Abnormal and Clinical Psychology an Introductory Textbook
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PRINT CMYK PROCESS COLOURS Cyan Magenta Yellow Black 28mm spine Abnormal and Clinical Psychology An Introductory Textbook Abnormal andClinicalPsychology Abnormal and Second Edition G What are the causes of mental health problems? G What are the best treatments for mental health problems? G How do the experiences of people with mental health problems compare with Clinical Psychology the academic models of disorders? Building on the success of the first edition, this textbook has been extensively updated to include the latest research and therapeutic approaches as well as An Introductory Textbook developments in clinical practice. This book now contains: G Expanded coverage of the aetiology of conditions G Assessment of the DSM-IV diagnostic criteria G Analysis of cross-cultural issues G Case studies that include patient perspectives G A new chapter on somatoform disorders G Improved pedagogy such as research boxes and thinking about features that encourage readers to think critically about what they are learning The book maintains the structure of the first edition with two main sections: the first introduces and critically evaluates the conceptual models of mental health problems and their treatment; the second contains in-depth analyses of a variety of disorders such as schizophrenia, trauma-related conditions and addictions. In the second section, chapters are now restructured to give a comprehensive aetiology of the disorder as well as analysis of treatments for the condition. Each disorder is viewed from psychological, social, and biological perspectives and different intervention types are investigated. Abnormal and Clinical Psychology provides the most comprehensive European alternative to the long-established US texts for undergraduates in this field. Paul Bennett Paul Bennett is Professor of Psychology at Cardiff University and also works as a clinical psychologist. He has authored a number of books including Introduction to Clinical Health Psychology (Open University Press, 2000). Cover design: Fielding Design ISBN 0-335-21943-8 Second Edition 9 780335 219438 Second Edition Paul Bennett Cyan Magenta Yellow Black Abnormal and Clinical Psychology SECOND EDITION Abnormal and Clinical Psychology AN INTRODUCTORY TEXTBOOK SECOND EDITION Paul Bennett Open University Press Open University Press McGraw-Hill Education McGraw-Hill House Shoppenhangers Road Maidenhead Berkshire England SL6 2QL email: [email protected] world wide web: www.openup.co.uk and Two Penn Plaza, New York, NY 10121–2289, USA First edition published 2003 Reprinted 2005 Copyright © Paul Bennett 2006 All rights reserved. Except for the quotation of short passages for the purposes of criticism and review, no part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publisher or a licence from the Copyright Licensing Agency Limited. Details of such licences (for reprographic reproduction) may be obtained from the Copyright Licensing Agency Ltd of 90 Tottenham Court Road, London, W1T 4LP. A catalogue record of this book is available from the British Library ISBN10: 0 335 21943 8 (pb) ISBN13: 978 0 335 21943 8 (pb) Library of Congress Cataloging-in-Publication Data CIP data applied for Typeset by RefineCatch Limited, Bungay, Suffolk Printed in Poland EU, by OZGraf S.A., www.polskabook.pl Contents Illustrations xiii Acknowledgements xv PART I Background and methods 1 1 Introduction 3 Modern concepts of abnormality 3 Historical overview 5 Somatogenic and psychogenic perspectives 6 Care in the community 7 Issues of diagnosis 8 The medical model 8 Alternatives to the medical model 13 The aetiology of mental health problems 18 Genetic models 18 Biological models 21 Psychological models 21 Socio-cultural models 23 Systemic models 25 Biopsychosocial models 26 Diathesis-stress model 26 Chapter summary 27 For discussion 27 Further reading 28 2 The psychological perspective 29 The psychoanalytic approach 29 Freud 29 Freud’s contemporaries and descendants 33 vi CONTENTS The practice of psychoanalysis 34 Behavioural approaches 36 Classical conditioning 36 Operant conditioning 37 Combining classical and operant conditioning 38 Behaviour therapy 38 Classical conditioning-based interventions 39 Cognitive approaches 42 A network model of emotions 43 Cognitive behavioural therapy 44 Emerging cognitive therapies 52 Humanistic approaches 54 Models of the individual and neurosis 54 Humanistic therapy 57 How effective are the therapies? 59 Meta-analyses 59 Chapter summary 59 For discussion 60 Further reading 61 3 Biological explanations and treatments 62 The behavioural anatomy of the brain 62 Hindbrain, midbrain and forebrain 62 Cerebrum 63 The synapse 66 The neurotransmitters 67 The autonomic nervous system 68 Drug therapies 69 Treating depression 70 Treating anxiety 75 Treating schizophrenia 76 Adherence to drug treatments 77 Electroconvulsive therapy (ECT) 79 Use of ECT 79 The ECT controversy 80 Psychosurgery 81 Availability of psychosurgery 82 Post-operative effects 83 Chapter summary 84 For discussion 84 Further reading 85 4 Beyond the individual 86 Family models of mental health disorders 86 Systemic therapy 87 How effective is systemic therapy? 91 CONTENTS vii Psychosocial explanations of mental health problems 93 Socio-economic status 93 Gender differences 95 Minority status 96 Wider cross-cultural issues 97 Presentation of problems 98 Help seeking 102 Treatment 102 Psychological therapy across cultures 103 Preventing mental health problems 104 Health promotion 104 Therapeutic interventions 104 Psychosocial interventions 104 Using the media 106 Public education 106 Organizational interventions 107 Chapter summary 108 For discussion 109 Further reading 109 PART II Specific issues 111 5 Somatoform disorders 113 Somatization disorder 113 Prevalence 114 Aetiology of somatization disorder 116 Treatment of somatization disorder 119 Hypochondriasis 119 Prevalence of hypochondriasis 120 Aetiology of hypochondriasis 120 Treatment of hypochondriasis 123 Body dysmorphic disorder 124 Aetiology of body dysmorphic disorder 128 Psychological treatment 131 Conversion disorder (hysteria) 131 Aetiology of conversion disorder 133 Treatment of conversion disorder 137 Chapter summary 138 For discussion 139 Further reading 140 6 Schizophrenia 141 The nature of schizophrenia 141 Personal experiences 142 viii CONTENTS DSM diagnostic criteria for schizophrenia 143 Alternative view of the symptoms 144 Deconstructing schizophrenia 145 Aetiology of schizophrenia 146 Genetic factors 146 Biological mechanisms 148 Substance abuse 151 Psychosocial factors 152 A psychobiological model 154 Psychological models 154 Treatment of schizophrenia 161 Antipsychotic medication 161 Electroconvulsive therapy 164 Psychological approaches 164 Chapter summary 167 For discussion 168 Further reading 168 7 Anxiety disorders 170 Generalized anxiety disorder 170 Aetiology of generalized anxiety disorder 171 Treatment of generalized anxiety disorder 175 Simple phobias 177 Aetiology of phobias 179 Treatment of phobias 183 Panic disorder 185 Aetiology of panic disorder 186 Treatment of panic disorder 190 Obsessive-compulsive disorder (OCD) 194 Aetiology of obsessive-compulsive disorder 196 Treatment of obsessive-compulsive disorder 199 Chapter summary 202 For discussion 204 Further reading 204 8 Mood disorders 205 Major depression 205 Aetiology of major depression 206 Treatment of major depression 212 Suicide 216 Aetiology of suicide 219 Treatment of attempted suicide 220 Seasonal affective disorder (SAD) 221 Aetiology of seasonal affective disorder 222 Treatment of seasonal affective disorder 224 Bipolar disorder 224 CONTENTS ix Aetiology of bipolar disorder 226 Treatment of bipolar disorder 228 Chapter summary 230 For discussion 231 Further reading 232 9 Trauma-related conditions 233 Post-traumatic stress disorder (PTSD) 233 9/11 and PTSD 235 Aetiology of post-traumatic stress disorder 236 Treatment of post-traumatic stress disorder 243 Recovered memory 245 Explanations of recovered memory 246 Evidence of recovered memory 247 Overview of the evidence 250 Dissociative identity disorder (DID) 251 Aetiology of dissociative identity disorder 252 Experimental evidence 257 Treatment of dissociative identity disorder 258 Chapter summary 259 For discussion 260 Further reading 260 10 Sexual disorders 262 Sexual dysfunctions 262 Erectile dysfunction 262 Aetiology of erectile dysfunction 263 Treatment of erectile dysfunction 264 Vaginismus 265 Aetiology of vaginismus 265 Treatment of vaginismus 266 The paraphilias 266 Paedophilia 267 Aetiology of paedophilia 270 Treatment of paedophilia 273 Treatment programmes 274 Transvestic fetishism 277 Aetiology of transvestic fetishism 278 Treatment of transvestic fetishism 280 Gender identity disorder 280 Aetiology of gender identity disorder 281 Treatment of gender identity disorder 283 Chapter summary 286 For discussion 287 Further reading 288 x CONTENTS 11 Personality disorders 289 Introduction 289 A dimensional approach 291 A cognitive model of personality disorders 291 Cluster A diagnoses 293 Cluster B diagnoses 295 Borderline personality disorder 295 Aetiology of borderline personality disorder 296 Treatment of borderline personality disorder 298 Antisocial personality and psychopathy 304 Aetiology of antisocial personality and psychopathy 305 Treatment of antisocial personality 308 Treatment of psychopathy 310 Cluster C diagnoses