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|1||Examples and Definitions of Abnormal Behavior||1|
|2||Causes of Abnormal Behavior: From Paradigms to Systems||30|
|3||Treatment of Psychological Disorders||70|
|4||Classification and Assessment||110|
|7||Acute and Posttraumatic Stress Disorders, Dissociative Disorders, and Somatoform Disorders||238|
|8||Stress and Physical Health||282|
|11||Substance Use Disorders||384|
|12||Sexual and Gender Identity Disorders||424|
|14||Dementia, Delirium, and Amnestic Disorders||500|
|15||Mental Retardation and Pervasive Developmental Disorders||530|
|16||Psychological Disorders of Childhood||570|
|17||Adjustment Disorders and Difficult Life Events: Life Cycle Transitions||608|
|18||Mental Health and the Law||640|
|About the Authors||763|
Abnormal psychology is not about "them." Abnormal psychology is about all of us. Emotional suffering touches all of our lives at some point in time. Psychological problems are prevalent and affect many of us directly and all of us indirectly—through our loved ones, friends, and the strangers whose troubled behavior we cannot ignore.
Integration always has been the overriding theme of our textbook. Rather than see abnormal psychology as fractured by competition among paradigms, split between psychology and psychiatry, or divided between scientists and practitioners, we see the most exciting and promising future for abnormal psychology in the integration of theoretical approaches, professional specialties, and science and practice.
We present abnormal psychology as a cohesive field, even with all its variations. Each disorder chapter unfolds in the same way, providing a coherent framework and consistent outline. We open with an Overview followed by one or two extended Case Studies. We then discuss Typical Symptoms and Associated Features, Classification, Epidemiology, Etiological Considerations and Research, and finally, Treatment. Each chapter reflects DSM-IV TRthroughout.
Embedded in this consistent structure are several features designed to help make the human aspects of mental disorders clearer to readers: Our cases and first person accounts, and a new feature, Getting Help.
In the new Getting Help sections included in every chapter of this edition, we address students' personal concerns most directly. We added this feature to begin to answer the sorts of questions that students have asked us privately after lecture or later in our offices. These sections also encourage students to think critically about the psychological information they may encounter on the Web and in self-help section of their bookstore. The Getting Help sections give responsible, empirically sound, and concrete guidance on such personal topics as:
Students can also find research-based information on the effectiveness and efficacy of various treatments in Chapter 3, Treatment of Psychological Disorders, and in the Treatment headings near the end of every disorder chapter.
We do not have simple answers to many pressing personal and intellectual questions. Many of our answers are complicated and equivocal. Others are simply incomplete. Such is the state of abnormal psychology at the beginning of the twenty-first century.
But far worse than offering incomplete answers would be to take the route of those well-intentioned experts, and some unscrupulous ones, who are ready to give "definitive" answers to questions that, in reality, cannot be answered definitively. Sometimes these "experts"' answers are wrong or clearly selfservihg. We are candid when the truthful answer is, "Honestly, we do not yet know."
The unanswered questions of abnormal psychology present intriguing and pressing puzzles. These unsolved mysteries challenge all of our intellectual and personal resources as scientific detectives. We include the latest scientific findings throughout this text, including references to hundreds of new scientific studies in this fourth edition. But the measure of a leading edge textbook is not merely the number of new references. It is the number of new studies the authors have reviewed and evaluated before deciding what to include and what to discard. For every new reference in this edition of our text, we have read many additional papers before selecting the one gem to include.
At least as important as including the latest and the best research, we also point to the most promising leads for finding more and better answers in the not-too-distant future. We are seasoned and active investigators, as well as authors. Our research—and this text—are fueled by the suffering of people with emotional conflicts and mental illnesses, and by the intellectual challenges we face in trying to answer some of the very complicated questions posed by abnormal psychology.
We report on the latest scientific findings, and we also explain in detail how psychological scientists do their detective work. Unlike any other text in this field, however, we do not cover research methods in a single chapter. We do this because many of our students have told us that the typical research methods chapter seems dry, difficult, and—to our great disappointment—irrelevant. Students understand the enormous need for new knowledge in this field, but they find the one-shot chapter on research methods to be detached from the substance of abnormal psychology.
Our solution to these problems is to offer brief Research Methods inserts in every single chapter. This approach makes the text flexible, and it makes learning research methods more manageable, more focused, and more relevant by connecting them to the chapter content. By the end of the text, this approach also allows us to cover research methods in more detail than we could reasonably cover in a single, detached chapter.
In addition to these discussions of research methods, we also offer Research Close-Ups, sections devoted to a detailed review of a particular study that has proved important in advancing our knowledge in a given area. These sections help make concrete not only the findings of the study, but also its process. For example, in Chapter 8 we discuss James Pennebaker, Janice Kiecolt-Glaser, and Ronald Glaser's study of the effect of disclosure on the immune system.
Often, the Research Methods and Research Close-up features work together. For example, in Chapter 17, the Research Methods discussion is on heritability, while the Research Close-up focuses on research studies examining the gene-environment correlation and the possible heritability of divorce.
Sometimes a study or problem suggests a departure from current thinking or raises issues that deserve to be examined. Our Further Thoughts sections cover these sorts of emerging ideas, such as evidence suggesting that, rather than employing the fight or flight response to threat, females appear to choose a "tend and befriend" approach (Chapter 8), or possible ways of classifying rapists, even though this type of abnormal behavior is not included in the official diagnostic manual (Chapter 12), or new ways of thinking about the close connection between depression and anxiety (Chapter 6).
Abnormal psychology is, of course, about real people; people like us. The many case studies we present help readers keep this in mind. Detailed Case Studies appear near the beginning of every chapter so that the symptoms and etiological issues are presented in the context of real lives and in their genuine complexity. In the extended opening cases, briefer cases, and first-person accounts throughout the chapters, readers see how ordinary lives are disrupted and how treatment proceeds in fits and starts.
Most of the cases are our own. Throughout our careers, we both have been active clinicians as well as active researchers. In fact, being a therapist is a lot like being a scientist. As therapists, we develop hypotheses and test them as we work to help individual clients to change. When we gain support for a hypothesis with one client, we wonder if the observation applies to others. Was the cause of this problem unique to this client, or have we discovered a general principle? Did our successful attempt to vary a proven treatment work only for this one client, or are we on to something bigger? Can we prove our clinical hunches to the world in an objective, scientific manner?
The Case Studies help take the reader along on this journey of pain, triumph, frustration, and fresh starts, and are designed to help students to think more deeply about psychological disorders, much as our own clinical experience enriches our understanding.
For much of the last century abnormal psychology was dominated by theoretical paradigms, and the belief that someday one single paradigm would triumph and provide all answers to all questions while all other paradigms collapsed into dust.
This circumstance reminds us of the parable of the seven blind men and the elephant. One blind man grasps a tusk and concludes that an elephant is very much like a spear. Another feels a knee and decides an elephant is like a tree, and so on. Our goal from the first edition of Abnormal Psychology has been to show the reader the whole elephant. We do this through our unique integrative systems approach, in which we focus on what we know rather than what we used to think.
In every chapter, we consider how biological, psychological, and social factors work together to produce mental disorders. What causes depression? A chemical imbalance? Cognitive errors? Or racial and gender bias? Our answer is: wrong questions. Depression appears to be caused by a combination of genetic risks, maladaptive patterns of thinking, and dysfunctional social roles (among other influences). Similarly, the appropriate treatment of depression may involve medication, psychotherapy, social action, or all three approaches.
We show how different factors function together in a system of reciprocal influences in producing different psychological disorders. We strive to appreciate the whole elephant even when we know that science has not yet illuminated all of its parts.
Every revision involves a fresh look at content and coverage and bringing discussions up-todate with current research. We have rewritten the openers to every chapter in order to help convey our "us, not them" theme, highlighting the connection between disordered and "normal" behavior. For example, the opener to the personality disorders chapter (Chapter 9) invites readers to consider the relationship between being skeptical and being paranoid and between self-confidence and grandiosity. There are many changes within the chapters of Abnormal Psychology, Fourth Edition as well: