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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


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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


this page left intentionally blank


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.



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