Essential Abnormal and Clinical Psychology
Publication Year: 2015
Subject: Clinical Psychology (general)
This essential introduction to abnormal and clinical psychology explores the key areas, controversies and debates in the field and encourages students to think critically. The textbook includes: • the latest updates from DSM-5 and ICD-10 and a balanced critique of the DSM approach • an extensive range of pedagogy including ‘Essential Debate’ and ‘Essential Experience’ boxes that encourage critical thinking and provide real-life case study examples • Concise, accessible and neatly structured chapters which provide you with answers to questions such as What is the disorder? How does the disorder develop? What is going on in the mind and brain of the sufferer? and How is the disorder treated? This is a must-read text for all students taking Undergraduate Abnormal and Clinical Psychology modules and ...
- Front Matter
- Back Matter
- Subject Index
- Chapter 1: The Big Issues in Classification, Diagnosis and Research into Psychological Disorders
- Chapter 2: How are Psychological Disorders Treated?
- Chapter 3: Childhood Disorders
- Chapter 4: Schizophrenia
- Chapter 5: Mood Disorders
- Chapter 6: Generalised Anxiety Disorder
- Chapter 7: Specific Phobias
- Chapter 8: Panic Disorder and Social Anxiety Disorder
- Chapter 9: Substance Use Disorders
- Chapter 10: Eating Disorders
- Chapter 11: Personality Disorders
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© Matt Field and Sam Cartwright-Hatton 2015
First published 2015
Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, this publication may be reproduced, stored or transmitted in any form, or by any means, only with the prior permission in writing of the publishers, or in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers.
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Library of Congress Control Number: 2014951829
British Library Cataloguing in Publication data
A catalogue record for this book is available from the British Library
ISBN 978-0-7619-4189-7 (pbk)
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List of Figures and Tables[Page ix]Figures
- 1.1 Is it appropriate to categorise psychological disorders in the way that we do? 8
- 1.2 Different instruments can be used to measure brain structure and activity in the brain while people perform tasks or look at different types of stimuli 14
- 1.3 Some published findings may arise from researchers ‘fishing’ for the results that they expected to find 22
- 2.1 Most people who get any treatment for their condition will receive medication … but would they be better off with a psychological therapy? 34
- 2.2 You are unlikely to have a couch in your office if you work in the NHS (as most UK psychologists do). You might get a couple of nice plastic chairs, with not too many mystery stains, if you’re lucky 47
- 3.1 Jack (portrayed by an actor) 71
- 3.2 Ruby (portrayed by an actor) 80
- 3.3 Josh (portrayed by an actor) 86
- 4.1 Frequent use of high-potency cannabis does increase the risk of developing schizophrenia 102
- 4.2 High levels of expressed emotion in relatives increase the risk of relapse in patients who have been treated for schizophrenia 107
- 4.3 While they may be effective, antipsychotic medications affect a broad range of neurotransmitter systems and produce unpleasant side effects 116
- 5.1 One-off stressful life events, such as divorce, can trigger major depressive episodes but they are unlikely to lead to major depressive disorder unless experienced as part of a sequence of negative life events 127
- 5.2 Children may learn to explain life events by copying their parents’ attributions for them 134
- 5.3 Adopting a more positive, optimistic cognitive style may explain why CBT leads to improved mood in depressed patients 142
- [Page x]6.1 Certain styles of parenting can increase the risk that children will develop anxiety disorders when they reach adulthood 151
- 6.2 Worrying about things is normal, so many psychological models of GAD attempt to explain what is abnormal about worry in GAD 155
- 6.3 The visual probe task (image from Hakamata et al., 2010) 157
- 6.4 The attentional bias data from MacLeod et al. (2002) 158
- 6.5 The mood data from MacLeod et al. (2002) 159
- 6.6 Hirsch and Mathews’ (2012) integrated cognitive model of worry 161
- 7.1 Keith had a specific phobia of crane flies 172
- 7.2 Can a single traumatic event cause a phobia? 178
- 7.3 Sarah confronts her fears (portrayed by an actor) 185
- 8.1 Most of us get a few butterflies when we have to give a presentation, but for people with social anxiety disorder, the anxiety can be overwhelming 196
- 8.2 The parasympathetic nervous system 201
- 8.3 The sympathetic nervous system 202
- 8.4 Clark’s Panic Cycle (1986) 203
- 8.5 Clark and Wells’s (1995) Model of Social Anxiety Disorder 208
- 9.1 The 2012 movie Flight stars Denzel Washington as an airline pilot who struggles to overcome alcohol dependence 225
- 9.2 Heritability estimates for different substance use disorders (Agrawal & Lynskey, 2008) 228
- 9.3 An important twin study suggests that heritable risk for cocaine dependence is associated with impaired self-control and subtle abnormalities of brain structure 233
- 10.1 Should obesity be added to the list of eating disorders? 248
- 10.2 Is it simplistic to attribute anorexia to social pressure to be thin? 252
- 10.3 The gene × environment interaction reported by Karwautz et al. (2011) 255
- 10.4 CBT aims to help bulimic patients to eat regular meals and reduce purging behaviours 267
- 11.1 One theory of BPD suggests that the hormone oxytocin, that plays an important role in mother–infant bonding, may function abnormally in patients with BPD and this may explain some of the symptoms 292
- 11.2 Therapeutic communities in prison settings may not reduce the rates of subsequent criminal offending, as intended – they may even have the opposite effect 297
About the Authors
Writing this book has been an enjoyable and stimulating experience, but like all big projects it took up much more of our time than we anticipated. We are very grateful to the following people who helped to shape it into the finished product: the team at SAGE, particularly Michael Carmichael, Keri Dickens and Chris Kingston, who made some really helpful suggestions to improve the first draft and generally tighten things up; the anonymous reviewers of the first draft, for their thoughtful and detailed comments; Noreen O’Sullivan for sending us lots of important articles for the Schizophrenia chapter; Helen Startup for feedback on the Personality Disorders chapter; Andy Jones for his constructive comments on the first drafts of many of the chapters; and Andy Field and Learning Matters for allowing us to adapt some of the material from Crucial Clinical Psychology.
Matt Field and Sam Cartwright-Hatton, September 2014[Page xiv]
This is a timely book, coming in an era when even the most ardent student will find it challenging to navigate through the shifting paradigms that generate waves of often conflicting research findings in the psychological sciences. The authors, with complementary backgrounds in experimental and clinical psychology, make light work of integrating a burgeoning body of research into a clear, comprehensive and engaging volume. I particularly welcome this book because it enables the reader to grasp the fact that they are embarking on a journey of exploration of what is in truth an interdisciplinary, multi-faceted subject: Understanding the mechanisms that govern normal and abnormal psychological processes requires both a wide angle lens and a sharp focus. The authors accomplish this with a lightness of touch that belies the complexity of the subject matter. The opening chapters equip the reader with the necessary methodological and conceptual tools in areas such as the metrics of normality and abnormality. These and successive chapters begin with a clear set of learning objectives and then offer lucid descriptions of key features, core mechanisms, theoretical models and treatment approaches. This encourages the reader to embrace both the research findings and the ‘real world’ applications that evolve from them. This also creates an ideal platform on which the student can develop the ‘scientist–practitioner’ perspective that defines applied psychology, especially in clinical settings. Addressing core processes such as cognitive biases or trans-generational influences such as coercive behaviour in developmental contexts, and much else besides, will provide the reader with plenty of scope for more intensive study or in time the pursuit of definitive career pathways. Common mental health problems including childhood disorders, depression, anxiety disorders, psychoses, substance misuse problems, eating disorders and personality disorders are thus addressed. In the process the reader is able to gauge and to appreciate the complex interplay of factors that are involved and the sometimes gentle, and often controversial, gradient between what is deemed normal or abnormal and thus needing remediation. In relation to the latter, the book introduces the reader to the key evidence-based treatments for these frequently occurring mental health problems. I wholeheartedly recommend this book as a comprehensive introduction to the student at undergraduate or postgraduate level. Dr Frank Ryan[Page xvi]
Many students choose to study psychology because they are interested in psychological disorders. Some want to pursue a career in clinical psychology, counselling or cognitive behaviour therapy so that they can help people who suffer from them. Because abnormal and clinical psychology are so intensively researched, there is a lot of information out there and a correspondingly huge choice of abnormal and clinical psychology textbooks on the market. We decided to write this book because we felt that many textbooks provide a good overview of everything, but most don’t ‘drill down’ into the details, controversies or debates in research or treatment, and this is because they are trying to give equal coverage to such a huge amount of material. We want this book to be different: we don’t pretend to cover everything, but we do introduce the topics and encourage you to think critically about the details of research and the way that research findings are interpreted. If you can develop these critical skills now, you will be able to apply them to other pieces of research that you read in addition to this book.Who is this book for?
This book is intended to introduce you to the essentials of abnormal and clinical psychology. It is an accessible resource for students from a range of disciplines and at different levels. For high school (e.g. A level) and level 1 university courses, it contains everything you need to get a broad understanding of the topics and some idea of the current debates and controversies. At higher levels (e.g. final year undergraduate, and postgraduate) the book should be used as a framework on which to build your own independent reading. Our intention is that all students will benefit from reading the first two chapters, and then you can pick and choose from the other chapters depending on which topics are being covered in your particular course.Overview of the structure and features of this book
The first two chapters are an introduction to some fundamental issues and you should read these before you dip into any of the subsequent chapters. The first chapter explains some of the current controversies in the way that psychological disorders are categorised and diagnosed, and then introduces you to some important issues regarding research, including how to evaluate research findings in a critical way. The second chapter provides an overview of how psychological disorders are treated, and covers key topics such as the practical problems involved in deciding the best way to treat a distressed patient, and the many ways that we can test whether treatments actually work.
[Page xviii]Subsequent chapters (3–11) focus on specific disorders or classes of disorders and you may not need to read all of these, depending on the syllabus of the module you are studying. However, we would hope that you will be sufficiently interested in these topics to want to read the whole book anyway, even if you don’t have to! Most of the chapters have the following structure:
- What is the disorder? In this section we introduce the classic symptoms and features of the disorder(s), explain how it is diagnosed, and discuss the controversies that surround diagnosis.
- How does the disorder develop? In this section we discuss risk factors for the disorder. These usually include heritability, environmental risk factors, and interactions between the two.
- What is going on in the mind and brain of the sufferer? In this section, which is usually the longest in the chapter, we introduce theories from psychology and neuroscience that try to make sense of the disorder. In most cases, these theories attempt to explain how risk factors for the disorder lead to changes in psychological function that ultimately lead to the symptoms of the disorder. So, the material in these sections is linked back to the things that were discussed in the previous section.
- How is the disorder treated? Here we provide an overview of the most common treatments and we discuss studies that have evaluated how effective those treatments are. Again, we link these treatments back to theories of the disorder(s) and we discuss options for the development of new treatments in the future, based on those theories. To give you a feel for how the theory is actually put into practice, some of the chapters focus on the nuts and bolts of what happens during treatment.
Each chapter includes a number of specific features and text boxes that highlight important issues and will help you to think critically about the material. These are:
- Assessment targets: Bear these in mind before you start to read the chapter, and then go back to them when you have finished the chapter. If you cannot answer ‘yes’ to these questions then look over the chapter again. If you still cannot answer these questions, you should return the book to the shop and demand a refund!
- Essential diagnosis boxes: These contain essential criteria for diagnosis of the disorder(s) and are taken straight from the main diagnostic manuals (the Diagnostic and Statistical Manual of Mental Disorders and/or the International Classification of Diseases). These boxes are important because people tend to have different opinions about what, for example, ‘depression’ is, so it is necessary to be clear about what clinicians and researchers mean when they talk about any particular disorder
- Essential experience: These are usually case studies of people who suffer from a psychological disorder in which they describe their symptoms, how the disorder has affected their life, or how treatment has affected them. You should think about how these relate to the diagnostic criteria (which can be a bit ‘dry’ and formal) and also about how they fit, or do not fit, with the theories and evidence described elsewhere in the chapter.
- [Page xix]Essential debate: Here we discuss some of the current controversies in a given topic, sometimes based around a published article in a scientific journal. We want you to think about these issues carefully, and also search for other papers that have been published more recently that relate to this debate. For broader issues, these debate boxes have a ‘pros versus cons’ format, or similar, and in these cases you should think carefully about the issues and make sure that you understand both sides of the argument.
- Essential research: Towards the front of the book, these boxes tend to introduce specific research methods that crop up throughout the book, and later on, highlight particular studies that have been influential, or controversial, or both. We want you to think carefully and critically about the research and, as above, conduct your own literature searches to see what has changed since this work was published. Sometimes we discuss fairly old studies that nicely illustrate a particular methodology or robust finding, and have become ‘classics’. Other times we focus on more recent studies that could fundamentally change the way we understand a particular disorder, and in other cases we show you why some studies are a bit rubbish and should not be trusted!
- Essential treatment: These boxes might describe how a treatment actually works in practice (the ‘nuts and bolts’), they might summarise important studies that have evaluated the effectiveness of treatments, or they might highlight recent research that has investigated new types of treatment. Again, we want you to think critically about the material that is presented in these boxes, and ask yourself: Am I convinced by this treatment? Does it follow from the evidence about the disorder, and would I recommend it to a close friend or family member that suffers from this disorder?
- Essential questions: These are some examples of coursework or exam questions that test your understanding of the material in the chapter. You could write short essay plans for each question, or if you are really keen you could have a go at writing the essay itself.
Companion Website[Page xxi]
Essential Abnormal and Clinical Psychology is supported by a wealth of online resources for both students and lecturers to aid study and support teaching, which are available at: study.sagepub.com/fieldcartwrighthatton
- Watch author-selected videos to give you insight into how an understanding of abnormal and clinical psychology is applied in practice.
- Interactive quizzes allow you to test your knowledge and give you feedback to help you prepare for assignments and exams.
- Weblinks direct you to relevant resources to deepen your understanding of chapter topics and expand your knowledge of abnormal and clinical psychology.
- Selected journal articles give you free access to scholarly articles chosen for each chapter to reinforce your learning of key topics.
- PowerPoint slides featuring figures and tables from the book which can be downloaded and customised for use in your own presentations.
- Test banks that provide a diverse range of pre-written options as well as the opportunity to edit any question and/or insert personalised questions to effectively assess students’ progress and understanding.
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