Diagnosis of somatic symptom disorder may be given to people who are overly anxious about their medical problems (page 257).
Clinicians no longer need to distin- guish hysteri- cal symptoms from medical symptoms.
People with a
serious medi- cal disease, such as cancer, may receive a psychiatric di- agnosis.
Diagnosis of major depressive disorder may be given to recently bereaved people (page 196).
Clinicians can more quickly spot and treat clini- cal depression among griev- ing people.
People experi-
encing normal grief reactions may receive a psychiatric di- agnosis.
Previous category of
Asperger’s disorder has been eliminated (page 486).
Better alterna- tive diagnoses may now be assigned to people with severe social impairments.
Individu- als may
no longer qual- ify for special educational services if they lose the As- perger’s label.
The new category substance use disorder combines substance abuse and substance dependence into one disorder (page 314).
Patterns of sub- stance abuse and substance dependence were often indistinguish- able.
Sub- stance
abuse and sub- stance depen- dence may re- quire different treatments.
Top DSM-5 DebaTeS Many of the DSM-5 changes have provoked debate. Several have been particularly controversial in some clinical circles.
Who DevelopeD DSM-5?
* World Health Organization ** National Institute of Mental Health
Field Testing DSM-5 From 2010 to 2012, DSM-5 researchers conducted field studies to see how well clinicians could apply the new criteria.
Disorders tested: 23
Clinical participants: 3,646
Clinicians: 879 (APA, 2013; Clarke et al., 2013; Regier et al., 2013)
Two-thirds of the DSM-5 work group members were psychiatrists and one-third were psychologists.
(APA, 2013)
Work groups (pathology groups)
13 160 persons
12 persons per group
Task force (oversight committee)
30 persons
New Categories Hoarding disorder (page 143)
Excoriation disorder (page 143)
Persistent depressive disorder (page 187)
Premenstrual dysphoric disorder (page 209)
Disruptive mood dysregulation disorder (page 472)
Somatic symptom disorder (page 255)
Binge eating disorder (page 288)
Mild neurocognitive disorder (page 511)
WhaT’S NeW iN DSM-5? DSM-5 features a number of changes, new categories, and eliminations. Many of the changes have been controversial.
Name Changes OLD NEW
Mental Retardation
Intellectual Disability (page 489)
Dementia Major Neurocognitive Disorder (page 511)
Hypochondriasis Illness Anxiety Disorder (page 261)
Male Orgasmic Disorder
Delayed Ejaculation (page 355)
Gender Identity Disorder
Gender Dysphoria (page 376)
Dropped Categories Dissociative fugue (page 168)
Asperger’s disorder (page 486)
Sexual aversion disorder (page 348)
Substance abuse (page 314)
Substance dependence (page 314)
CoMpeTiTorS Both within North America and around the world, the DSM faces competition from 2 other diagnostic systems—the International Classification of Disorders
(ICD) and Research Domain Criteria (RDoC).
DSM
ICD
RDoC
Producer Disorders Criteria
APA Psychological Detailed
WHO* Psychological/
medical Brief
NIMH** Psychological Neuro/scanning
Gambling disorder is considered an addiction (page 342).
Excessive gambling and substance addictions often share similar brain dysfunc- tioning.
Many other be-
haviors pursued excessively, such as sex, Internet use, and shopping, could eventually be considered behavioral ad- dictions.
Mild neurocognitive disorder is added as a category (page 515).
This diag-nosis may help clinicians identify early symptoms of Alzheimer’s dis- ease.
People with nor-
mal age-related forgetfulness may receive a psychiatric diag- nosis.
1950
1970
1960
1990
2010
• 1980
book price $32.00
• 1994
book price $49.00
• 2000
book price $75.00
DSM-5 • 2013
book price $199.00
128 diagnoses
• 1952
book price $3.00
• 1987
book price $40.00
DSM-III
DSM-IV
DSM-IV-TR
DSM-I
DSM-III-R
DSM-II • 1968
book price $3.50
193 diagnoses
228 diagnoses
253 diagnoses
383 diagnoses
383 diagnoses
541 diagnoses
DSM-5 vS. ItS PreDeceSSorS The new edition of DSM is bigger and more expensive than all previous editions. It cost the APA $25 million to produce, an amount that was immediately recouped by presales of 150,000 copies (Gorenstein, 2013).
Outside advisors
300 persons
(B la
sh fi
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e t
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20 14
; G
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n 2013, the American Psychiatric Association (APA) published DSM-5, its new edition of the Diagnostic and Statistical Manual of Mental Disorders — the most widely used classification system in North America. DSM-5 is a 947-page manual that lists 541 diagnoses (Blashfield et al., 2014). The production of DSM-5 was a monumental 12-year undertaking, marked by long delays, controversies, and protests (page 95).
Inside DSM-5
Application Area of Use
Practice/research North America
Practice/research Worldwide
Research United States
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Abnormal Psychology Fundamentals of
this page left intentionally blank
Princeton University
Abnormal Psychology
Ronald J. Comer
EIGHTH EDITION
Fundamentals of
New York
Publisher: Rachel Losh Executive Acquisitions Editor: Daniel McDonough Editorial Assistant: Kimberly Morgan Senior Marketing Manager: Lindsay Johnson Marketing Assistant: Allison Greco Executive Media Editor: Rachel Comerford Associate Media Editor: Jessica Lauffer Director, Content Management Enhancement: Tracey Kuehn Managing Editor: Lisa Kinne Senior Project Editor: Jane O’Neill Media Producer: Eve Conte Photo Editor: Jennifer Atkins Permissions Editors: Felicia Ruocco, Melissa Pellerano Permissions Associate: Chelsea Roden Director of Design, Content Management: Diana Blume Cover and Interior Designer: Babs Reingold Layout Designer: Paul Lacy Infographics Artist: Charles Yuen Senior Production Supervisor: Sarah Segal Composition: codeMantra Printing and Binding: RR Donnelley Cover Image: Ed Fairburn
Credits to use previously published material can be found in the Credits section, starting on page C-1.
Library of Congress Control Number: 2015957306
ISBN-13: 978-1-4641-7697-5 ISBN-10: 1-4641-7697-3
© 2016, 2014, 2011, 2008 by Worth Publishers
All rights reserved
Printed in the United States of America
First Printing
Worth Publishers One New York Plaza Suite 4500 New York, NY 10004-1562
http://www.macmillanhighered.com
http://www.macmillanhighered.com
To Delia and Emmett Comer, The World Awaits
viii
About the Author
Ron ComeR has taught in Princeton University’s Department of Psychology for the past 41 years, serving also as Director of Clinical Psychology Studies and as chair of the university’s Institutional Review Board. His courses—Abnormal Psychology, Theories of Psychotherapy, Childhood Psychopathology, Experimental Psychopathology, and Controversies in Clinical Psychology—have been among the university’s most popular offerings.
Professor Comer has received the President’s Award for Distinguished Teaching at the university. He is also a practicing clinical psychologist and a consultant to Eden Autism Services and to hospitals and family practice residency programs throughout New Jersey.
In addition to writing Fundamentals of Abnormal Psychology, Eighth Edition, Professor Comer is the author of the textbook Abnormal Psychology, now in its ninth edition; coauthor of the introductory psychology textbook Psychology Around Us, Second Edition; and coauthor of Case Studies in Abnormal Psychology, Second Edition. He is the producer of numerous videos for courses in psychology and other fields of education, including The Higher Education Video Library Series, Video Anthology for Abnormal Psychology, Video Segments in Neuroscience, Introduction to Psychology Video Clipboard, and Developmental Psychology Video Clipboard. He also has published journal articles in clinical psychol- ogy, social psychology, and family medicine.
Professor Comer completed his undergraduate studies at the University of Pennsylvania and his graduate work at Clark University. He lives in Lawrenceville, New Jersey, with his wife, Marlene. From there he can keep a close eye on the Philadelphia sports teams with which he grew up. Pa
ul L
. B re
e
ix
Contents in brief Abnormal Psychology in Science and Clinical Practice 1 Abnormal Psychology: Past and Present 1
2 Models of Abnormality 37
3 Clinical Assessment, Diagnosis, and Treatment 77
Problems of Anxiety and Mood 4 Anxiety, Obsessive-Compulsive, and Related Disorders 105
5 Disorders of Trauma and Stress 149
6 Depressive and Bipolar Disorders 183
7 Suicide 221
Problems of the Mind and Body 8 Disorders Featuring Somatic Symptoms 249
9 Eating Disorders 279
10 Substance Use and Addictive Disorders 309
11 Disorders of Sex and Gender 347
Problems of Psychosis 12 Schizophrenia 385
Life-Span Problems 13 Personality Disorders 421
14 Disorders Common Among Children and Adolescents 463
15 Disorders of Aging and Cognition 501
Conclusion 16 Law, Society, and the Mental Health Profession 527
x
Contents
Preface xvii
chapter : 1 Abnormal Psychology: Past and Present 1 What Is Psychological Abnormality? 2
Deviance 3 Distress 3 Dysfunction 4 Danger 4 The elusive nature of Abnormality 4
What Is Treatment? 5
How Was Abnormality Viewed and Treated in the Past? 7
Ancient Views and Treatments 7 Greek and Roman Views and Treatments 8 europe in the middle Ages: Demonology Returns 8 The Renaissance and the Rise of Asylums 9 The nineteenth Century: Reform and
moral Treatment 10 The early Twentieth Century: The Somatogenic
and Psychogenic Perspectives 11
Current Trends 14 How Are People with Severe Disturbances
Cared for? 15 How Are People with Less Severe
Disturbances Treated? 15 A Growing emphasis on Preventing Disorders
and Promoting mental Health 16 multicultural Psychology 17 The Increasing Influence of Insurance Coverage 17 What Are Today’s Leading Theories and Professions? 18 Technology and mental Health 20
What Do Clinical Researchers Do? 22 The Case Study 22 The Correlational method 23 The experimental method 27 What Are the Limits of Clinical Investigation? 31 Protecting Human Participants 32
Putting it together: A Work in Progress 34
Key terms 34
QuicK Quiz 35
LaunchPad 35
PsychWatch Verbal Debuts 2
PsychWatch Marching to a Different Drummer: Eccentrics 6
InfoCentral Happiness 19
MindTech Mental Health Apps Explode in the Marketplace 21
MindTech A Researcher’s Paradise? 24
MediaSpeak Flawed Study, Gigantic Impact 28
chapter : 2 Models of Abnormality 37 The Biological Model 39
How Do Biological Theorists explain Abnormal Behavior? 39
Biological Treatments 42 Assessing the Biological model 44
The Psychodynamic Model 44 How Did Freud explain normal and Abnormal
Functioning? 45 How Do other Psychodynamic explanations Differ
from Freud’s? 47 Psychodynamic Therapies 47 Assessing the Psychodynamic model 49
The Behavioral Model 50 How Do Behaviorists explain Abnormal Functioning? 51 Behavioral Therapies 52 Assessing the Behavioral model 53
The Cognitive Model 54 How Do Cognitive Theorists explain Abnormal
Functioning? 54 Cognitive Therapies 55 Assessing the Cognitive model 56
The Humanistic-Existential Model 58
CONTENTS : xi
Rogers’ Humanistic Theory and Therapy 59 Gestalt Theory and Therapy 60 Spiritual Views and Interventions 61 existential Theories and Therapy 61 Assessing the Humanistic-existential model 63
The Sociocultural Model: Family-Social and Multicultural Perspectives 64
How Do Family-Social Theorists explain Abnormal Functioning? 65
Family-Social Treatments 67 How Do multicultural Theorists explain Abnormal
Functioning? 71 multicultural Treatments 72 Assessing the Sociocultural model 72
Putting it together: integrAtion of the Models 73
Key terms 75
QuicK Quiz 75
LaunchPad 75
InfoCentral Dietary Supplements: An Alternative Treatment 43
PsychWatch Cybertherapy: Surfing for Help 57
MediaSpeak Saving Minds Along with Souls 62
MindTech Have Your Avatar Call My Avatar 67
chapter : 3 Clinical Assessment, Diagnosis, and Treatment 77 Clinical Assessment: How and Why Does the Client Behave Abnormally? 77
Characteristics of Assessment Tools 78 Clinical Interviews 79 Clinical Tests 81 Clinical observations 89
Diagnosis: Does the Client’s Syndrome Match a Known Disorder? 92
Classification Systems 92 DSm-5 93 Is DSm-5 an effective Classification System? 94 Call for Change 95 Can Diagnosis and Labeling Cause Harm? 96
Treatment: How Might the Client Be Helped? 97 Treatment Decisions 98
The effectiveness of Treatment 98
Putting it together: AssessMent And diAgnosis At A CrossroAds 102
Key terms 103
QuicK Quiz 103
LaunchPad 103
MindTech Psychology’s Wiki Leaks? 83
PsychWatch The Truth, the Whole Truth, and Nothing but the Truth 87
MediaSpeak Intelligence Tests Too? eBay and the Public Good 90
InfoCentral Common Factors in Therapy 101
chapter : 4 Anxiety, Obsessive-Compulsive, and Related Disorders 105 Generalized Anxiety Disorder 106
The Sociocultural Perspective: Societal and multicultural Factors 107
The Psychodynamic Perspective 108 The Humanistic Perspective 110 The Cognitive Perspective 111 The Biological Perspective 116
Phobias 119 Specific Phobias 120 Agoraphobia 120 What Causes Phobias? 122 How Are Phobias Treated? 124
Social Anxiety Disorder 127 What Causes Social Anxiety Disorder? 128 Treatments for Social Anxiety
Disorder 130
Panic Disorder 132 The Biological Perspective 133 The Cognitive Perspective 135
Obsessive-Compulsive Disorder 137 What Are the Features of obsessions
and Compulsions? 137 The Psychodynamic Perspective 138 The Behavioral Perspective 139 The Cognitive Perspective 140 The Biological Perspective 141
: CONTENTSxii
obsessive-Compulsive-Related Disorders 143
Putting it together: diAthesis-stress in ACtion 146
cLinicaL choices 146
Key terms 147
QuicK Quiz 147
LaunchPad 147
PsychWatch Fears, Shmears: The Odds Are Usually on Our Side 113
InfoCentral Mindfulness 115
MediaSpeak The Fear Business 121
MindTech Social Media Jitters 129
chapter : 5 Disorders of Trauma and Stress 149 Stress and Arousal: The Fight-or-Flight Response 151
Acute and Posttraumatic Stress Disorders 152 What Triggers Acute and Posttraumatic
Stress Disorders? 154 Why Do People Develop Acute and Posttraumatic
Stress Disorders? 158 How Do Clinicians Treat Acute and Posttraumatic
Stress Disorders? 161
Dissociative Disorders 166 Dissociative Amnesia 167 Dissociative Identity Disorder 170 How Do Theorists explain Dissociative Amnesia
and Dissociative Identity Disorder? 172 How Are Dissociative Amnesia and Dissociative
Identity Disorder Treated? 176 Depersonalization-Derealization Disorder 177
Putting it together: getting A hAndle on trAuMA And stress 179
cLinicaL choices 180
Key terms 181
QuicK Quiz 181
LaunchPad 181
InfoCentral Sexual Assault 156
PsychWatch Adjustment Disorders: A Category of Compromise? 159
MindTech Virtual Reality Therapy: Better Than the Real Thing? 163
PsychWatch Repressed Childhood Memories or False Memory Syndrome? 169
PsychWatch Peculiarities of Memory 175
chapter : 6 Depressive and Bipolar Disorders 183 Unipolar Depression: The Depressive Disorders 184
How Common Is Unipolar Depression? 184 What Are the Symptoms of Depression? 184 Diagnosing Unipolar Depression 187 Stress and Unipolar Depression 187 The Biological model of Unipolar Depression 188 Psychological models of Unipolar Depression 196 The Sociocultural model of Unipolar Depression 205
Bipolar Disorders 211 What Are the Symptoms of mania? 212 Diagnosing Bipolar Disorders 212 What Causes Bipolar Disorders? 214 What Are the Treatments for Bipolar Disorders? 215
Putting it together: MAking sense of All thAt is knoWn 218
cLinicaL choices 218
Key terms 219
QuicK Quiz 219
LaunchPad 219
InfoCentral Sadness 185
PsychWatch Sadness at the Happiest of Times 190
MediaSpeak Immigration and Depression in the 21st Century 199
MindTech Texting: A Relationship Buster? 207
PsychWatch Premenstrual Dysphoric Disorder: Déjá Vu All Over Again 209
PsychWatch Abnormality and Creativity: A Delicate Balance 214
chapter : 7 Suicide 221 What Is Suicide? 222
How Is Suicide Studied? 226 Patterns and Statistics 226
What Triggers a Suicide? 227 Stressful events and Situations 228
CONTENTS : xiii
mood and Thought Changes 228 Alcohol and other Drug Use 229 mental Disorders 229 modeling: The Contagion of Suicide 230
What Are the Underlying Causes of Suicide? 232 The Psychodynamic View 232 Durkheim’s Sociocultural View 233 The Biological View 234
Is Suicide Linked to Age? 235 Children 235 Adolescents 236 The elderly 239
Treatment and Suicide 242 What Treatments Are Used After Suicide
Attempts? 242 What Is Suicide Prevention? 242 Do Suicide Prevention Programs Work? 245
Putting it together: PsyChologiCAl And BiologiCAl insights lAg Behind 246
Key terms 247
QuicK Quiz 247
LaunchPad 247
MediaSpeak Videos of Self-Injury Find an Audience 225
PsychWatch The Black Box Controversy: Do Antidepressants Cause Suicide? 238
InfoCentral The Right to Commit Suicide 240
MindTech Crisis Texting 243
chapter : 8 Disorders Featuring Somatic Symptoms 249 Factitious Disorder 250
Conversion Disorder and Somatic Symptom Disorder 253
Conversion Disorder 253 Somatic Symptom Disorder 255 What Causes Conversion and Somatic
Symptom Disorders? 257 How Are Conversion and Somatic Symptom
Disorders Treated? 260
Illness Anxiety Disorder 261
Psychophysiological Disorders: Psychological Factors Affecting Other Medical Conditions 262
Traditional Psychophysiological Disorders 262 new Psychophysiological Disorders 267
Psychological Treatments for Physical Disorders 273 Relaxation Training 273 Biofeedback 273 meditation 273 Hypnosis 274 Cognitive Interventions 275 Support Groups and emotion expression 275 Combination Approaches 275
Putting it together: exPAnding the BoundAries of ABnorMAl PsyChology 276
cLinicaL choices 276
Key terms 276
QuicK Quiz 277
LaunchPad 277
PsychWatch Munchausen Syndrome by Proxy 252
MindTech Can Social Media Spread “Mass Hysteria”? 255
InfoCentral Sleep and Sleep Disorders 264
MediaSpeak When Doctors Discriminate 270
chapter : 9 Eating Disorders 279 Anorexia Nervosa 280
The Clinical Picture 281 medical Problems 282
Bulimia Nervosa 282 Binges 284 Compensatory Behaviors 284 Bulimia nervosa Versus Anorexia nervosa 286
Binge-Eating Disorder 288
What Causes Eating Disorders? 289 Psychodynamic Factors: ego Deficiencies 289 Cognitive Factors 290 Depression 290 Biological Factors 291 Societal Pressures 292 Family environment 293 multicultural Factors: Racial and ethnic Differences 295 multicultural Factors: Gender Differences 296
How Are Eating Disorders Treated? 298 Treatments for Anorexia nervosa 298 Treatments for Bulimia nervosa 302
: CONTENTSxiv
Treatments for Binge-eating Disorder 305
Putting it together: A stAndArd for integrAting PersPeCtives 306
cLinicaL choices 306
Key terms 306
QuicK Quiz 307
LaunchPad 307
InfoCentral Body Dissatisfaction 287
MindTech Dark Sites of the Internet 294
PsychWatch The Sugar Plum Fairy 304
chapter : 10 Substance Use and Addictive Disorders 309 Depressants 311
Alcohol 311 Sedative-Hypnotic Drugs 316 opioids 316
Stimulants 319 Cocaine 319 Amphetamines 322 Stimulant Use Disorder 323
Hallucinogens, Cannabis, and Combinations of Substances 323
Hallucinogens 323 Cannabis 326 Combinations of Substances 328
What Causes Substance Use Disorders? 330 Sociocultural Views 330 Psychodynamic Views 330 Cognitive-Behavioral Views 331 Biological Views 332
How Are Substance Use Disorders Treated? 334 Psychodynamic Therapies 335 Behavioral Therapies 335 Cognitive-Behavioral Therapies 337 Biological Treatments 337 Sociocultural Therapies 339
Other Addictive Disorders 342 Gambling Disorder 342 Internet Gaming Disorder: Awaiting official Status 343
Putting it together: neW Wrinkles to A fAMiliAr story 343
cLinicaL choices 344
Key terms 344
QuicK Quiz 345
LaunchPad 345
PsychWatch College Binge Drinking: An Extracurricular Crisis 313
MindTech Neknomination Goes Viral 315
InfoCentral Smoking, Tobacco, and Nicotine 320
PsychWatch Club Drugs: X Marks the (Wrong) Spot 325
MediaSpeak Enrolling at Sober High 336
chapter : 11 Disorders of Sex and Gender 347 Sexual Dysfunctions 348
Disorders of Desire 348 Disorders of excitement 351 Disorders of orgasm 354 Disorders of Sexual Pain 358
Treatments for Sexual Dysfunctions 360 What Are the General Features of Sex Therapy? 360 What Techniques Are Used to Treat Particular
Dysfunctions? 363 What Are the Current Trends in Sex Therapy? 366
Paraphilic Disorders 367 Fetishistic Disorder 369 Transvestic Disorder 370 exhibitionistic Disorder 371 Voyeuristic Disorder 372 Frotteuristic Disorder 372 Pedophilic Disorder 372 Sexual masochism Disorder 374 Sexual Sadism Disorder 375
Gender Dysphoria 376 explanations of Gender Dysphoria 378 Treatments for Gender Dysphoria 378
Putting it together: A PrivAte toPiC drAWs PuBliC Attention 382
cLinicaL choices 382
Key terms 382
QuicK Quiz 383
LaunchPad 383
InfoCentral Sex Throughout the Life Cycle 350
PsychWatch Sexism, Viagra, and the Pill 365
CONTENTS : xv
MindTech “Sexting”: Healthy or Pathological? 368
MediaSpeak A Different Kind of Judgment 380
chapter : 12 Schizophrenia 385 The Clinical Picture of Schizophrenia 387
What Are the Symptoms of Schizophrenia? 387 What Is the Course of Schizophrenia? 391
How Do Theorists Explain Schizophrenia? 392 Biological Views 393 Psychological Views 398 Sociocultural Views 399
How Are Schizophrenia and Other Severe Mental Disorders Treated? 401
Institutional Care in the Past 403 Institutional Care Takes a Turn for the Better 404 Antipsychotic Drugs 406 Psychotherapy 409 The Community Approach 411
Putting it together: An iMPortAnt lesson 418
cLinicaL choices 418
Key terms 419
QuicK Quiz 419
LaunchPad 419
InfoCentral Hallucinations 390
PsychWatch Postpartum Psychosis: The Case of Andrea Yates 394
MindTech Can Computers Develop Schizophrenia? 396
PsychWatch Lobotomy: How Could It Happen? 405
MindTech Putting a Face on Auditory Hallucinations 410
MediaSpeak “Alternative” Mental Health Care 416
chapter : 13 Personality Disorders 421 “Odd” Personality Disorders 424
Paranoid Personality Disorder 425 Schizoid Personality Disorder 427 Schizotypal Personality Disorder 428
“Dramatic” Personality Disorders 431 Antisocial Personality Disorder 431 Borderline Personality Disorder 436
Histrionic Personality Disorder 441 narcissistic Personality Disorder 444
“Anxious” Personality Disorders 447 Avoidant Personality Disorder 447 Dependent Personality Disorder 450 obsessive-Compulsive Personality Disorder 452
Multicultural Factors: Research Neglect 454
Are There Better Ways to Classify Personality Disorders? 455
The “Big Five” Theory of Personality and Personality Disorders 456
“Personality Disorder—Trait Specified”: Another Dimensional Approach 458
Putting it together: disorders of PersonAlity—redisCovered And reConsidered 460
cLinicaL choices 460
Key terms 460
QuicK Quiz 461
LaunchPad 461
PsychWatch Mass Murders: Where Does Such Violence Come From? 434
MediaSpeak The Patient as Therapist 440
MindTech Selfies: Narcissistic or Not? 446
InfoCentral Lying 457
chapter : 14 Disorders Common Among Children and Adolescents 463 Childhood and Adolescence 464
Childhood Anxiety Disorders 465 Separation Anxiety Disorder 467 Treatments for Childhood Anxiety Disorders 468
Childhood Depressive and Bipolar Disorders 469 major Depressive Disorder 469 Bipolar Disorder and Disruptive mood
Dysregulation Disorder 471
Oppositional Defiant Disorder and Conduct Disorder 473
What Are the Causes of Conduct Disorder? 474 How Do Clinicians Treat Conduct Disorder? 474
Elimination Disorders 476 enuresis 476 encopresis 476
: CONTENTSxvi
Neurodevelopmental Disorders 479 Attention-Deficit/Hyperactivity Disorder 479 Autism Spectrum Disorder 483 Intellectual Disability 488
Putting it together: CliniCians DisCover ChilDhooD anD aDolesCenCe 498
CliniCal ChoiCes 498
Key terms 499
QuiCK Quiz 499
launChPad 499
InfoCentral Child and Adolescent Bullying 466
MindTech Parent Worries on the Rise 470
PsychWatch Child Abuse 478
PsychWatch A Special Kind of Talent 485
PsychWatch Reading and ‘Riting and ‘Rithmetic 491
chapter : 15 Disorders of Aging and Cognition 501 Old Age and Stress 502
Depression in Later Life 503
Anxiety Disorders in Later Life 505
Substance Misuse in Later Life 505
Psychotic Disorders in Later Life 508
Disorders of Cognition 509 Delirium 509 Alzheimer’s Disease and Other Neurocognitive
Disorders 511
Issues Affecting the Mental Health of the Elderly 522
Putting it together: CliniCians DisCover the elDerly 524
CliniCal ChoiCes 524
Key terms 525
QuiCK Quiz 525
launChPad 525
PsychWatch The Oldest Old 503
InfoCentral The Aging Population 506
MindTech Remember to Tweet; Tweet to Remember 510
MediaSpeak Focusing on Emotions 521
chapter : 16 Law, Society, and the Mental Health Profession 527 Law and Mental Health 528
How Do Clinicians Influence the Criminal Justice System? 528
How Do the Legislative and Judicial Systems Influence Mental Health Care? 536
In What Other Ways Do the Clinical and Legal Fields Interact? 541
What Ethical Principles Guide Mental Health Professionals? 544
Mental Health, Business, and Economics 546 Bringing Mental Health Services to the Workplace 546 The Economics of Mental Health 546
Technology and Mental Health 548 The Person Within the Profession 550
Putting it together: operating Within a larger system 552
Key terms 553
QuiCK Quiz 553
launChPad 553
PsychWatch Famous Insanity Defense Cases 531
PsychWatch Serial Murderers: Madness or Badness? 543
MindTech New Ethics for a Digital Age 549
InfoCentral Personal and Professional Issues 551
Glossary G-1 References R-1 Credits C-1 Name Index NI-1 Subject Index SI-1
xvii
It was the spring of 1981. Over the previous eight months, the Philadelphia Phillies had won the World Series, and the Eagles, Sixers, and Flyers had made it to the Super Bowl, NBA Finals, and Stanley Cup Finals, respectively. I had two adorable children ages 5 and 3. I had been granted tenure at Princeton. My life was full—or so I thought.