neurocognitive Disorder (Dementia) 490 Criteria for Body Dysmorphic Disorder 204 Criteria for Attention-Deficit/Hyperactivity Disorder 512 Criteria for Major Depressive Disorder 213 Criteria for Conduct Disorder 515 Criteria for Manic Episode 214 Criteria for Separation Anxiety Disorder 519 Criteria for Persistent Depressive Disorder (Dysthymia) 217 Criteria for Autistic Spectrum Disorder 528 Criteria for Cyclothymic Disorder 238 Criteria for Somatic Symptom Disorder 265 Criteria for Illness Anxiety Disorder 270 Thinking Critically about DSM-5 Criteria for Conversion Disorder 271 Criteria for Factitious Disorder 274 What Is the DSM and Why Was It Revised? 7 Criteria for Depersonalization/Derealization Disorder 277 Completion Does Not Assure Acceptance 125 Criteria for Dissociative Amnesia 278 Changes to the Diagnostic Criteria for PTSD 147 Criteria for Dissociative Identity Disorder 281 Why is OCD No Longer Considered to be an anxiety disorder? 164 Criteria for Anorexia Nervosa 295 Was It Wise to Drop the Bereavement Exclusion Criteria for Bulimia Nervosa 297 for Major Depression? 215 Criteria for Binge-Eating Disorder 299 Where Does Conversion Disorder Belong? 280 Criteria for Paranoid Personality Disorder 334 Other Forms of Eating Disorders 300 Criteria for Schizoid Personality Disorder 336 Why Were No Changes Made to the Way Criteria for Schizotypal Personality Disorder 337 Personality Disorders Are Diagnosed? 331 Criteria for Histrionic Personality Disorder 339 Nonsuicidal Self-Injury: Distinct Disorder or ­Symptom Criteria for Narcissistic Personality Disorder 340 of Borderline Personality Disorder? 343 Criteria for Borderline Personality Disorder 342 Can Changes to the Diagnostic Criteria Result in Increased Drug Use? 393 Criteria for Avoidant Personality Disorder 346 Pedophilia and Hebephilia 423 Criteria for Dependent Personality Disorder 348 Attenuated Psychosis Syndrome 462 Criteria for Obsessive-Compulsive Personality Disorder 349 Is the Inclusion of Mild Neurocognitive Disorder a Good Idea? 484 Criteria for Antisocial Personality Disorder 353 Changes to the Diagnostic System are Criteria for Alcohol Use Disorder 370 Nominal for Some Disorders 533 Criteria for Gambling Disorder 400 What Are Some of the Clinical Implications Criteria for Several Different Paraphilic Disorders 410 of the Recent Changes? 574 FEATURES  xiii A01_BUTC4286_16_SE_FM.indd 13 11/06/13 9:50 AM  What’s New in DSM-5? A Quick Guide The diagnosis of phobia no longer requires that the person rec- ognize that his or her anxiety is unreasonable. Many changes occurred from DSM-IV to DSM-5. Here is a sum- Panic disorder and agoraphobia have been unlinked and are mary of some of the most important revisions. Many of these now separate diagnoses in DSM-5. changes are highlighted in the “Thinking Critically about DSM-5” boxes throughout this edition. Obsessive-compulsive disorder is no longer classified as an anxiety disorder. DSM-5 contains a new chapter that covers The chapters of the DSM have been re-organized to reflect a obsessive compulsive and related disorders. consideration of developmental and lifespan issues. Disorders New disorders in the obsessive compulsive and related disor- that are thought to reflect developmental perturbations or that ders category include hoarding disorder and excoriation manifest early in life (e.g., neurodevelopmental disorders and (skin picking) disorder. disorders such as schizophrenia) are listed before disorders that occur later in life. Post-traumatic stress disorder is no longer considered to be an anxiety disorder. Instead, it is listed in a new chapter that cov- The multiaxial system has been abandoned. No distinction is ers trauma- and stressor-related disorders. now made between Axis I and Axis II disorders. The diagnostic criteria for post-traumatic stress disorder have DSM-5 allows for more gender-related differences to be taken been significantly revised. The definition of what counts as into consideration for mental health problems. a traumatic event has been clarified and made more explicit. It is extremely important for the clinician to understand the DSM-5 now also recognizes four-symptom clusters rather than client’s cultural background in appraising mental health prob- the three noted in DSM-IV. lems. DSM-5 contains a structured interview that focuses upon Dissociative fugue is no longer listed as a separate diagnosis. the patient’s cultural background and characteristic approach Instead, it is listed as a form of dissociative amnesia. to problems. The DSM-IV diagnoses of hypochondriasis, somatoform dis- The term intellectual disability is now used instead of the term order, and pain disorder have been removed and are now sub- mental retardation. sumed into the new diagnosis of somatic symptom disorder. A new diagnosis of autism spectrum disorder now encompasses Binge eating disorder has been moved from the appendix of autism, Asperger’s disorder, and other forms of pervasive devel- DSM-IV and is now listed as an official diagnosis. opmental disorder. The diagnosis of Asperger’s disorder has been eliminated from the DSM. The frequency of binge eating and purging episodes has been reduced for the diagnosis of bulimia nervosa. Changes to the diagnostic criteria for attention deficit disorder now mean that symptoms that occur before age 12 (rather than Amenorrhea is no longer required for the diagnosis of anorexia age 7) have diagnostic significance. nervosa. A new diagnosis, called disruptive mood regulation disorder, The DSM-IV diagnoses of dementia and amnestic disorder has been added. This will be used to diagnose children up to have been eliminated and are now subsumed into a new cat- age 18 who show persistent irritability and frequent episodes of egory called major neurocognitive disorder. extreme and uncontrolled behavior. Mild neurocognitive disorder has been added as a new The subtypes of schizophrenia have been eliminated. diagnosis. The special significance afforded to bizarre delusions with No changes have been made to the diagnostic criteria for per- regard to the diagnosis of schizophrenia has been removed. sonality disorders. Bipolar and related disorders are now described in a separate Substance-related disorders are divided into two separate chapter of the DSM and are no longer listed with depressive groups: substance use disorders and substance-induced disorders. disorders. Premenstrual dysphoric disorder has been promoted from the A new disorder, gambling disorder, has been included in appendix of DSM-IV and is now listed as a new diagnosis. substance-related and addictive disorders. A new diagnosis of persistent depressive disorder now sub- Included for the first time in Section III of DSM-5 are several sumes dysthymia and chronic major depressive disorder. new disorders regarded as being in need of further study. These include attenuated psychosis syndrome, non-suicidal self-injury The bereavement exclusion has been removed in the diagnosis disorder, Internet gaming disorder, and caffeine use disorder. of major depressive episode. xiv  FEATURES A01_BUTC4286_16_SE_FM.indd 14 11/06/13 9:50 AM  The guidelines and standards that we follow in our professional Each brings different areas of expertise and diverse research inter- activities are not set in stone. Change is a big part of life and new ests to the textbook. Importantly, these different perspectives research or novel new theories can impact the way mental health come together in a systematically integrated text that is accessible professionals view problems. Although many of the ideas and to a broad audience. The depth and breadth of the author team diagnostic concepts in the field of abnormal psychology have per- provides students with learning experiences that can take them sisted for hundreds of years, changes in thinking do occur. And, to new levels of understanding. Our approach emphasizes the at some point there are events that occur that force a rethinking importance of research as well as the need to translate research of some issues. Most recently in abnormal psychology, the pub- findings into informed and effective clinical care for all who suf- lication of the DSM-5, after years of development and consider- fer from mental disorders. able controversy, is one of those momentous changes. Reflecting Abnormal Psychology has a long and distinguished tradition this, we have revised this new edition of Abnormal Psychology to as an undergraduate text. Ever since James Coleman wrote the reflect the most up-to-date information about diagnostic catego- first edition many years ago, this textbook has been considered ries, classifications, and criteria. the most comprehensive in the field. Along the way there have Every time we work on a revision of Abnormal Psychology been many changes. However, the commitment to excellence in we are reminded of how dynamic and vibrant our field is. this now-classic textbook has remained ever constant. In this new Developments in areas such as genetics, brain imaging, behavioral edition, we seek to open up the fascinating world of abnormal observation, and classification, as well changes in social and gov- psychology, providing students with comprehensive and up-to- ernment policy and in legal decisions, add to our knowledge base date knowledge in an accessible and engaging way. We hope that and stimulate new treatments for those whose lives are touched by this newest edition conveys some of the passion and enthusiasm mental disorders. This is exciting. But the rapid progress of our for the topic that we still experience every day. field also presents its own challenges. One of the most important is how best to provide students with an integrated perspective— one that respects new ideas and discoveries and places them into Why Do You Need This New Edition? the existing body of knowledge in a way that emphasizes multiple If you’re wondering why you should buy this new edition of perspectives, provokes thought, and increases awareness. Abnormal Psychology, here are 7 good reasons! We use a biopsychosocial approach to provide a sophisti- cated appreciation of the total context in which abnormalities 1. The sixteenth edition of Abnormal Psychology includes the of behavior occur. For ease of understanding we also present most up-to-date and in-depth information about biological material on each disorder in a logical and consistent way. More influences on the entire spectrum of behavioral abnormalities, specifically, we focus on three significant aspects: (1) the clinical while still maintaining its comprehensive and balanced bio- picture, where we describe the symptoms of the disorder and its psychosocial approach to understanding abnormal behavior. associated features; (2) factors involved in the development of the 2. After years of planning, DSM-5 was published in May 2013. disorder; and (3) treatment approaches. In each case, we examine This major revision of the diagnostic system means that the evidence for biological, psychosocial (i.e., psychological and the diagnostic criteria for many disorders have changed. To interpersonal), and sociocultural (the broader social environment stay current, you need to know about the changes that have of culture and subculture) influences. Because we wish never to been made in DSM-5. Books that do not include coverage of lose sight of the person, we try to integrate as much case material DSM-5 are books that are out of date. as we can into each chapter. An additional feature of this book 3. Our new edition provides you with detailed tables showing is a focus on treatment. Although treatment is discussed in every the current DSM-5 diagnostic criteria for all the disorders chapter in the context of specific disorders, we also include a covered in the book. separate chapter that addresses issues in treatment more broadly. 4. New highlight boxes alert you to some of the most important This provides students with increased understanding of a wide changes in DSM-5. These include changes to the diagnostic range of treatment approaches and permits more in-depth cover- criteria for attention-deficit hyperactivity disorder as well as age than is possible in specific disorder–based chapters. new diagnoses such as binge eating disorder and premenstrual The Butcher–Hooley–Mineka author team is in a unique dysphoric disorder. position to provide students with an integrated and comprehen- 5. Other feature boxes provide opportunities for critical think- sive understanding of abnormal psychology. Each author is a ing by illustrating some of the controversies associated with noted researcher, an experienced teacher, and a licensed clinician. the changes that were (or were not) made. Throughout the xv A01_BUTC4286_16_SE_FM.indd 15 11/06/13 9:50 AM  book we also provide readers with different perspectives on pleased to know that all of this has been accomplished without the likely implications that these changes will have for clinical adding length to the book! diagnosis and research in psychopathology. 6. Changes have been made in many chapters to improve the flow of the writing and enhance learning. Reflecting the ever- Features and Pedagogy changing field of abnormal psychology, new references have The extensive research base and accessible organization of this been added and new research findings highlighted. book are supported by high-interest features and helpful peda- 7. Finally, at the beginning of each chapter clearly defined gogy to further engage students and support learning. We also Learning Objectives provide the reader with an overview of hope to encourage students to think in depth about the topics topics and issues that will be included in the chapter. At the they are learning about through specific highlight features that end of each chapter a summary of answers to these Learning emphasize critical thinking. Objective questions are provided. In-Review Questions at the end of major sections within chapters also provide additional opportunities for self-assessment and increased Features learning. Feature Boxes Special sections, called Developments in Research, Developments What’s New in Thinking, Developments in Practice, and The World Around Us, highlight topics of particular interest, focusing on applica- A major change in the 16th edition of Abnormal Psychology is tions of research to everyday life, current events, and the latest the focus on DSM-5. This important revision to the diagnostic research methodologies, technologies, and findings. system was published in May 2013. To assist both instructors and students, we include specialized feature boxes, highlighting many of the key changes that were made in DSM-5. This makes Critical Thinking new material immediately accessible. Other important changes New to this edition are special highlight boxes about DSM-5. in DSM-5 are also mentioned throughout the text. Providing Many of the revisions to DSM-5 were highly contentious and students with this material as soon as possible after the publica- controversial. A new feature box called “Thinking Critically tion of DSM-5 reflects our commitment to staying ahead of About DSM-5” introduces students to the revised DSM and the curve and to providing students with the most up-to-date encourages them to think critically about the implications of information possible. these changes. This new edition of Abnormal Psychology has been rede- signed to remain visually engaging to the newest generation Unresolved Issues of students. Chapters begin with learning objective questions. All chapters include end-of-chapter sections that demonstrate These orient the reader to the material that will be presented how far we have come and how far we have yet to go in our in each specific chapter. Learning objective questions are also understanding of psychological disorders. The topics covered repeated at the end of each chapter and answers to each are pro- here provide insight into the future of the field and expose vided. Most chapters also begin with a case study that illustrates students to some controversial topics. New to this edition is a the mental health problems to be addressed in the chapter. This discussion of the problems associated with the study of trauma. serves to capture students’ interest and attention right from In another chapter, we raise the contentious issue of whether the outset. Numerous new photographs and illustrations have treatment with antipsychotic medications is helpful or harmful also been added. In addition, this edition also contains updated in the very long term. case material, new unresolved issues (e.g., why is the study of trauma so contentious?; why are recovery rates in schizophrenia not improving?), and new feature boxes designed to be of high Pedagogy interest to students (e.g., non-suicidal self-injury disorder). Learning Objectives Reflecting the ever-changing field of abnormal psychology, Each chapter begins with learning objective questions. These numerous new references have been added. Outdated material ­orient the reader to the material that will be presented in each has been replaced, current findings have been included, and specific chapter. Learning objective questions are also repeated new developments have been identified. The 16th edition also at the end of each chapter, along with their answers. This pro- includes the most up-to-date and in-depth information about vides students with an excellent tool for study and review. In this the role of biological factors in abnormal behavior, while at ­edition, sections of many chapters have also been reorganized and the same time placing this in the context of a comprehensive material has been streamlined whenever possible. All the changes biopsychosocial approach. Our coverage of cultural issues and that have been made are designed to improve the flow of the diversity has also been strengthened. We hope readers will be writing and enhance pedagogy. xvi  PREFACE A01_BUTC4286_16_SE_FM.indd 16 11/06/13 9:50 AM  Case Studies Speaking Out: Interviews with People Who Extensive case studies of individuals with various disorders